• Journal of Chest Surgery
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• v.31 no.5
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• pp.466-471
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• 1998

Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6${\pm}$41.8 (Range: 1∼148) months and 14.5${\pm}$9.9(Range: 3.0∼40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection(cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I- or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. Result: A mean length of skin incision was 6.1${\pm}$1.0(range: 4.0∼9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0${\pm}$1.1 (range: 2.0∼7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9${\pm}$20.0(range: 28∼147), 29.8${\pm}$12.8(range: 11∼79), and 161.1${\pm}$34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0${\pm}$68.1 (range: 0∼267) cc. All patients were extubated mean 11.3${\pm}$13.8(range: 1∼73) hours after operation. A mean total amount of analgesics used was 0.8${\pm}$1.8(range: 0∼9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0${\pm}$32.2 (range: 10∼194) hours and 6.2${\pm}$2.0(range: 3∼11) days. There were no wound complications and hospital deaths. Conclusion: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.806-812
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• 1999

Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.275-280
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• 2006

Background: Aortopulmonary window (APW) is a very rare congenital heart anomaly, often associated with other cardiac anomalies. It causes a significant systemic to pulmonary artery shunt, which requires early surgical correction. Accurate diagnosis and surgical correction will bring good outcomes. The purpose of this study was to describe our 20-year experience of aortopulmonary window. Material and Method: Between March 1985 and January 2005, 16 patients with APW underwent surgical repair. Mean age at operation was $157.8{\pm}245.3$ ($15.0{\sim}994.0$) days and mean weight was $4.8{\pm}2.5$ ($1.7{\sim}10.7$) kg. Patent ductus arteriosus (8), atrial septal defect (7), interruptedaortic arch (5), ventricular septal defect (4), patent foramen ovate (3), tricuspid valve regurgitation (3), mitral valve regurgitation (2), aortic valve regurgitation (1), coarctation of aorta (1), left superior vena cavae (1), and dextrocardia (1) were associated. Repair methods included 1) division of the APW with primary closure or patch closure of aorta and pulmonary artery primary closure or patch closure (11) and 2) intra-arterial patch closure (3). 3) Division of the window and descending aorta to APW anastomosis (2) in the patients with interrupted aortic arch or coarctation. Result: There was one death. The patient had 2.5 cm long severe tracheal stenosis from carina with tracheal bronchus supplying right upper lobe. The patient died at 5th post operative day due to massive tracheal bleeding. Patients with complex aortopulmonary window had longer intensive care unit and hospital stay and showed more morbidities and higher reoperation rates. 5 patients had reoperations due to left pulmonary artery stenosis (4), right pulmonary artery stenosis (2), and main pulmonary artery stenosis (1). The mean follow-up period was $6.8{\pm}5.6$ (57.0 days$\sim$16.7 years)years and all patients belonged to NYHA class 1. Conclusion: With early and prompt correction of APW, excellent surgical outcome can be expected. However, optimal surgical method needs to be established to decrease the rate of stenosis of pulmonary arteries.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.456-465
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• 1998

Cardiopulmonary bypass(CPB) in children is associated with the accumulation of body water after cardiac operation, as a consequence of an inflammatory capillary leak. Following work by Elliott in 1991, modified ultrafiltration(MUF) was introduced after bypass as a means of hemoconcentrating patients and a potential way of removing water from the tissues. We have carried out a prospective randomized study of 20 children undergoing open heart surgery, comparing MUF with nonfiltered controls. MUF was carried out for a mean of 18.9 minutes after completion of CPB to a hematocrit of 37.1%(mean). The mean water volulme removed by the ultrafiltration was 38.4 ml/kg and the mean blood volume retransfused from the oxygenator during the ultrafiltration was 32.1 ml/kg. Fluid balance, hemodynamics, hematocrit, osmolarity and dosage of drug treatment were recorded for 4∼12 hours postoperatively. The results were analyzed using Student t-test and ANOVA, comparing controls(n=10) to MUF(n=10). Blood loss(ml/kg/24hr) was 14.5(mean) in MUF versus 13.7 in controls; blood transfused(ml/kg/24hr) 6.6 in MUF versus 15.2 in controls; plasma transfused(ml/kg/24hr) 65.7 in MUF versus 59.6 in controls. There was rise in arterial blood pressure and hematocrit during MUF. Percent rise of systolic blood pressure was 28.8% in MUF versus 18.7% in controls(p=0.366); percent rise of diastolic blood pressure was 28.8% in MUF versus 8.5% in controls(p=0.135); and percent rise of mean blood pressure was 36.2% in MUF versus 8.2% in controls (p=0.086). Percent rise of hematocrit was 40.0% in MUF versus 23.5% in controls(p=0.002). There was no significant difference in the inotropic requirement and the postoperative serum osmolarity between two groups. The number of days on the ventilator, the duration of stay in the intensive care unit, and the postoperative hospital stay were not significantly different between the two groups.

