• Journal of Chest Surgery
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• v.55 no.2
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• pp.118-125
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• 2022

Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

• Journal of Chest Surgery
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• v.55 no.3
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• pp.206-213
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• 2022

Background: Surgical repair of partial anomalous pulmonary venous return (PAPVR) to the superior vena cava (SVC) using the Warden procedure has favorable outcomes. However, there remain some concerns after the Warden procedure, such as sinoatrial nodal dysfunction and systemic or pulmonary venous stenosis. We investigated the outcomes of the Warden procedure for repair of PAPVR to the SVC. Methods: This retrospective study included 22 consecutive patients who underwent the Warden procedure for PAPVR between 2002 and 2018. The median age and body weight at operation were 27.5 months (interquartile range [IQR], 5.0-56.8 months) and 13.2 kg (IQR, 6.5-16.0 kg), respectively. The median follow-up duration was 6.2 years (IQR, 3.5-11.6 years). Results: There were no cases of early or late mortality. No patients had postoperative heart rhythm problems, except 1 patient who showed transient sinoatrial nodal dysfunction in the immediate postoperative period. Procedure-related complications requiring reintervention occurred in 5 patients, including 3 of 4 SVC stenosis cases and 2 pulmonary venous stenosis cases during follow-up. The rate of freedom from reintervention related to the Warden procedure was 75.9% at 10 years. Conclusion: In cases requiring extension or creation of an atrial septal defect to achieve a sufficient venous pathway, or interposition of an entire circumferential conduit between the SVC and right atrium due to the shortness of the SVC in the Warden procedure, stenotic complications of the venous pathway occurred. Careful observation of changes in the pressure gradient or anatomical stenosis is required in such patients.

• Journal of Conservation Science
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• v.37 no.6
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• pp.712-722
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• 2021

This study presents a method for conserving shamanistic spirits in Chiseonggwang Buddha. Scientific investigation has revealed that these spirits have been subject to degeneration as a result of severe exfoliation and pollution. The materials and preservation treatment techniques used in create these shamanistic spirits were identified through visual inspection and using appropriate scientific equipment. The different types of background paper, background material, and color pigments used in create the shamanistic spirits were analyzed using a colorimeter, stereoscopic microscope, and SEM-EDS techniques. The analysis revealed that the pulp paper was used as the background and synthetic fiber polyester as the background material. In addition, the study of the pigment revealed that the color components were all synthetic, except for red lead [Pb₃O₄] and oyster shell white [CaCO₃]. Moreover, it was confirmed that the green pigment, identified as emerald green [Cu(C₂H₃O₂)₂.3Cu(AsO₂)₂], was a major component of shamanistic spirits in the late 19^th century. The shamanistic spirits in Chiseonggwang Buddha were conserved by identifying raw materials and pigments through this detailed analysis.

• Journal of Conservation Science
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• v.38 no.2
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• pp.133-143
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• 2022

In this study, we analyzed the rickshaw (Owned by the Daegu Modern History Museum) by measuring each material. The purpose of the study was to identify the materials in modern cultural assets that utilize a variety of materials in a complex way, and establish basic data for preservation and management. Using portable X-ray fluorescence analyzers (P-XRF), species identification, fiber identification, paint film analysis (microscope observation, SEM-EDS, FTIR) on metal, wood, fiber and paint was carried out. Brass, an alloy of Copper, Zinc and Iron, was measured in the metal parts. Further, wooden parts, such as Oak (Quercus acutissima), Japanese Cedar (Cryptomeria japonica), Bamboo (Bambusoideae). Torreya nucifera (Torreya spp.) were identified in the body. Fiber parts consisted mainly of cotton, but some parts were also made of leather. In terms of paint, rickshaws were applied with multiple layers, using cashew (synthetic paint used in place of lacquer). In sum, the rickshaw body part appeared to overlap with layers of fiber, metal (soild), paint, and colored (black, red) layer.

• Journal of Conservation Science
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• v.38 no.2
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• pp.144-153
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• 2022

This study conducted scientific analysis and preservation treatment for the local 7 relics (depurator bottle, eagle patten button, rank insignia, mess tin, M1 Grand-gun cleaning tool kit, Carbine bullet, cartridge) of the fallen of Korean War excavated through the MND Agency for KIA Recovery & Identification that are possessed in the exhibition hall of the Ground Operations Command. FT-IR analysis results show that remainder of depurator bottle is assumed to play a role of water and food purifier during the war for its spectrum similar to Trisodium phosphate, and inscription carved on the cartridge that is hard to observe with naked eyes was also confirmed through 3D digital shooting method. This study also established directivity of preservation treatment of relics for stable treatment by carrying out a survey of conditions based on the microscope and visual observation. The result is expected to be used as basic data for establishment of future directivity of preservation treatment for a variety of war relics.

• Journal of Conservation Science
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• v.37 no.6
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• pp.701-711
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• 2021

This study identifies the structure and material characteristics of the mural paintings in Daeungjeon at Ssanggyesa temple in Jindo by conducting scientific research and analysis including microscope examination, SEM-EDS, XRD, particle size analysis, and others. According to the analyses, the murals were considered to be of a typical soil mural style for Korean Buddhist murals, given that the walls were made of sand and soil and the murals had layers consisting of wall layers and a finishing layer. However, some finishing layer used calcite, while some ground layer used zinc white beneath the thick paint. In addition, there were similar features to those found on the surfaces of oil paintings such as cracks along with the paint layer, high gloss on surfaces, and thick brush strokes in many areas. It was found that the walls on which the murals were painted were made of soil but that the paint layer was created based on the oil painting technique using drying oil. It determined that the murals were painted in a unique painting style that is rarely found in other typical Buddhist murals in Korea.

