• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.726-734
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• 2023

Objective : Chronic subdural hematoma (CSDH) patients using antithrombotic agents (AT) at high risk for cardiovascular disease are increasing. The authors aimed to analyze the factors influencing outcome by targeting patients using AT and to establish a desirable treatment strategy. Methods : A retrospective analysis was performed on data from 462 patients who underwent burr hole trephination (BHT) surgery for CSDH at five hospitals from March 2010 to June 2021. Outcomes included incidence of postoperative acute bleeding, recurrence rate, and morbidity or mortality rate. Patients were divided into the following four groups based on their history of AT use : no AT. Only antiplatelet agents (AP), only anticoagulants (AC), both of AP and AC. In addition, a concurrent literature review was conducted alongside our cohort study. Results : Of 462 patients, 119 (119/462, 25.76%) were using AT. AP prescription did not significantly delay surgery (p=0.318), but AC prescription led to a significant increase in the time interval from admission to operation (p=0.048). After BHT, AP or AC intake significantly increased the period required for an in-dwelling drain (p=0.026 and p=0.037). The use of AC was significantly related to acute bleeding (p=0.044), while the use of AP was not (p=0.808). Use of AP or AC had no significant effect on CSDH recurrence (p=0.517 and p=1.000) or reoperation (p=0.924 and p=1.000). Morbidity was not statistically correlated with use of either AP or AC (p=0.795 and p=0.557, respectively), and there was no significant correlation with mortality for use of these medications (p=0.470 and p=1.000). Conclusion : Elderly CSDH patients may benefit from maintenance of AT therapy during BHT due to reduced thromboembolic risk. However, the use of AC necessitates individualized due to potential postoperative bleeding. Careful post-operative monitoring could mitigate prognosis and recurrence impacts.

• Journal of Korean Academy of Nursing
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• v.21 no.2
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• pp.129-149
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• 1991

Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entrainment of the pacemaker timing the human circadian sleep - wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. This study was a quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to a weekly shift group and another ten to a biweekly shift group engaged in a semi -continuous shift schedule(sunday off) with a backward direction, that is, morning -evening - night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking tim, sleep - wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep- wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep -wake cycle for subjects on the morning, evening, and night shift in both of the shift groups(weekly shift group : λ＝0.121, p＜0.01, λ＝0.112, p＜0.01, biweekly shift group : λ＝0.116, p＜0.01, λ＝0.084, p＜0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group. In the weekly shift group, physical fatigue was significantly different for the first day and the sixth day of the night shift(t＝-2.28, p＜0.05). Physical fatigue and total fatigue on the first day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝5.79, p＜0.01, F＝4.56, p＜0.05). There was a significant difference between the shift groups and the control group(p＜0.05), Physical fatigue, neurosensory fatigue and total fatigue on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝12.65, p＜0.01, F＝7.77, p＜0.01, F＝9.68, p＜0.01). There was a significant difference between the shift groups and the control group(p＜0.05). 4. No difference in mental performance was seen between the first day and the last day of work in each case. An arithmatic test on the first day of the night shift revealed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝3.79, p＜0.05). There was a significant difference between the shift groups and the control group(p＜0.05) . The digital symbol substitution test and the arithmetic test on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝3.68, p＜0.05, F＝5.55, p＜0.01), and both showed a significant difference between the shift groups and the control group(p＜0.05). Accordingly, this study showed that during night duty, the waking time, sleep- wake cycle, and fatigue increased and mental performance decreased compared with morning and evening duty. It was also found that the weekly shift group had a higher fatigue score on the sixth day of night duty as compared to the -first day, but the waking time, sleep- wake cycle, and mental performance revealed no difference for the duration of the night duty or between shift groups, and complete adaptation of temperature rhythm was achieved between the sixth and ninth day of night duty. It is possible to conclude from these results that for intermediate circadian type in a healthy young woman, a biweekly shift system is more compatible with the circadian timing system than weekly shift system.