• Korean Journal of Soil Science and Fertilizer
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• v.33 no.1
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• pp.1-7
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• 2000

Management of phosphorus availability in the plastic film house soils in Korea merits attention because salts have been accumulated for last decades due to the heavy application of fertilizers and intensive cropping practices. In an attempt to characterize the P availability, available phosphorus contents and electrical conductivity of the saturated extracts ($EC_e$) were measured for soils collected from the 169 plastic film houses in Kangwon-do. Soil phosphorus contents were analyzed by methods of Lancaster, Bray No. 1, Olsen, Truog, water extractable and saturation extracts. Phosphorus concentrations in the saturated extracts of the plastic film house soils ranged from 0.02 to $34mg\;L^{-1}$, with the average of $8mg\;L^{-1}$. The available $P_2O_5$ of the soils ranged from 136 to $3,689mg\;Kg^{-1}$, with the average of $1,261mg\;Kg^{-1}$. The water soluble $P_2O_5$ ranged from 2 to $118mg\;L^{-1}$, with the average of $39mg\;L^{-1}$. A significant correlation existed between saturation extract P (Y) and available $P_2O_5$ (X) [Y = -5.075 + 0.018X, $r=0.662^{***}$] indicating $1.0mg\;P\;L^{-1}$ of in the saturated extract was equivalent to $337mg\;Kg^{-1}$ of the available $P_2O_5$ by Lancaster method. Electrical conductivity of the saturated pastes ($EC_e$) was highly significantly correlated with EC (1:5), yielding the slope of 12.2 for the coarse textured plastic film house soils. Results of higher concentrations of available P in soil solution and dilution factor of 12.2 for $EC_e$ demonstrate that a special care must be taken in terms of fertilizer management and data interpretation for soils under this specific condition.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.101-109
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• 2013

Purpose: Pediatric urolithiasis is uncommon in children but is a cause of significant morbidity and damage to the kidney. Although much information on adult urolithiasis is available in the literature, large studies on the pediatric population are still scarce. In this report, we review our experience with pediatric urolithiasis over 22 years at a tertiary referral center. Method: We retrospectively reviewed the records of children with newly diagnosed urolithiasis between January 1991 and May 2013. We assessed the age, sex, family history, initial symptoms, location of stones, underlying cause, stone analysis, treatment, and recurrence among the patients. Results: In total, 137 patients (96 male, 41 female) were assessed. The age range was 0-17 years (mean age, 6.0 years). Forty-three (31%) children were aged <1 year, and 37% (16/43) had a history of intensive care unit (ICU) admission. Thirteen patients (9.5%) had a family history of stones. The most common symptoms at presentation among the patients were gross hematuria (56/137, 41%) and flank or abdominal pain (46/137, 34%). The stones were located in the kidney (85/137, 62%), ureter (29/137, 21%), bladder (2/137, 1.4%), and multiple locations (20/137, 15 %). Congenital abnormalities of the genitourinary (G-U) tract, with or without metabolic abnormality, or urinary tract infection (UTI) was detected in 26 children (19%). Ninety-one patients (66%) underwent metabolic examination, and 38% of these patients exhibited an abnormality. UTI, with or without abnormalities of the G-U tract, or metabolic abnormality was detected in 26 children (19%). Of the 35 stones analyzed, the majority were calcium stones (20/35, 57%), followed by infected stones (5/35, 14%), uric acid stones (4/35, 11%), carbonate apatite stones (3/35, 7%), cystine stones (2/35, 6%), and phosphate stones (1/35, 3%). Five patients (4%) required open procedures, with or without non-open procedures, whereas 77 patients (56%) were managed conservatively; the remaining 55 patients (40%) received some other form of intervention. Eighteen patients (13%) had stone recurrence during the follow-up period. Conclusions: Pediatric urolithiasis is commonly associated with abnormalities of the G-U tract and/or metabolic disorders and/or UTI. Half of the patients will pass their stones spontaneously, and all the techniques of minimally invasive surgery are applicable in the treatment of children with stones. As the recurrence rates are high among this population, long-term follow-up is recommended and the complete clearance of stones is important.

