• Journal of Chest Surgery
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• v.29 no.8
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• pp.875-882
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• 1996

Multlvalvular heart surgery was performed In 78 cases, in the Department of Thoracic & Cardiovascu far Surgery of Chonbuk national University Hospital from november 1983 to March 1994. There Where 31 men and 47 women. whose ranged from 14 to 63 years. The causes of the valvular lesions were 57 rheumatic origin, 18 degenerative, 1 previous endocarditls, 1 prosthetic valve mal-function. There were 25 double valve replacement with or wit out tricuspid valve repair, i M VR and aortic valve repair, 18 MVR and tricuspid valve repair, 1 MVR and aortic and tricuspid valve repair, 10 AVR and mi- tral valve repair, 1 AVR and tricuspid valve repair, 8 mitral aortic valve repair, 13 mitral and tricuspid valve repair. They were improved mean New York Heart Association functional cldss, from 2.72% 121 Early deaths were 5 cases(6.4%). The cause of death wet'e low cArdiac output syndrome. veritricular tachycardia, massive bleeding and cerebral thromboembolism. All the survivors belonged to New York Heart Association functional class I or ll at discharge. The patients who had had valve replacement operation were medicated with warfarin to maintain the level of 30∼ 50% of normal prothrombin time. During follow-up(93.6%, mean 49.9 months), 2 late deaths were developed. One was due to intracranial hemorrhage and the other congestive heart failure. The pre-operative New York Heart Association Functional class IV was statistically sig ificant operat- ive risk factors(p< 0.05).

• Journal of Chest Surgery
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• v.37 no.6
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• pp.504-510
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• 2004

Background: Vasodilatory shock after cardiac surgery may result from the vasopressin deficiency following cardio-pulmonary bypass and sepsis, which did not respond to usual intravenous inotropes. In contrast to the adult patients, the effectiveness of vasopressin for vasodilatory shock in children has not been known well and so we reviewed our experience of vasopressin therapy in the small babies with a cardiac disease. Material and Method: Between February and August 2003, intravenous vasopressin was administrated in 6 patients for vasodilatory shock despite being supported on intravenous inotropes after cardiac surgery. Median age at operation was 25 days old (ranges; 2∼41 days) and median body weight was 2,870 grams (ranges; 900∼3,530 grams). Preoperative diag-noses were complete transposition of the great arteries in 2 patients, hypoplastic left heart syndrome in 1, Fallot type double-outlet right ventricle in 1, aortic coarctation with severe atrioventricular valve regurgitation in 1, and total anomalous pulmonary venous return in 1. Total repair and palliative repair were undertaken in each 3 patient. Result: Most patients showed vasodilatory shock not responding to the inotropes and required the vasopressin therapy within 24 hours after cardiac surgery and its readministration for septic shock. The dosing range for vasopressin was 0.0002∼0.008 unit/kg/minute with a median total time of its administration of 59 hours (ranges; 26∼140 hours). Systolic blood pressure before, 1 hour, and 6 hours after its administration were 42.7$\pm$7.4 mmHg, 53.7$\pm$11.4 mmHg, and 56.3$\pm$13.4 mmHg, respectively, which shows a significant increase in systolic blood pressure (systolic pressure 1hour and 6 hours after the administration compared to before the administration; p=0.042 in all). Inotropic indexes before, 6 hour, and 12 hours after its administration were 32.3$\pm$7.2, 21.0$\pm$8.4, and 21.2$\pm$8.9, respectively, which reveals a significant decrease in inotropic index (inotropic indexes 6 hour and 12 hours after the administration compared to before the administration; p=0.027 in all). Significant metabolic acidosis and decreased urine output related to systemic hypoperfusion were not found after vasopressin admin- istration. Conclusion: In young children suffering from vasodilatory shock not responding to common inotropes despite normal ventricular contractility, intravenous vasopressin reveals to be an effective vasoconstrictor to increase systolic blood pressure and to mitigate the complications related to higher doses of inotropes.

• Magazine of the Korean Society of Agricultural Engineers
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• v.17 no.3
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• pp.3860-3871
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• 1975