• The Korean Journal of Pharmacology
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• v.19 no.1
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• pp.15-35
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• 1983

Although it has been well known that ventricular fibrillation is the most important complication during hypothermia, much investigation has failed to show the exact nature of the etiology of ventricular fibrillation. Recently, there has been considerable research on the relationship between sympathetic activity and ventricular fibrillation under hypothermia. Cardiac muscle normally contains a certain amount of norepinephrine and the dramatic effect of this catecholamines on the cardiac muscle is well documented. It is, therefore, conceivable that cardiac catecholamines might exert an influence on the susceptibility of heart muscle to tachycardia, ventricular fibrillation and arrhythmia, under hypothermia. Hypothermia itself is stress enough to increase tonus of sympatheticoadrenal system. The normal heart is supplied by an autonomic innervation and is subjected to action of circulating catecholamines which may be released from the heart. If the reaction of the heart associated with a variable amount of cardiac catecholamines is. permitted to occur in the induction of hypothermia, the action of this agent on the heart has not to be differentiated from the direct effects of cooling. The studies presented in this paper were designed to provide further information about the cardio-physiological effects of reduced body temperature, with special reference to the role of catecholamines in ventricular fibrillation. Healthy cats, weighing about 3 kg, were anesthetized with pentobarbital(30 mg/kg) intraperitoneally. The trachea was intubated and the endotracheal tube was connected to a C.F. Palmer type A.C. respirator. Hypothermia was induced by immersing the cat into a ice water tub and the rate of body temperature lowering was $1^{\circ}C$ per 5 to 8 min. Esophageal temperature and ECG (Lead II) were simultaneously monitored. In some cases the blood pH and serum sodium and potassium were estimated before the experiment. After the experiment the animals were killed and the hearts were excised. The catecholamines content of the cardiac muscle was measured by the method of Shore and Olin (1958). The results obtained are summarized as follows. 1) In control animal the heart rate was slowed as the temperature fell and the average pulse rates of eight animals were read 94/min at $31^{\circ}C$, 70/min at $27^{\circ}C$ and 43/min at $23^{\circ}C$ if esophageal temperature. Ventricular fibrillation was occurred with no exception at a mean temperature of $20.3^{\circ}C(21-l9^{\circ}C)$. The electrocardiogram revealed abnormal P waves in each progressive cooling of the heart. there was, ultimately, a marked delay in the P-R interval, QRS complex and Q-T interval. Inversion of the T waves was characteristic of all animals. The catecholamines content of the heart muscle excised immediately after the occurrence of ventricular fibrillation was about thirty percent lower than that of the pre-hypothermic heart, that is, $1.0\;{\mu}g/g$ wet weight compared to the prehypothermic value of $1.41\;{\mu}g/g$ wet weight. The changes of blood pH, serum sodium and potassium concentration were not remarkable. 2) By the adrenergic receptor blocking agent, DCI(2-3 mg/kg), given intramuscularly thirty minutes before hypothermia, ventricular fibrillation did not occur in one of five animals when their body temperature was reduced even to $16^{\circ}C$. These animals succumbed at that low temperature, and the changes of heart rate and loss of myocardial catecholamines after hypothermia were similar to those of normal animals. The actual effect of DCI preventing the ventricular fibrillation is not predictable. 3) Administration of reserpine(1 mg/kg, i.m.) 24 hours Prior to hypothermia disclosed reduced incidence of ventricular fibrillation, that is, six of the nine animals went into fibrillation at an average temperature of $19.6^{\circ}C$. By reserpine myocardial catecholamines content dropped to $0.045\;{\mu}g/g$ wet weight. 4) Bretylium pretreatment(20 mg/kg, i.m.), which blocks the release of catecholamines, Prevented the ventricular fibrillation under hypothermia in four of the eight cats. The pulse rate, however, was approximately the same as control and in some cases was rather slower. 5) Six cats treated with norepinephrine(2 mg/kg, i.m.) or DOPA(50 mg/kg) and tranylcypromine(10 mg/kg), which tab teen proved to cause significant increase in the catecholamines content of the heart muscle, showed ventricular fibrillation in all animals under hypothermia at average temperature of $21.6^{\circ}C$ and the pulse rate increased remarkably as compared with that of normal. Catecholamines content of cardiac muscle of these animals markedly decreased after hypothermia but higher than control animals. 6) The functional refractory periods of isolated rabbit atria, determined by the paired stimulus technique, was markedly shortened by administration of epinephrine, norepinephrine and isoproterenol. 7) Adrenergic beta-blocking agents, such as pronethalol, propranolol and sotalol(MJ-1999), inhibited completely the shortening of refractory period induced by norepinephrine. 8) Pretreatment with either phenoxftenbamine or phentolamine, an adrenergic alphatlocking agent, did not modify the decrease in refractory period induced by norepinephrine. From the above experiment it is possible to conclude that catecholamines play an important role in producing ventricular fibrillation under hypothermia. The shortening of the refractorf period of cardiac muscle induced by catecholamines mar be considered as a partial factor in producing ventriculr fibrillaton and to be mediated by beta-adrenergic receptor.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.2
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• pp.11-26
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• 1964

