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Mitral Valve Reconstruction in Patients with Moderate to Severe Left Ventricular Dysfunction (중등도 이상의 좌심기능부전 환자에서 승모판성형술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Sae;Kim, Woong-Han;Whang, Sung-Wook;Kim, Soo-Cheol;Lim, Cheong;Kim, Wook-Sung;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.812-819
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    • 2003
  • Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.

Behavioral Response of the Western Flower Thrips Frankliniella occidentalis (Thysanoptera: Thripidae) to Different Chrysanthemum Flower Colors (국화 화색별 꽃노랑총채벌레의 행동반응)

  • Choi, Yong-Seok;Whang, In-Su;Park, Deog-Gee;Lee, Jun-Seok;Ham, Eun-Hye;Choe, Kwang-Ryul
    • Korean journal of applied entomology
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    • v.53 no.1
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    • pp.65-71
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    • 2014
  • Frankliniella occidentalis is attracted to flowers and is a major pest of chrysanthemums. Even when some chrysanthemum plants are not flowering, the ones that have already flowered attract F. occidentalis. Therefore, we investigated the efficacy of chrysanthemum as a trap plant that attract F. occidentalis by using an olfactometer. The numbers of F. occidentalis collected from the flowers of pink, wihte and yellow standard chrysanthemums on a tray with wet paper during the flowering period were 18.4, 56.6, and 52.6 respectively; the numbers of F. occidentalis collected from leaves were 7.8, 16.6, and 15.4 respectively. the numbers of F. occidentalis collected from the buds of pink, white and yellow standard chrysanthemums were 15.2, 45.8, and 41.6 respectively; the numbers of F. occidentalis collected from the leaves were 2, 8.8 and 3.4 respectively. In the Y-tube olfactometer test, the number of F. occidentalis attracted to the 2-way arms of the Y-tube was not significantly different for the yellow, red, violet and white flowers. In the four-choice olfactometer test, when the same visual cues and odor cues were provided, the frequency of F. occidentalis was higher in the yellow (10.7) flowers than in the red (1.3), violet (3.7) and white (2.0) flowers. When visual cues with disturbed odor cues, F. occidentalis preferred yellow (10.0) color over red (3.3), violet (1.3) and white (3.0) colors. When the same visual and odor cues, except for yellow visual cues, were provided, F. occidentalis preferred white (8.3) color over red (4.7), violet (4.7) and yellow (2.0) colors. Therefore, F. occidentalis were attracted to buds before the flowering of chrysanthemum plants and attracted to yellow flowers after the flowering.

Host Preference of Ricania spp. (Hemiptera: Ricaniidae) at Different Developmental Stages (갈색날개매미충의 발육단계별 기주선호성)

  • Choi, Yong-Seok;Seo, Hwa-Young;Jo, Shin-Hyuk;Whang, In-Su;Lee, Young-Su;Park, Deog-Kee
    • Korean journal of applied entomology
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    • v.56 no.4
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    • pp.319-329
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    • 2017
  • We investigated the host preference of Ricania app. at different developmental stages to select the effective control methods. Ricania spp. at different developmental stages preferred different host plants. During the nymphal period, individuals moved to the bottom due to environmental factors such as wind and rain, rather than inhabiting trees, and fed on various plants ranging from 1 year-old herbaceous plants to shrubs. Especially, at Palbong Mt. in Gonju, Ricania spp. nymphs preferred Symplocos chinensis f. pilosa, Celastrus orbiculatus, Euonymus alatus, Kalopanax septemlobus, Aralia elata, Styrax japonicas, Rubus parvifolius, Ru. coreanus, Ru. crataegifolius, Quercus acutissima, Cornus officinalis, Lespedeza bicolor, Albizia julibrissin, L. maximowiczii, Rhododendron schlippenbachii and Rh. indicum. At Yongbong Mt. in Hongseong, Ricania spp. adults preferred herbaceous plants, such as Helianthus annuus, Solanum nigrum, and Oenothera biennis rather than trees during the pre-oviposition stage. Subsequently, as the oviposition season began, Ricania spp. adults were rarely found in H. annuus, S. nigrum, or O. biennis and appeared to migrate to the perennial trees and shrubs hosts to lay eggs. At Palbong Mt., the main laying hosts of Ricania spp. adults were Weigela subsessilis, Ailanthus altissima, Q. aliena, Boehmeria platanifolia, Diospyros lotus, Ziziphus jujubae var. inermis, St. japonicus, Prunus mume, P. serrulata var. spontanea, Spiraea prunifolia f. simpliciflora, Ru. crataegifolius, Salix koreensis, Ru. yedoense f. poukhanense, and Co. controversa. The degree of egg laying, number of egg masses and adult Ricania spp. were significantly higher in sunlit areas than in shaded areas, in addition, the lower the altitude, the more adults were present. This study contributes toward the development of traps that can attract and control Ricania spp. and reduce the density of Ricania spp. that disturb the ecosystem.

