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

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

• Journal of Chest Surgery
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• v.35 no.6
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• pp.430-438
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• 2002

It is known that low birth weight is a risk factor for poor outcome in cardiac surgery for many cardiac defects. We reviewed our recent surgical experiences on congenital heart defect (other than patent ductus arteriosus) in low birth weight babies. Material and Method: From September 1994 to February 2001, 31 consecutive infants weighing 2500 g or less underwent cardiac surgery with (OHS group n=12) or without cardiopulmonary bypass (CHS group n=19). A retrospective study was carried out to evaluate short-and intermediate-term outcome. Mean gestational age and age at operation were 36.9 weeks(range, 32.3-42weeks) and 32.1days (range, 0-87days) respectively. Mean body weight at birth and operation were 1972g (range, 1100-2500g) and 2105g (range, 1450-2500 g) respectively. There was no difference between the two groups in age and body weight. Defects included ventricular septal defect (VSD) (n=3), VSD with arch anomaly (n=2), total anomalous pulmonary venous return (n=2), transposition of the great arteries (TGA) (n=2), truncus arteriosus (n=2), and univentricular heart with cor triatriatum (n=1) in OHS group, and coarctation of aorta (n=7), tetralogy of Fallot (TOF) (n=3), TOF with pulmonary atresia (n=3), multiple muscular VSDs (n=1), double outlet right ventricle (n=1), pulmonary atresia with intact ventricular septum (n=2), tricuspid atresia (n=1), and TGA with multiple VSD (n=1) in CHS group. 13 patients (41.9%) were intubated pre-operatively. Result: There were 4 early deaths(＜30 days); 1 (8.3%) in OHS group and 3 (15.8%) in non-OHS group. All these early deaths were related to the pulmonary artery banding(PAB). There was no operative mortality in infants undergoing complete repair and palliative operations other than PAB. Delayed sternal closure was required in 3 patients. Prolonged postoperative mechanical ventilation (>7 days) was required in 7 patients(58.3%) in OHS and 7(38.8%) in CHS group. Late mortality occurred in 3 patients, two of which were non-cardiac. A patient in OHS group was documented to have neurologic sequelae. All the survivors except two are in NYHA class 1. Conclusion: Complete repair and palliative operations other than PAB can be performed in low birth weight infants with low operative mortality and an acceptable intermediate-term result. However, about a half of the patients required long-term postoperative mechanical ventilation.

• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.17-24
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• 2007

Background: The aim of this study is to assess the clinical results of various procedures in congenital aortic stenosis. Material and Method: From August 1987 to June 2004, 53 patients of congenital aortic stenosis underwent procedures such as percutaneous balloon valvuloplasty, aortic valvuloplasty, Ross procedure, and aortic valve replacement. The mean age of initial procedures was $8.2{\pm}6.0$ years. Percutaneous balloon valvuloplasty was peformed in sixteen patients, aortic valvulopiasty in thirty two patients, Ross procedure in nineteen patients, and aortic valve replacement in fourteen patients. The mean follow duration was $80.6{\pm}60\;(0{\sim}207)$ months. Result: There was 15.1% (8/53) of early mortality and no late mortality. The six patients with critical aortic stenosis were died of left ventricular dysfunction in early series (before 1 year; 4 cases) and two patients died after the Ross procedure and aortic valve replacement respectively. After percutaneous balloon valvuloplasty, most patients needed reoperations (14/16). Thirteen patients needed reoperation, after aortic valvuloplasty. After Ross procedure, two patients needed reoperation due to aortic regurgitation caused by progressive aortic root dilatation. The actuarial survival rate after Ross procedure at 7 years was 90.5%. Conclusion: In young children before the age of one, percutaneous balloon valvuloplasty was considered as :he safe initial palliative procedure. But children over one year-old, aortic valvuloplasty were the effective procedure. Ross procedure can be preformed safely with good results.