This experiment was carried out to establish the mechanized methods in stumping and root-clearing, which were the most important works in the reclamation of sloping uplands. The determination of optimum teeth interval of rake blades and its operation methods to reduce the quantity of transported topsoil during the works, are the aims of this investigation. A newly designed rake blade, whose net teeth intervals could be regulated by three stages as 15cm, 25cm, and 35cm, was manufactured to attach to the bulldozer of 13ton. The experiments were carried out at Kilsang-Myon, Kwangwha-Gun, from Aug. 9 to Aug. 23, 1975. For each interval, 36 test plots of 50${\times}$10mn in size, which were regulated under three levels of land slopes of 10, 20, and 30% and two different tree stand density of high or medium values, were randomly chosen and arranged by two-replicated split-split plot design. Each stump classified by its diameter was stumped and cleared by the rake dozer to be related between diameter and stumping time. The results obtained in this experiment can be summarized as follows: 1. Stumping times for the diameters ranging from 6 to 18cm of stumps are almost the same and they are not varied by the difference of teeth intervals of rake dozer. 2. By back-ward stumping method, the number of stumps which can be stumped per hour ranges almost from 100 to 170, showing significant difference with respect to the teeth intervals. The working area is sharply varied with not only the stand density of stumps but the teeth intervals. 3. Optimum stumping distance for each teeth interval of rake dozer to minimize the quantity of transported topsoil are varied with such the rates as it is 15m or 20m for 15cm of teeth interval, but 25m for 25cm or 35cm, respectively. The clearing distance could be chosen almost double as long as the operating distance. 4. The working areas per hour of the simultaneous stumping and clearing methods are no significant difference among the various treatments of working conditions, but they are affected by the operating techniques. However, the influencing factors of the working conditions as classified before and the working directions are ranged from 10 to 15 per cent of total working area, respectively. 5. The residual rates of stumps which are not stumped by the rake dozer in each test plot are generally reduced as the teeth interval gets narrower, but there are no significant difference among them. The mean residual rates average to be about 4% for the simultaneous stumping and clearing method. The back-ward stumping method are recommended to be supervised and directed by more than one man, to show the operator where the stumps are located. 6. The results according to the stumping and clearing methods are summarized as Table IV-2. And the selection of working methods is recommended to follow as shown in Fig. IV-9 with respect to the stand density of the field. 7. Generally speaking, the narrower the teeth interval, the better become the working results, but the more the quantity of transported topsoil is increased. Therefore, it is recommended that the teeth interval should be reduced from the present distance of more than 30cm to 25cm or 15cm, by developing suitable working methods through more field works and experiments.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.199-207
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• 2002

Purpose : Since the successful application of total atrio-pulmonary connection(TAPC) to patients with various types of physiologic single ventricles in 1971, post-operative survival rates have reached more than 90%. However some patients have been shown to present with late complications such as right atrial thrombosis, atrial fibrillation and protein losing enteropathy eventually leading to re-operation to control the long-term complications. The aim of this study is to review the results of total cavo-pulmonary connection(TCPC) in cases with late complications after TAPC. Methods : Between Jan. 1995 and Dec. 2000, 6 patients(5 males and 1 female) underwent cardiac catheterization $11{\pm}3$ months after conversion of previous TAPC to TCPC. We compared the hemodynamic and morphologic parameters before and after TCPC and also assessed the clinical outcomes. The indications for TAPC were tricuspid atresia in 4 cases and complex double-outlet right ventricle with single ventricle physiology in 2 cases. Results : There was no peri-operative mortality and all patients were clinically and hemodynamically improved at a mean follow-up of 11 months(range : 4 to 13). However, protein losing enteropathy recurred in 2 patients; this was were successfully treated with subcutaneous administration of heparin. Right atrial pressure before TCPC was $18.0{\pm}3.6mmHg$, but baffle pressure, corresponding to right atrial pressure decreased to $14.8{\pm}3.6mmHg$ after TCPC. The size of the pulmonary arteries did not regress after TCPC. Conclusion : The conversion of TAPC to TCPC improves clinical and hemodynamic status by decreasing the right atrial pressure and by providing a laminar cavo-pulmonary flow which enhances the effective pulmonary circulation in the so-called Fontan circulation.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.9 no.2
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• pp.380-389
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• 2005

The Goldschmidt iterative algorithm for a floating point divide calculates it by performing a fixed number of multiplications. In this paper, a variable latency Goldschmidt's divide algorithm is proposed, that performs multiplications a variable number of times until the error becomes smaller than a given value. To calculate a floating point divide '$\frac{N}{F}$', multifly '$T=\frac{1}{F}+e_t$' to the denominator and the nominator, then it becomes ’$\frac{TN}{TF}=\frac{N_0}{F_0}$'. And the algorithm repeats the following operations: ’$R_i=(2-e_r-F_i),\;N_{i+1}=N_i{\ast}R_i,\;F_{i+1}=F_i{\ast}R_i$, i$\in${0,1,...n-1}'. The bits to the right of p fractional bits in intermediate multiplication results are truncated, and this truncation error is less than ‘$e_r=2^{-p}$'. The value of p is 29 for the single precision floating point, and 59 for the double precision floating point. Let ’$F_i=1+e_i$', there is $F_{i+1}=1-e_{i+1},\;e_{i+1}',\;where\;e_{i+1}, If '$[F_i-1]<2^{\frac{-p+3}{2}}$ is true, ’$e_{i+1}<16e_r$' is less than the smallest number which is representable by floating point number. So, ‘$N_{i+1}$ is approximate to ‘$\frac{N}{F}$'. Since the number of multiplications performed by the proposed algorithm is dependent on the input values, the average number of multiplications per an operation is derived from many reciprocal tables ($T=\frac{1}{F}+e_t$) with varying sizes. 1'he superiority of this algorithm is proved by comparing this average number with the fixed number of multiplications of the conventional algorithm. Since the proposed algorithm only performs the multiplications until the error gets smaller than a given value, it can be used to improve the performance of a divider. Also, it can be used to construct optimized approximate reciprocal tables. The results of this paper can be applied to many areas that utilize floating point numbers, such as digital signal processing, computer graphics, multimedia, scientific computing, etc