The Relationships between Mathematically Gifted Students and Regular Students in Perfectionism and the Affective Traits (중등 영재학생과 일반학생의 완벽주의 성향과 수학교과에 대한 정의적 특성과의 관계)

  • Whang, Woo-Hyung;Lee, Yu-Na
    • Communications of Mathematical Education
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    • v.23 no.1
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    • pp.1-38
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    • 2009
  • This study investigates the relationships of perfectionism and the affective traits(academic self-concept, learning attitude, interest, mathematical anxiety, learning habits) in mathematics between the gifted students and the regular students in Korean Middle Schools. The findings of this study can be used for the understanding of the gifted students, and as data or resources for counsellors when they advise the gifted students on enhancing study strategies and developing future courses. This study was investigated by measuring the relationships between perfectionism and the affective traits on mathematics between two groups. Here, the correlation analysis, t-test, and regression analysis of the SPSS for Window 12.0 Program were applied to measure the differences of both groups. Therefore, there were no differences in perfectionism between the gifted students and the regular students. But the self-oriented perfectionism of the gifted students appeared higher compare with regular students. The affective traits in mathematics of the gifted students appeared more positive compare with regular students. There were a few correlations between the perfectionism and the affective traits in mathematics at two group all. however the self-oriented perfectionism and the affective traits in mathematics showed to correlation. There were several suggestions based on the results of this study. First, the results showed that professional assistance is needed for the gifted students so that their perfectionism flows positively into developing their gifts. Secondly, the results suggested that specialized mathematical program reflecting on the affective traits of the gifted students in mathematics should be offered.Lastly, tthe results of this study suggested a researcher regarding relevance with perfectionism and affective traits regarding subject shall be performed more. The result of research shall be included to contents of training for the gifted students and their parents.

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A Study on Evaluation of Visual Factor for Measuring Subjective Virtual Realization (주관적인 가상 실감화 측정 방법에 대한 시각적 요소 평가 연구)

  • Won, Myeung-Ju;Park, Sang-In;Kim, Chi-Jung;Lee, Eui-Chul;Whang, Min-Cheol
    • Science of Emotion and Sensibility
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    • v.15 no.3
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    • pp.389-398
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    • 2012
  • Virtual worlds have pursued reality as if they actually exist. In order to evaluate the sense of reality in the computer-simulated worlds, several subjective questionnaires, which include specific independent variables, have been proposed in the literature. However, the questionnaires lack reliability and validity necessary for defining and measuring the virtual realization. Few studies have been conducted to investigate the effect of visual factors on the sense of reality experienced by exposing to a virtual environment. Therefore, this study was aimed at reinvestigating the variables and proposing a more reliable and advisable questionnaire for evaluating the virtual realization, focusing on visual factors. Twenty-one questions were gleaned from the literature and subjective interviews with focused groups. Exploratory factor analysis with oblique rotation was performed on the data obtained from 200 participants(females: 100) after exposing to a virtual character image described in an extreme way. After removing poorly loading items, remained subsets were subjected to confirmatory factor analysis on the data obtained from the same participants. As a result, 3 significant factors were determined to efficiently measure the virtual realization. The determined factors included visual presence(3 subset items), visual immersion(7 subset items), and visual interactivity(4 subset items). The proposed factors were verified by conducting a subjective evaluation in which participants were asked to evaluate a 3D virtual eyeball model based on the visual presence. The results implicated that the measurement method was suitable for evaluating the degree of the virtual realization. The proposed method is expected to reasonably measure the degree of the virtual realization.