• Pediatric Infection and Vaccine
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• v.18 no.2
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• pp.163-172
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• 2011

Purpose : The purpose of this study was to review our recent experiences with deep neck abscesses in children and adolescents and to provide helpful information in treatment and diagnosis by comparing them with those in other available literatures. Methods : Medical records of 36 children and adolescents admitted for deep neck abscess at two hospitals from January 2000 to October 2010 were reviewed retrospectively. Results : Male to female ratio was 1.4 : 1 and the mean age was 6.5 years. Painful neck swelling and fever were the most frequent symptoms in patients under thirteen years of age whereas trismus and headache were frequent symptoms in patients over fourteen years of age. Submandibular space was the most common site of deep neck abscess in patients under thirteen years of age, whereas peritonsillar space was the most common site in patients over fourteen years of age. The results of bacterial cultures were positive in 61.5% of drained cases. Staphylococcus aureus was the most commonly identified bacteria in 6 patients (37.5%) and 5 of them were under 2 years of age. Twenty six patients received surgical drainage while the others were treated with antibiotics only. There were no statistically significant differences in the durations of admission, fever after admission, and antibiotic treatment between surgical and medical treatment groups. Conclusion : The common sites of deep neck abscess, associated symptoms, and causative organisms were different between children and adolescents. As there were no differences in durations of admission, fever, or antibiotics treatments between surgical and medical treatment groups, surgical drainage may be avoided by early recognition and suspicion. However, if there is no improvement of symptoms or size of abscesses within 48-72 hours of antibiotic treatment, surgical drainage should be considered.

• 한국호스피스완화의료학회:학술대회논문집
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• 2004.07a
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• pp.100-102
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• 2004

Under the current medical system, a terminal patient and his/her family who are neglected inevitably face various aspects of crises including not only physical, but also psychological, social, economic, spiritual and legal problems. Nurses often look after many terminal patents with these types of complicated problems. Therefore, educating the nurses who will take care of such patents would greatly reduce stress so the patents end could their lives in peace and without losing their dignity. This research is a quasi experimental study of nonequivalent control group. A pretest-posttest design where a basic education program is developed for nurses, who frequently treat terminal patents, to understand the importance of the role of hospice and to apply their understandings to treat terminal lancer patents. A sample of the nurses were taken from those who were working in general wards at two general hospitals in Seoul during October, 2003${\sim}$December 2003. The study was composed of 46 experimental group and 43 control group. A basic hospice education program was developed by taking emphasized and overlapping parts from advanced practice hospice nurses education course, short-term education course, an extensive literature survey and by consulting three professionals as well. With the group of 5 professors with vast experiences in oncolgy, 5 nursing administrator, 3 nursing practitioner, the tentative first version of the program was developed and reviewed. Afterwards, by utilizing person to person interviews with 2 head nurses experienced with terminal patients, 1 nurse in charge of hospice, 1 nurse on the contents of the program, and a person to person rating on the educating medium by a nurse were performed. The final version of a basic education program was developed after the second revision. The hospice basic education program consists of introduction to hospice, hospice and commucation, management of pain for terminal cancer patients, physical management for terminal cancer patients, socio-psycological caring of terminal cancer patients and management of death and separation. Total education time was four hours organized into 50 minutes of instruction and 10 minutes of break. $Powerpoint^{(R)}$ software was used as the education medium. As research tools, "Knowledge on Hospice" was developed by the author after receiving a review from one expert. "Attitude of Hospice Nursing" was revised Kim(2001)'s attitude measuring tool which was based on Wang(1998), Kwon(1989), Park and Sung(1991)'s tool. "Liability on nursing terminal patients" was used as developed by Zarits(1980) and Mongomory(1985) translated by Lee(1985). For collecting data, preliminary investigation prior to 1 week of the hospice basic education program and post-investigations after 1 week and 4 weeks of the education were carried out for the nurses at a general ward who understood and agreed on the purpose of the program. Collected data were analyzed throughout t-test, $x^2-test$, Manova test and Bonferroni correction in $SAS^{(R)}$ program. The summary of the investigation is as follows: Hypothesis 1: "Educated experimental group would possess more knowledge on hospice compared to the un-educated control group" was supported after 1 (F=12.14, p=.00) and 4 (F=5.3, p=.02) weeks of education. Hypothesis 2: "Educated experimental group would take a positive attitude toward hospice nursing compared to the un-educated control group" was supported after 1(F=3.92, p=.05) and 4(F=5.05, p=.02) weeks of education. Hypothesis 3: "Educated experimental poop would feel less liability compared to the un-educated control group in nursing terminal cancer patients' was rejected. In this study, it was found that knowledge on hospice was significantly important. By applying hospice basic education programs to nurses, the education program helped nurses to take a positive attitude toward terminal patients. It was, however, seen that the education program had no effect on alleviating liability in nursing terminal patients. Therefore, it is expected that this educational program would help hospices and nurses at general wards to understand the concept and the role of hospice so that terminal patents, now neglected under current medical system, would be able to end their lives in peace.