• Journal of Conservation Science
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• v.37 no.6
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• pp.670-678
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• 2021

Anseong Cheonryongsa, a temple located in Anseong Seoun Mountain, is a part of the second Jogye Order of Korean Buddhism, under the Yongju Temple, and enshrines a gilt-bronze seated Avalokitesvara Bodhisattva. In this study, X-ray fluorescence (XRF) analysis revealed that this statue is composed of Cu-27.2 wt%, Sn-12.6 wt% and Pb-48 wt%. A gamma (γ) ray (Ir-192) image confirmed damage on the backside of the statue, which was later repaired with wood. The XRF analysis and visual observation determined the boundary between the metal and wood in the statue. In addition, results of standard X-ray peak intensity of gold foil and correlation with thickness helped to derive an equation for calculating the thickness of the Avalokitesvara Bodhisattva's gold foil. It was determined that the gilded chest (21 ㎛) and face (20.7 ㎛) of the statue were the thickest sections, the wooden substratum (11.9 ㎛) was the next-most thick, and the bronze (7.4 ㎛) was the thinnest layer.

• Journal of Conservation Science
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• v.37 no.6
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• pp.748-766
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• 2021

The Iksan Ssangneung (twin tombs), a pair of tombs comprising the Daewangneung (large royal tomb) and the Sowangneung (small royal tomb), were constructed in the typical style of stone tunnel and chamber tombs in the Baekje Kingdom during the Sabi period (538 to 660 AD) of ancient Korea. Soil layers exposed during excavation of Sowangneung in a trench east of the tomb are: the bottommost layer, the ground level layer, the Panchuk (rammed earth) layer of the Baekje, the layer created by a grave robbery, and soil recovered during the Japanese colonial period. Soil samples were obtained by segmenting an easy stratigraphic horizon into sub categorized soil layers, and their material properties were analyzed; they are composed mainly of sandy loam based on the particle size distributions. In the site foundation, loamy sand is packed in the bottommost layer, and sandy loam with high sand and silty sand fills most of the overlying layer. The central and topmost portion of the Baekje layer is composed of loam with high clay content. All soil layers show geochemical behaviors similar to those of the bottommost layer. X-ray diffraction analysis verified kaolinite in all layers, also observed in soil layers displaying high crystallinity. Kaolinite and halloysite were identified by scanning electron microscopy. Thus, we conclude that the Baekje layer of the Sowangneung is composed of sandy loam containing kaolin procured from near the site. An impermeable middle to upper layer was created using viscous loam. The top of the tomb was closed tightly.

• Journal of Conservation Science
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• v.37 no.6
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• pp.807-820
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• 2021

A study on the Joseon Dynasty's furnace walls, excavated from south Korea, was conducted to identify the correlations and differences of the furnace walls found in Jeolla and Gyeongsang regions. Three ruins in the Jeolla region and two in the Gyeongsang region were selected for the analysis. The results showed a layer change depending on the degree of plasticity and difference in the number of layers and particle phase. Furthermore, although the temperature to be subjected to heat was divided into 1300℃ and 1100℃, it was not a phenomenon that appeared according to the region. Additionally, analysis result of major components revealed that the TiO₂ content of most samples does not exceed 1wt%, This means that the furnace did not smelt iron sand or smelted it into low-titanium sand. This study indicated a slight similarity between the furnace walls found in the two regions, and the correlation was determined based on the nature of the ruins, raw materials of the metals ores, and composition of the raw materials constituting the furnace walls.

• Journal of Conservation Science
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• v.37 no.6
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• pp.778-790
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• 2021

The Stone Seated Buddha Triad and Stone Standing Buddha in Bijung-ri are state-designated heritage (treasure) statues having the Buddha style of the Goryeo dynasty from the 6th century. Conservation scientific investigations were conducted to understand the preservation status of these stone Buddha statues and to establish a conservation plan. The Stone Seated Buddha Triad and Stone Standing Buddha are composed of fine-medium grained biotite granite, which is considered to be of the same origin owing to their low magnetic susceptibility distribution of less than 0.2 (×10^-3 SI unit) and similar mineral characteristics. The Stone Seated Buddha Triad has highly homogenous mineral composition and particle size, whole-rock magnetic susceptibility, and geochemical characteristics very similar to those of the nearby outcrop. It was confirmed that a combination of physical, chemical, and biological factors affects the Stone Buddha statues. In particular, both the Stone Seated Buddha Triad and Stone Standing Buddha tend to be chipped off from the front and cracked and scaled from the back. The Stone Standing Buddha located outdoors experiences granularity decomposition and black algae formation, which accelerate the weathering under unfavorable conservation environments. The result of non-destructive physical property diagnosis using ultrasonic velocity showed that both the Stone Seated Buddha Triad and Stone Standing Buddha have been completely weathered (CW), indicating very poor physical properties.