The studies reported herein are on the varietal differences of rice in the effects of seeding times and nursery periods on the components such as, culm length, ear length, number of ears, ear weight, straw weight, and grain/straw ratio following the first series of studies on heading date. In the present investigations, 50 rice varieties, as the preceding studies, were seeded nine times at the interval of 15 days from March 15 to July 28 in 1963. Each variety seeded at respective time was transplanted in 40 days in nursery after seeded. Reviewing the result obtained from the first series of the studies on heading date, the number of days required to heading from seeding were decreased by delaying the seeding time. Most varieties tended to decrease in the number of days from seeding to heading by the 8th planting time. Some of varieties seemed to be decreased in the number of days from seeding to heading by 9th seeding time. However most varieties were failed to show heading delaying the seeding date at the 10th seeding. The results on the effects of altering the seeding time on the components and varietal differences of the response are summarized as follows; 1) Culm length; It appeared that culm length was shortened when the number of days from seeding to heading was decreased by delaying the seeding date. The varieties which needed many days to heading were also shortened in their culm length. 2) Ear length; Ear length was also shortened when the number of days needed tocheading was decreased, by delaying the seeding time. The varieties which needed many days for heading were also shortened in their ear length, while those which headed earlier seemed to be lengthened in their ear lengths. 3) Number of ears; It was shown that the number of ears was increased with the delay of the heading date, whereas, at the 9th seeding the number of ears was decreased when delayed the heading date. 4) Ear weight; Ear weight per hill was also likely to be heavy throughout the seeding times and varieties except the 7th and 8th seedings in which it appeared to be light on the contrary. 5) Straw weight; Straw weight became heavier as delayed the seeding date throughout all the varieties and seeding dates. 6) The grain/straw ratio; The grain/straw ratio was gradually increased by the 5th seeding time, reaching the pick at 5th. An examination of the varieties at each seeding date showed that the grain/straw ratio was low from 1st to 3rd seeding and from 7th to 9th seeding, when the number of days required to heading from seeding are increased. At the 4th seeding time-which is standard seeding time-5th, and 6th seeding times the ratio was high with the delay of heading.

• The Korean Journal of Pharmacology
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• v.7 no.1
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• pp.53-65
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• 1971