• Journal of Nutrition and Health
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• v.50 no.3
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• pp.284-293
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• 2017

Purpose: This study was conducted to examine the behavioral intentions of breastfeeding in single women using the theory of planned behavior. Methods: The questionnaires were distributed to 350 single women in her 20~30s, and 316 respondents were analyzed by descriptive statistics, Spearman's correlation, and multiple regression analysis. Results: The subjects showed strong intentions and favorable attitudes toward breastfeeding. The subjects were more favorably influenced by their mothers, siblings, friends, and coworkers who previously experienced breastfeeding than ones with no breastfeeding experiences. There were significant correlations between breastfeeding intention and attitudes (r = 0.321, p < 0.0001), subjective norms (r = 0.434, p < 0.0001), and perceived control (r = 0.307, p < 0.0001). However, regression analysis with two different age groups revealed that subjective norms (p < 0.0001) and perceived control (p < 0.001) contributed to the model of explaining breastfeeding intentions in subjects who were 25 years old or younger, whereas attitudes did not. In addition, subjects who were more than 25 years old showed that attitudes (p < 0.003) and subjective norms (p = 0.002) contributed to the model of explaining breastfeeding intentions while perceived control (p < 0.070) showed less contribution. Conclusion: These results suggest that the theory of planned behavior can be a useful tool to increase the rate of breastfeeding intentions in single women when designing educational materials, which requires consideration of age differences.

• Journal of Oral Medicine and Pain
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• v.34 no.2
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• pp.207-216
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• 2009

Trigeminal neuralgia is defined "a sudden, usually unilateral, severe, brief, stabbing, recurrent pain in the distribution of one or more branches of the fifth cranial nerve". The initial treatment of choice for trigeminal neuralgia is medical therapy. In patients with medically intractable pain or intolerable medication side effects, invasive therapeutic approaches are often necessary. Based on the amount of evidence and estimated efficacy, carbamazepine is the drug of choice in the management of trigeminal neuralgia. In case of insufficient or no response to carbamazepine, second-line drugs can be added. In this study, the author tried to review and analyzed the cases of 90 patients whom had visited for treatment of trigeminal neuralgia at the Department of Oral Medicine, Kyungpook National University Hospital from 2003 to 2008. The results were as follows: 1. Trigeminal neuralgia was significantly more common with advancing age, and nearly twice as common in women than men (ratio of 2.1:1) 2. The maxillary branch of the trigeminal nerve involved most often (51.1%), and the right side of the face is affected more commonly than the left (ratio of 2.9:1). 3. 85(94.4%) patients had experiences visiting medical or dental specialties before being referred to the Department of Oral Medicine. 4. 40(44.4%) patients with trigeminal neuralgia had systemic diseases. 5. Treatment with carbamazepine monotherapy was satisfactory initially in 69(76.7%) the patients, and the mean daily dose of carbamazepine was 402.9mg. On the other hand, 16(17.8%) patients expressed effectiveness after combination therapy of carbamazepine and other drugs. 6. Of the 69 patients who had a good initial response to carbamazepine monotherapy, 18 patients became resistant, so that combination therapy of carbamazepine and other drugs were necessary. 7. 54(60%) patients developed side effects such as dizziness, drowsiness, nausea, vomiting, blood dyscrasias, skin rash and constipation, and 11 of the patients decided to stop tmedicaion due to side effects.

