• Journal of Chest Surgery
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• v.34 no.10
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• pp.787-791
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• 2001

Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.16 no.4
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• pp.223-237
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• 2011

The intermittent freshwater discharge has an critical influence upon the biophysical environments and the ecosystems of the Yeongsan Estuary where the estuary dam altered the continuous mixing of saltwater and freshwater. Though freshwater discharge is controlled by human, the extreme events are mainly driven by the heavy rainfall in the river basin, and provide various impacts, depending on its magnitude and frequency. This research aims to evaluate the magnitude and frequency of extreme freshwater discharges, and to establish the magnitude-frequency relationships between basin-wide rainfall and freshwater inflow. Daily discharge and daily basin-averaged rainfall from Jan 1, 1997 to Aug 31, 2010 were used to determine the relations between discharge and rainfall. Consecutive daily discharges were grouped into independent events using well-defined event-separation algorithm. Partial duration series were extracted to obtain the proper probability distribution function for extreme discharges and corresponding rainfall events. Extreme discharge events over the threshold 133,656,000 $m^3$ count up to 46 for 13.7y years, following the Weibull distribution with k=1.4. The 3-day accumulated rain-falls which occurred one day before peak discharges (1day-before-3day -sum rainfall), are determined as a control variable for discharge, because their magnitude is best correlated with that of the extreme discharge events. The minimum value of the corresponding 1day-before-3day-sum rainfall, 50.98mm is initially set to a threshold for the selection of discharge-inducing rainfall cases. The number of 1day-before-3day-sum rainfall groups after selection, however, exceeds that of the extreme discharge events. The canonical discriminant analysis indicates that water level over target level (-1.35 m EL.) can be useful to divide the 1day-before-3day-sum rainfall groups into discharge-induced and non-discharge ones. It also shows that the newly-set threshold, 104mm, can just separate these two cases without errors. The magnitude-frequency relationships between rainfall and discharge are established with the newly-selected lday-before-3day-sum rainfalls: $D=1.111{\times}10^8+1.677{\times}10^6{\overline{r_{3day}}$, (${\overline{r_{3day}}{\geqq}104$, $R^2=0.459$), $T_d=1.326T^{0.683}_{r3}$, $T_d=0.117{\exp}[0.0155{\overline{r_{3day}}]$, where D is the quantity of discharge, ${\overline{r_{3day}}$ the 1day-before-3day-sum rainfall, $T_{r3}$ and $T_d$, are respectively return periods of 1day-before-3day-sum rainfall and freshwater discharge. These relations provide the framework to evaluate the effect of freshwater discharge on estuarine flow structure, water quality, responses of ecosystems from the perspective of magnitude and frequency.