• Journal of dental hygiene science
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• v.5 no.4
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• pp.233-238
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• 2005

The study was intended to investigate elementary schoolers' oral health status according to whether the school have and manage an school oral health clinic or not in order to provide useful information for continuously developing the school oral health clinic 1,163 children in Hwasan elementary school in Hwasung city and 485 children in S elementary school in the same locality were selected as the experimental group and the control group, respectively, and orally examined from May 1st to 30th, 2004. The findings from the oral examination were as follows. 1. DMF rate was higher in the higher grades in both the groups. The rate was lower in the experimental group with 45.1% of the children than in the control group with 65.3% of the children. 2. DMFT rate also were higher as the grades were higher in both the groups. The ratio was lower in the experimental group with 30.4% of the children than in the control group with 44.6% of the children. 3. DMFT index was 1.0 in number in the experimental group and 1.6 in the control group. Index increase from the 1st grade to the sixth grade was also more positive in the experimental group. 4. DT rate was a little higher in the experimental group in the first graders, but comparatively decreased to the grades while increased in the control group. In the sixth graders, the rate was 42.4% in the experimental group and 87.7% in the control group, the former was less than the latter by about 50% point. 5. FT rate was a little higher in the control group for the first graders but increased in the experimental group to the grades. The rate in the sixth graders was higher by more than double in the experimental group. Based on the above findings, the region of the study had better oral health statistics than in other regions. The operation of school oral health clinics that provide dental health care to children at the right time seems to contribute to enhancing their dental health status by preventing against dental diseases and changing their relevant knowledge, attitude and behaviors. In the future, more school oral health clinics should gradually be prepared to push ahead with a sustained, extensive dental health project geared toward school-aged children. To make it happen, dental hygienists who are professional medical personnels should be taken advantage of, and in order to beef up the efficiency of preventive measures and oral health education, the best dental health care services should be offered by harnessing dental hygienists and dentists who work at public dental clinics run by local governments.

• Journal of Gastric Cancer
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• v.8 no.2
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• pp.97-103
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• 2008

Purpose: Radical surgery is the standard therapy for patients with resectable cardia cancer. In the case of type II disease with esophageal invasion, a transhiatal extended radical total gastrectomy is needed or a gastroesophagectomy through an abdomino-thoracotomy, depending on the extent of the esophageal invasion. We analyzed the indications and outcome of left colon interposition as an esophageal substitution. Materials and Methods: Between 1 January 1994 and 31 December 2006, 10 patients underwent left colon interposition after gastroesophagectomy through an abdomino-thoracotomy or the tanshiatal approach for type II cardia cancer at the Department of surgery, Yonsei University College of Medicine. The outcomes of these patients were reviewed and compared, with those who underwent a Roux-en-Y, by gender and age matched analysis, retrospectively. Results: There were nine males and one female with a mean age of 52.5 (range, 16~72). The operation time was $449.00{\pm}87.39minutes$. The mean distance between the proximal resection margin and the cancer was $6.56{\pm}3.65cm$; the maximum size of the tumor was $9.90{\pm}3.97cm$. These measures differed significantly from patients who underwent Roux-en-Y. The patients had a double primary cancer in the cardia and esophagus. There were no events of colon necrosis. However, a pneumothorax occurred in one patient (10%) and a proximal anastomotic stricture occurred in one patient. There were no reports of heartburn, regurgitation, thoracic or epigastric fullness, and one patient even gained weight, 16 kg. Conclusion: Colon interposition after esophagogastrectomy was safe and effective and should be considered as an additional surgical option for locally advanced type II cardia cancer patients with esophageal invasion.