• Cross-Cultural Studies
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• v.28
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• pp.115-139
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• 2012

Interval or duration of segments, syllables, words and phrases is an important acoustic feature which influences the naturalness of speech. A number of cross-sectional studies regarding acoustic characteristics of children's speech development found that intervals of segments, syllables, words and phrases tend to change with the growing age. One hypothesis assumed that decreases in intervals would be greater when children were younger and smaller decreases in intervals when older (Thelen,1991), it has been supported by quite a number of researches on the basis of cross-sectional studies (Tingley & Allen,1975; Kent & Forner,1980; Chermak & Schneiderman, 1986), but the other hypothesis predicted that decreases in intervals would be smaller when children were younger and greater decreases in intervals when older (Smith, Kenney & Hussain, 1996). Researchers seem to come up with conflicting postulations and inconsistent results about the change trends concerning intervals of segments, syllables, words and phrases, leaving it as an issue unresolved. Most acoustic investigations of children's speech production have been conducted via cross-sectional designs, which involves studying several groups of children. So far, there are only a few longitudinal studies. This issue needs more longitudinal investigations; moreover, the acoustic measures of the intervals of child speech are hardly available. All former studies focus on word stages excluding the babbling stages especially the canonical babbling stage, but we need to find out when concrete changes of intervals begin to occur and what causes the changes. Therefore, we conducted an acoustic study of interval characteristics of segments and words concerning Canonical Babble ( CB) and early speech in an infant aged from 0;9 to 2;4 acquiring Mandarin Chinese. The current research addresses the following two questions: 1. Whether decreases in interval would be greater when children were younger and smaller when they were older or vice versa? 2. Whether the child speech concerning the acoustic features of interval drifts in the direction of the language they are exposed to? The female infant whose L1 was Southern Mandarin living in Changsha was audio- and video-taped at her home for about one hour almost on a weekly basis during her age range from 0;9 to 2;4 under natural observation by us investigators. The recordings were digitized. Parts of the digitized material were labeled. All the repetitions were excluded. The utterances were extracted from 44 sessions ranging from 30 minutes to one hour. The utterances were divided into segments as well as syllable-sized units. Age stages are 0;9-1;0,1;1-1;5, 1;6-2;0, 2;1-2;4. The subject was a monolingual normal child from parents with a good education. The infant was audio-and video-taped in her home almost every week. The data were digitized, segments and syllables from 44 sessions spanning the transition from babble to speech were transcribed in narrow IPA and coded for analysis. Babble was coded from age 0;9-1;0, and words were coded from 1;0 to 2;4, the data has been checked by two professionally trained persons who majored in phonetics. The present investigation is a longitudinal analysis of some temporal characteristics of the child speech during the age periods of 0;9-1;0, 1;1-1;5, 1;6-2;0, 2;1-2;4. The answer to Research Question 1 is that our results are in agreement with neither of the hypotheses. One hypothesis assumed that decreases in intervals would be greater when children were younger and smaller decreases in intervals when older (Thelen,1991); but the other hypothesis predicted that decreases in intervals would be smaller when children were younger and greater decreases in intervals when older (Smith, Kenney & Hussain, 1996). On the whole, there is a tendency of decrease in segmental and syllabic duration with the growing age, but the changes are not drastic and abrupt. For example, /a/ after /k/ in Table 1 has greater decrease during 1;1-1;5, while /a/ after /p/, /t/ and /w/ has greater decrease during 2;1-2;4. /ka/ has greater decrease during 1;1-1;5, while /ta/ and /na/ has greater decrease during 2;1-2;4.Across the age periods, interval change experiences lots of fluctuation all the time. The answer to Research Question 2 is yes. Babbling stage is a period in which the children's acoustic features of intervals of segments, syllables, words and phrases is shifted in the direction of the language to be learned, babbling and children's speech emergence is greatly influenced by ambient language. The phonetic changes in terms of duration would go on until as late as 10-12 years of age before reaching adult-like levels. Definitely, with the increase of exposure to ambient language, the variation would be less and less until they attain the adult-like competence. Via the analysis of the SPSS 15.0, the decrease of segmental and syllabic intervals across the four age periods proves to be of no significant difference (p>0.05). It means that the change of segmental and syllabic intervals is continuous. It reveals that the process of child speech development is gradual and cumulative.