It is well known that diabetes mellitus is associated with metabolic derangements, such as hyper-glycemia, ketosis, glycosuria, and also widespread alterations in the blood vessels, kidneys, eyes, peripheral nerves and heart. It is also recognized that healing of skin wound is delayed in diabetics. In bone, according to Aegerter, osteopenia develops in diabetes mellitus and it is chiefly ascribed to overutilization of protein. Shim claims that total blood flow to the entire skeletal system is approximately 4 to 8 percent of resting cardiac output and blood supply to the skeletal system would be decreased on account of secondary arteriosclerotic changes in the diabetics. An adequate blood supply is an essential factor in the healing process of fracture, and disturbed blood flow, either local or systemic, will invariably delay union of the fragments or the fragments from being fused. As the author has encountered several cases of diabetics in whom healing of fracture was delayed or incomplete, this experimental study was undertaken to elucidate the effects of hyperglycemia and diabetes mellitus on the healing process of fracture. In this experiment adult albino rabbits, weighing about 2 kg. were used and divided into 6 groups. The femur of each animal was fractured surgically, and then the healing process of fracture was periodically checked by radiography at an interval of one week for a period of 6 weeks. Thereafter, all the rabbits were killed to obtain tissue preparation of the femur. The experimental groups were as follows; 1) Control group: Six rabbits sustained a surgical fracture to the femur, without being given any other treatment or drug. 2) Alloxan-treated group: For inducing diabetes, alloxan was given intravenously to 17 rabbits in various dose as follows; to 7 of them 40 mg/kg, to 6 rabbits 80 mg/kg and to 4 rabbits 120 mg/kg of body weight, respectively. 3) Insulin-treated group: Protamine-zinc insulin was injected subcutaneously to each of 6 rabbits in a daily dose of 1 unit per kilogram of body weight. 4) Group treated with insulin after alloxan: Four rabbits were given 80 mg of alloxan once and than 1 unit of insulin per kilogram of body weight daily. Another 5 rabbits were injected 1 unit of insulin per kg of body weight daily following administration of alloxan in a dose of 120 mg/kg. 5) Homotransplantation group: Following intravenous injection of alloxan in a dose of 120 mg/kg, 10 rabbits underwent homotransplantation of a short bone segment to the femur. Five of them were subsequently given 1 unit/kg of insulin daily. 6) Sugar-treated group: six rabbits were fed $15{\sim}20$ gm of sugar daily throughout the period of experiment. The results obtained are summarized as follows; 1. Blood sugar level and damage to the pancreatic islet increased proportionately when alloxan was given to the rabbits in various doses. No appreciable change could be observed in the islets when the blood sugar level was altered by either oral administration of sugar or subcutaneous injection of insulin. 2. Comparing with the control group, healing of fracture was delayed in the alloxan-treated group, while callus formation and periosteal reaction were shown to be more prominent in this group and subsequently, the ultimate osseous tissue formed at the fracture site was significantly smaller in amount and less compact. These findings were more marked as the amount of alloxan increased. 3. Administration of insulin prevented the delay in healing process of fracture in the rabbits with alloxan-induced hyperglycemia. In this case, the course and progression of fracture healing were almost similar to those of control group. 4. Union between the host bone and the fragment transplanted from other rabbit of the same species was more delayed in the group treated with alloxan alone than in the group to which insulin was administered after development of alloxan-induced diabetes. In both groups periosteal new bone developed from the ends of the host bone, above and below the transplanted fragment, and directly fused with failure of periosteal callus to bridge the adjacent ends of the host bone and the transplanted fragment. 5. The healing process of fracture was not inhibited by alteration in blood sugar level when the blood sugar was abnormally increased by excessive sugar intake or lowered by administration of insulin alone. The healing of fracture in these groups progressed similarly as in the control group. In brief summary, it appears that the healing process of fracture would be definitely disturbed in diabetic state brought about by damage to the pancreatic islet. As such an inhibition could be overcome with insulin, it seems that insulin plays an important role in healing of fracture, but alteration in blood sugar level alone does not modify healing process of fracture to significant degree.

• Korean Journal of Medicinal Crop Science
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• v.4 no.3
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• pp.218-223
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• 1996