• Neonatal Medicine
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• v.15 no.1
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• pp.67-74
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• 2008

Purpose : The purpose of this study was to assess the natural history and perinatal outcomes of twin gestations according to chorionicity. Methods : We retrospectively reviewed the medical records of 99 monochorionic (MC) and 206 dichorionic (DC) twin gestations delivered at Il Sin Christian Hospital in Busan between January 2002 and December 2007. The incidences of twin-to-twin transfusion syndrome (TTS) and selective intrauterine growth restriction (sIUGR), as well as perinatal morbidity and mortality, were evaluated. Results : MC twins had a lower gestational age (35.7 vs. 36.6 weeks, P=0.03) at birth and a higher incidence of intrauterine fetal loss (10% vs. 1.5%, P<0.001) than DC twins. The incidence of intrauterine fetal loss was higher in MC sIUGR than in DC sIUGR (19% vs. 2.5%, P=0.025) twins. The number of admissions to the neonatal intensive care unit (NICU; 31% vs. 16%, P=0.042), and the incidence of periventricular leukomalacia (7% vs. 0%, P=0.031), and respiratory distress syndrome with surfactant treatment (27% vs. 11%, P=0.049) were higher in MC than DC twins. The incidences of sIUGR and TTS were 21 and 9% among the MC twins. The incidences of intrauterine fetal loss were higher in MC twins with TTS [6 of 9 (67%)] or sIUGR [4 of 21 (19%)] than uncomplicated MC twins (P<0.001). The frequency of admission to the NICU (P=0.001), the length of hospital stay (P=0.033), the prevalence of periventricular leukomalacia (P=0.011), and intraventricular hemorrhage (P=0.007) were also higher in MC with TTS or sIUGR than in uncomplicated MC twins. Conclusion : The incidence of neonatal complications was higher in MC twins, especially those gestations complicated by TTS or sIUGR.

• (The) Research of the performance art and culture
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• no.37
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• pp.33-60
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• 2018

This article is to present that the research on the Mudang Gut Chum should be within the context of the performance of Mudang Gut and examines its meanings and implications with focus on Seoul Mudang Gut Chum and Hwanghae-do Mudang Gut Chum. Seoul and Hwanghae-do Mudang Gut Chums do not exist in the form of simple dance or movement. They feature continuity while serving the function of revealing the existence of spirit and sometimes show the process of the spirit joining the Gut ritual, which means that the Mudang Gut Chum should not be understood as the dance itself only. Instead, care attention should be paid to the status of the tune of Gut where the dance is placed, relationship between the gut and the spirit, and the flow of narrativity. Also, the Mudang Gut Chum has a lot to do with the tune. Looking at the Mudang Gut Chum simply focusing on dancing steps, and the movement of feet and/or hands fails to gain an accurate understanding of the fundamentals of the Mudang Gut Chum. Closely connected to the tune, which is also associated with the grade of the spirit, the dance shows a variety of performances conducted by entering the Gut ritual of the spirit. In that respect, complex views on the Mudang Gut Chum are required. The same applies to the hereditary shaman Mudang Gut as well. The Korean Mudang Gut Chum has a slight difference between the Gangshinmu gut and the hereditary gut but is in basically the same aspect. The Gut Chum holds its meaning in the flow of gutgeori (tune or dance performed during exorcism, a shaman song) and delivers its own meaning in connection with the tune. It is definitely meaningful to focus on the individual movements of a dancing shaman but one should be able to derive the network of meanings that such movements have within the performance of the gutgeori, which means that intensive studies on the field performance and circumstances should be completed before studying the Mudang Gut Chum. In addition, the Mudang Gut Chum discloses the characteristics of the performance group. The Mudang Gut Chum exists in a complex manner. With respects to the status of the spirit, it shows the characteristics of the performance group. It represents the progress of Gut while closely connected with the tune. Therefore, the way of describing the Mudang Gut Chum should be far more than just simply keeping the dance notations. With this in mind, one should investigate and record the Mudang Gut Chum.