• FLOWER RESEARCH JOURNAL
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• v.18 no.4
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• pp.315-322
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• 2010

To analyze our country's education program for flower decoration and occupational satisfaction of florist, 60 present florists and 60 applicants were surveyed. To investigate satisfaction of florist, the questionnaire items consisted of satisfaction for occupation etc. experienced by attendants, contents of related education, recognition from society, social treatment. And this study analyzed followings : considerations to select occupation, satisfaction on job of person who majored in related subject and non- person without such an educational background, satisfaction on present occupation, satisfaction on education period, significance of florist ability, significance of requirements for occupational development. The points which present florists and applicants consider as important were aptitude for gardening and prospect. From the analysis by major of florists, majored persons had more satisfaction than non-majored persons but there was no statistically significant difference between them. From the analysis by applicant, as in present florists, majored persons had more satisfaction than non-majored persons. For the satisfaction by career and education period of present florists and applicants, the satisfaction on education related to flower decoration or learning experiences and lecturer's teaching method showed that the lower the career is, the less the satisfaction is. Seeing the result by education period of applicants, the satisfaction on job was similar each other regardless of education period. For difference in recognition on ability by major of present florists and applicants, the result of analysis by major of present florists showed that majored persons considered the ability more important comparing to non-majored persons in the fields of gardening and making decorations. In the other hand, in the fields of quality maintenance, flower decoration, and flower distribution and management, there was no significance difference between majored and non-majored persons about the recognition of ability. The result of analysis by major of applicants showed that majored persons considered the ability more important comparing to non-majored persons in the fields of gardening, flower decoration, making decorations, flower distribution and management. For the significance of quality maintenance, majored persons wholly considered the significance more important comparing to non-majored persons but there was no significant difference. Based on the results of this study, in working as a florist, persons who majored in flower decoration had more occupational satisfaction than non-majored persons. And among the contents of education, the education related to gardening was recognized as most important. But at present the systematic and special education programs to cultivate professional florists are deficient. Therefore it is suggested that courses based on systematic educational contents which integrate theory and practice are needed to solve education problem related to flower decoration in this rapidly changing society.

• Journal of Korean Classical Literature and Education
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• no.37
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• pp.253-281
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• 2018

The purpose of this paper is to analyze the meaning of of "Nikolai Garin - Mikhailovsky's the "Joseon tale". talks about the origins of the Joseon Dynasty and the Qing Dynasty. In this paper, we revealed the features of the form of "Otter Legend". And analyzed the confrontation between Nurhachi's family and Yi Seong-gye's family shown in the story. The result is as follows. is complex tale. The start of is 'the typr of Yaraeja'. Next is the story of Myoung-Dang. Myoung-Dang is deep in the water. also has anecdotes of Jeong, Chung-shin. rearranged at least three stories or more. transformed each type of stories, communing the different patterns of stories with different logic. The basic logic of the transformation was to maximize the confrontation between the NuruhachI and Yi Seong-gye clans, the origins of Manchuria and the Chosun Dynasty. As a result, the sacredness of Nurhachi's Family, the origin of the Qing Dynasty, was expanded. On the other hand, Yi Seong-gye s Family was less extraordinary than Nurhachi's Family. Also, the ability of the person is also inferior. This is not the yearning for the Qing Dynasty. This is because the Qing Dynasty and the Joseon have the same pedigree. shows that the Qing Dynasty's experiences should be shared since the Qing Dynasty was born of another clan of Joseon. This is a new perception of Qing Dynasty. This is similar to the interpretation that dragged the Qing Dynasty's history into the Joseon's ethnographic historical point of view.