This experiment was carried out to investigate the effect of planting date and planting density on yield and yield components of Fritillariae bulbus from 1989 to 1991. The Chungbuk local variety was used, and the experimental materials were planted six times with 10 days interval from Aug. 20 to Oct. 10. 33, 22, 17 and 13 bulbs were planted by the square meter, respectively. The compound fertilizer for garlic $(N\;-\;P_2O\;-\;K_2O_5=9\;-\;14\;-\;10)$ was applied by 80kgs to the 0.1ha before planting. The experimental design was randomized block design with 3 replications. As the planting dates were earlier, the emerging dates were earlier, too. But the delay of 50 days in the planting affected to the delay of 14 days in the em­erging dates. The plant height was 22.7cms in the Aug. 20 plot. As the planting were later, the plant heights were shorter by $2.4{\sim}5.6cms$ than that. As compared with the 829kgs by the 0.1ha of Aug. 30 plot, the others recorded 1 percent increase in the Aug. 20 plot, 4 percent decrease in the Sep. 10 plot, 26 percent decrease in the Sep. 20 plot, 35 percent decrease in the Sep 30 plot, and 38 percent decrease in the Oct. 10 plot. So, the suitable planting dates were from Aug. 20 to Aug. 30.The emerging date of 33 bulb plot by the square meter was March 7, but as the planting densities were sparse, the emerging dates delayed by one to three days. The plant height of the 33 bulb plot by the square meter was 21. 8cms, but the other plots were short by $0.7{\sim}1.8cms$. The number of shoots of the 33 bulb plot by the square meter was 6.1. but the other plots recorded 0.4 increase in the 22 bulb plot, 0.6 increase in the 17 bulb plot and 0.5 increase in the 13 bulb plot compared with that of the 33 bulb plot. Accordingly, the number of shoots in the sparse planting plot was more than that in the dense planting plot. As compared with the 854kgs by the 0.1ha of the 22 bulb plot, the other plots recored 2 percent in­crease in the 33 bulb plot, 16 percent decrease in the 17 bulb plot and 34 percent decrease in the 13 bulb plot. All things considered, for the culture of Fritillaria thungergii MIQUEL in the middle region, Aug. 25 and 22 bulbs by the square meter were suitable for the planting date and density.

• Korean Journal of Agricultural Science
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• v.4 no.1
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• pp.94-104
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• 1977

In order to investigate the effects of mechanical transplanting on the rice, four rice varieties including Jo-saing Tongil were planted in case nursering bed for three times with 10 days interval beginning from April 16. Fourty days old seedlings were transplanted with rice-transplanter, and growth habits of seedlings in bed and rice plants in main field and yield were examined and summerized as follows: 1. The plant height and number of leaves of the 40 days old seedling in case nursery bed were appeared to be less than those of seedlings grown in ordinary nursery bed. In case nursery, the plant height and number of leaves of seedlings grown in case nursery were apparently higher than those of seedlings grown in upland case nursery. 2. The root of 40 days old seedlings were cut to investigate the rooting ability of seedlings, and the rooting ability of the seedlings grown in the case nursery bed were apparently lower in the rooting ability compared with the seedlings grown in ordinary nursery bed. The rooting ability of the seedlings grown in the lowland case nursery was higher than that of the seedlings grown in the upland case nursery. 3. The tip of leaves of the varieties derived from Indica type were becoming yellow and yellow-red in color 25 to 30 days after planted in the case nursery bed. Those varieties was almost stopped growth. 4. The seedlings transplanted by transplanter had shown more than five to seven days of delay in rooting, compared with the seedlings transplanted by ordinary method. The heading dates was delayed five to seven days when transplanter was used, even though the delay of heading dates was a little different depending on the varieties. 5. The yields of unhulled rice were a little lower than that of Yusin variety which was hand planted. When mechanically transplanted, the yield of Tongil variety was highest in the plot where seedlings were transplanted on May 26. When transplanted on June 15, Milyang#15 was highest in yield, indicating the importance of varietal selection in mechanical transplantation. 6. The rice transplanter could transplant from 73 to 108 seedlings per $3.3m^2$. If the seeds of rice were evenly planted in the bed, the two-row rice transplanter could be used five to six times more effectively with less than one percent of missing plant compared with the hand transplanting. This suggests that rice transplanter could be utilized in the mono cropping area. 7. Since the time of transplantings in the double-cropping area is rather limitted, mechanical transplantation might be possible without reducings yield providing better adapted varieties and improved case-nursery techniques.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.347-353
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• 2008