• Journal of Chest Surgery
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• v.34 no.7
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• pp.561-565
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• 2001

Patients who have complex endocarditis with involvement of both the aortic and mitral valves and intervalvular fibrous skeleton are among the most difficult to treat and still have the highest surgical mortality and morbidity rates. We report one case of aortic and mitral valve replacement with reconstruction of the fibrous skeleton performed in a 55-year-old female patient who had an aortic annular abscess and both the aortic and mitral prosthetic valve endocarditis with destruction of the fibrous skeleton. Previously, she had undergone redo double valve replacement\`, Transesophageal echocardiogram showed the paravalvular defect at the noncoronary aortic sinus and abnormal sinus tract along the fibrous skeleton. Emergent operation was performed due to positive blood cultures of staphylococcus epidermidis and persistent sepsis despite appropriate antibiotic therapy. After aortotomy extended to the roof of left atrium, both prosthetic valves and destroyed fibrous skeleton were completely resected and the aortic annular abscess was debrided and closed with a bovine pericardial patch. Reconstructions of both aortic and mitral annuli and the fibrous skeleton were done by using two separate bovine pericardial patches in triangular shape and mechanical valves were implanted. Postoperatively, adequate antibiotic therapies were continued and the patient was discharged at the postoperative 72 days without evidence of recurrence of endocarditis. Transthoracic echocardiogram of the postoperative 8 months shows no paravalvular leakage or recurrence of endocarditis and the patient has been followed up with no symptom.

• The KIPS Transactions:PartA
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• v.12A no.5 s.95
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• pp.413-420
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• 2005

The Newton-Raphson iterative algorithm for finding a floating point reciprocal square mot calculates it by performing a fixed number of multiplications. In this paper, a variable latency Newton-Raphson's reciprocal square root algorithm is proposed that performs multiplications a variable number of times until the error becomes smaller than a given value. To find the rediprocal square root of a floating point number F, the algorithm repeats the following operations: '$X_{i+1}=\frac{{X_i}(3-e_r-{FX_i}^2)}{2}$, $i\in{0,1,2,{\ldots}n-1}$' with the initial value is '$X_0=\frac{1}{\sqrt{F}}{\pm}e_0$'. The bits to the right of p fractional bits in intermediate multiplication results are truncated and this truncation error is less than '$e_r=2^{-p}$'. The value of p is 28 for the single precision floating point, and 58 for the double precision floating point. Let '$X_i=\frac{1}{\sqrt{F}}{\pm}e_i$, there is '$X_{i+1}=\frac{1}{\sqrt{F}}-e_{i+1}$, where '$e_{i+1}{<}\frac{3{\sqrt{F}}{{e_i}^2}}{2}{\mp}\frac{{Fe_i}^3}{2}+2e_r$'. If '$|\frac{\sqrt{3-e_r-{FX_i}^2}}{2}-1|<2^{\frac{\sqrt{-p}{2}}}$' is true, '$e_{i+1}<8e_r$' is less than the smallest number which is representable by floating point number. So, $X_{i+1}$ is approximate to '$\frac{1}{\sqrt{F}}$. Since the number of multiplications performed by the proposed algorithm is dependent on the input values, the average number of multiplications Per an operation is derived from many reciprocal square root tables ($X_0=\frac{1}{\sqrt{F}}{\pm}e_0$) with varying sizes. The superiority of this algorithm is proved by comparing this average number with the fixed number of multiplications of the conventional algorithm. Since the proposed algorithm only performs the multiplications until the error gets smaller than a given value, it can be used to improve the performance of a reciprocal square root unit. Also, it can be used to construct optimized approximate reciprocal square root tables. The results of this paper can be applied to many areas that utilize floating point numbers, such as digital signal processing, computer graphics, multimedia, scientific computing, etc.

• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.281-313
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• 2016

Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution and one of them is to prohibit the operation of multiple medical institutions In the past, there was a provision stipulating the same purpose. But because the Supreme Court interpreted that several medical institutions could be opened if the medical treatment was not made at the additional medical instition which was opened in the another doctor,s license, multiple medical institutions could be opened and operated. However, some health care providers opened the several medical institutions to another doctor's license just by the excuse of the business management and then did illegal medical cares like the unfair luring of patients, overtreatment, and commition treatment for more profits. So, the health rights of the people came to be infringed on. Accordingly, lawmakers amended the Medical Law for medical personnel not to open and to operate more than one medical institution. As the amended medical law prohibited a medical personnel to open multiple medical institution, some medical personnels insisted that the amended medical law is unconstitutional under which they could not be able to open and operate medical institutions on based on free investment and bring out the benefits of network hospitals. But the regulation to prohibit multiple institutions does not apply only to a medical personnel. Many other experts like lawyer and pharmacist can open only one office under such a restriction. If the regulation goes out of force, the procedure that multiple medical institutions should be opened and operated in the capacity as a medical corporation or a non-profit corporation does not have to be followed. And we should keep in mind that the permission for medical personels to open multiple medical institutions could lead virtually to commercial hospital. If in the nation with a very low rate of public medical service, If only a few medical personnels with capital own many medical institutions and operate commercially them, this could cause a falling-off in quality of medical service, ultimately infringe on the health rights and the life right of the people.