• The Journal of the Korean Institute of Forest Recreation
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• v.22 no.4
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• pp.59-69
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• 2018

This is a cross-sectional study that suggests ways to activate forest welfare services (FWS) by investigating the infrastructure, service status, and perception on FWS in Korea. In August 2016, a structured email survey was conducted in nation widely. The respondents were mostly directors and general secretary (75.0%). The considerable number (16.3%) of nursing homes (NH) use some floors of the complex buildings that would be difficult to have FWS infrastructure and about 30% of those without forests near the facilities. The directors of NH recognize that FWS has positive effects on the elderly. However, FWS is not an requisite of the longterm care insurance benefit, and so costly and effort-intensive that FWS has not been activated so far. In order to activate FWS in NHs, it is necessary to develop and disseminate the guidelines on FWS that anyone can easily followed. In addition, when the National Health Insurance Corporation evaluates NHs, they should evaluate not only whether there is a wandering or walking space, but also whether it has forest healing factors such as forests. It is also necessary to create a barrier-free environment both inside and outside of NHs, increasing accessibility to the toilet in gardens, paving a passage for wheelchairs and lifts in forests near NHs. Through these efforts, it is expected that FWS will be activated to provide physical, mental rest and comfort, appropriate cognitive stimulation to the NH residents at the end of life.

• Journal of the Korean Society of Food Culture
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• v.24 no.3
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• pp.331-337
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• 2009

The principal objective of the present study was to survey the demands of an education program for evaluations of the efficacy of health functional foods. A questionnaire was developed and sent to 2,225 members of the Biofood Network Center. A total of 101 (4.6%) individuals responded, 54.5% of the respondents were male and 45.5% were female; the respondents' occupations (in order of prevalence) were as follows: company worker (48.5%)>researcher (27.7%)>student (13.9%)>professor (5.0%)>pharmacist (2%), and dietitian (2%). The businesses in which the respondents worked were (again in order of prevalence) as follows: research & development (64.4%)>marketing (11.9%)>consultation and education (5.9%)>manufacturing and others (17.9%). 41.6% of the respondents reported experience in businesses relevant to KFDA approval for functional ingredients and health functional foods. The results showed that 63.4% of the respondents had previously been educated about functional foods; the types of education program reported were (in order of prevalence): 'overview and acts of health functional food' (n=49)>'standards and specification for health functional food' (n=41)>'efficacy evaluation-human study' (n=24)>'safety evaluation' (n=21)>'efficacy evaluation-in vivo study' (n=13)>and 'others' (n=10). Respondents preferred off-line education programs (62.4%) to on-line programs (22.8%). The preferred duration of an educational program was '$2{\sim}3$ days: total $14{\sim}24$ hours' (30.7%); thus, short-term programs were favored. The primary requirements of a program, from the perspective of the learner, were as follows (scored on a 7-point scale); 'efficacy evaluation and case study-human study' (5.80 points)>'standards and specification for health functional food' (5.72 points)>safety evaluation' (5.7 points)>'overview and acts of health functional food' (5.67 points) and 'efficacy evaluation methods of health functional food by efficacy (intensive)' (5.67 points). Preference for functionality was as follows; 'body weight & body fat' (21.8%), 'immune function' (18.8%) > 'blood glucose' (10.9%). In summary, the educational demand for 'efficacy evaluation and case study' was highest among the curriculum options provided, and with regard to functionality, 'body weight & body fat', 'immune function' and 'skin care' were considered most important by respondents. These results differed among respondents with different jobs and duties, and this suggests that customized education programs for health functional food should be developed.