Background: Esophageal perforation is an emergency that. requires early diagnosis and effective treatment. A delay in diagnosis and treatment. significantly increases morbidity and mortality. Material and Method: Thirty-seven patients with esophageal perforation were surgically treated at our institutions between January 1990 and December 2006. We retrospectively reviewed the results of surgical treatment for esophageal perforation to understand the risk factors affecting survival inpatients. Result: Patients ranged in age from 21 to 87 years, with an average age of $52.7{\pm}16.98$ years. Thirty-one of the patients were men and six were women. There were 23 patients (62%) with spontaneous perforations, 10 patients (27%) with a traumatic perforation, and 4 patients (11%) with an iatrogenic perforation. The site of esophageal perforation was the cervical esophagus in 5 patients, the thoracic esophagus in 31 patients, and the abdominal esophagus in one patient. Twenty-nine patients underwent primary closure of the perforation and five patients had T-tube drainage. Exclusion-diversion procedures were performed in two patients and an esophagectomy was performed in one patient. There were six cases of mortality (16.22%) and 25 cases of postoperative complications in 15 patients (40.5%). Patients that were treated later than 24 hours after detection of the perforation showed a statistically significant high morbidity and mortality rate (p<0.05). Conclusion: The most important risk factor of esophageal perforation was the time interval between detection of the perforation and the initiation of treatment. A prompt diagnosis and effective treatment are necessary to decrease morbidity and mortality.

• Korean Journal of Agricultural Science
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• v.4 no.1
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• pp.51-60
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• 1977

In order to determine ecological variations of flowering date and yields under the different seasonal cultures, and to select the higher yielding varieties which were adaptable to Korean climate, 100 mungbean cultivars were sown at the interval of 15 days from April 22 to July 21 in 1976. The results obtained are summarized as follows: 1. The number of days required to flowering from seeding were decreased by delaying the seeding date. 2. When accumulated temperature at first flowering from seeding were reached $945-1,126^{\circ}C$, the mungbean cultivars started to flower regardless of seeding dates. Especially, when mungbean was planted around standard planting date, the plants flowered for very short duration. 3. There were highly significant correlations between the number of days from seeding to flowering at each seeding date and standard planting date. 4. Yields per plant were tend to decrease with the delay of seeding date but there were no significant difference between seeding dates. Therefore, it appears that mungbean can be planted for longer period of time compared to other crops such as rice and soybean. 5. Highly significant correlations were found between the number of days of first flowering and yields per plant at most seeding dates. 6. It may be feasible to grow high yielding mungbean cultivars such as CES 140, LM 2100, LM 690, L 576 and LM 689 after harvesting of spring vegetables in May and before planting of fall vegetables.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.41 no.6
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• pp.727-736
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• 2021

Road tunnel lengths are increasing. Some 1,300 tunnels with 1,102 km in length had been increased till 2019 from 2010. There are 64 tunnels over 3,000 m in length, with their total length adding up to 276.7 km. Safety facilities in the event of a tunnel fire are critical so as to prevent large-scale casualties. Standards for installing disaster prevention facilities are being proposed based on the guidelines of the Ministry of Land, Infrastructure and Transport, but they may be limited to deep underground tunnels. This study was undertaken to provide guidelines for the spacing of evacuation connection passages and the widths of evacuation connection doors. Evacuation with various spacing and widths was simulated in regards to evacuation time, which is the measure of safety, using the evacuation analysis simulation software EXODUS Ver.6.3 and the fire/smoke analysis software SMARTFIRE Ver.4.1. Evacuation connection gates with widths of 0.9 m and 1.2 m, and spacings of 150 m to 250 m, were set to every 20 m. In addition, longitudinal slopes of 6 % and 0 % were considered. It was determined to be safe when the evacuation completion time was shorter than the delay diffusion time. According to the simulation results, all occupants could complete evacuation before smoke spread regardless of the width of the evacuation connection door when the longitudinal slope was 6 % and the interval of evacuation connection passage was 150 m. When the evacuation connection passage spacing was 200 m and the evacuation connection gate width was 1.2 m, all occupants could evacuate when the longitudinal slope was 0 %. Due to difference in evacuation speed according to the longitudinal slope, the evacuation time with a 6 % slope was 114 seconds shorter (with the 190 m connection passage) than with a 0 % slope. A shorter spacing of evacuation connection passages may reduce the evacuation time, but this is difficult to implement in practice because of economic and structural limitations. If the width of the evacuation junction is 1.2 m, occupants could evacuate faster than with a 0.9 m width. When the width of a connection door is 1.2 m with appropriate connection passage spacing, it might provide a means to increase economic efficiency and resolve structural limitations while securing evacuation safety.