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A study for diagnosis and pattern identification of Hwa-Byung (화병의 진단 및 변증유형에 관한 연구)

  • Lee, Hui-Young;Park, Jong-Hoon;Whang, Wei-Wan;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.1
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    • pp.1-17
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    • 2005
  • Objective : This empirical research is performed to recognize diagnostic concept, pattern identification, and clinical features of Hwa-byung. In other words, the aims of this research are to examine the differences of the diagnosis between Hwa-Byung and the other psychiatric disorders, and to find out pattern identification, and clinical characteristics of Hwa-Byung for prescriptions of this syndrome. Method : In the experiment, there were participated 30 patients who were met for our criterions according to HBDIS (Hwa-Byung Diagnostic interview Schedule). These patients were diagnosed as Axis1 according to criterions of DSM-IV with administering SCID-I. OMS-prime was utilized for finding out pattern identification of oriental medicine. Symptom Check List-90-Revision(SCL-90-R), Hemilton rating Scale for Depression(HRSD), Heart Rate Variability(HRV), and Digital Infrared Thermographic imaging(D.I.T.I.) were also utilized to discover clinical characteristics of Hwa-Byung Patients. Results : 1. Regarding Sex-ratio, male subjects were 3(10%), and female subjects are 27(90%). The age of subjects ranged from 22 year old to 75 $(51.87{\pm}11.04;\:Mean{\pm}SD)$ 2. In the results of diagnosis on the basis of DSM-IV, the 17(56.67%) patients were MOD (Major Depressive Disorder), the 5(16.67%) patients were USD (Undifferentiated Somatoform Disorder), the 4(13.33%) patients were Dysthymic Disorder, the 3(10%) patients were GAD (Generalized Anxiety Disorder), and the 1(3.33%) was Panic Disorder. Two of the patients who diagnosed as MOD were diagnosed as Panic Disorder too, and one of them was diagnosed as Pain Disorder too. 3. Regarding pattern identification, Hwa-Byung is positively correlated to deficiency of Heart(心). and then to stagnancy of Liver-Gall bladder. Hwa-Byung is correlated deficiency symptom-complex rather than excessiveness symptom-complex. That is also correlated positively to Pathological heat and fire. 4. In SCL90-R, the mean of PSDI was $(75.3{\pm}10.7;\:Mean{\pm}SD)$. The each mean of the other 11 factors was distributed between50-70. 5. The mean of HRSD was $(17.9{\pm}5.6;\:Mean{\pm}SD)$ in the entire subject's group. Then the group of MDD was $20.9{\pm}4.4$ and the group of USD was $12.0{\pm}4.8$ 6. In the results of HRV. the mean of TP is $972.4{\pm}1174(Mean{\pm}SD)$, this is lower than normal range 1000-200. The other factors were within normal range. Then, there were no significant differences between them (p<0.05). 7. The temperatures of each acupoint have significant differences between HNl(印堂) and PC6(內關), between CV17(顫中) and PC6(內關), between HN1(印堂) and CV8(神闕), between CV17(顫中) and CV8(神闕) in comparison with the average of body temperature in the use of D.I.T.I. (p<0.01) 8. In the analysis of correlation between SCL-90-R, HRSD, HRV. and D.I.T.I. there were no significant results. According to results that the correlation was analyzed with only the MDD group as subjects, there was negative correlation between RMSSD of HRV and HRSD, between LF of HRV and PDSIof SCL-90-R, and between LF/HF of HRV and ANX, PSY, and PDSI of SCL-90-R. Conclusion : In the observation of clinical features of 30 cases of Hwa-Byung patients by using diverse structured tests, there could make diverse diagnosis as depressive disorder, anxiety disorder, and Somatoform Disorder. Particularly. MDD was highly distributed. Considering oriental medicine's pattern identification of Hwa-Byung, this syndrome is related strongly to Heart, and there were demonstrated deficiency symptom-complex, and Pathological heat and fire. One of the limits of this study is lack of control subject's group, therefore, in the future study, it requires reexamination through a comparative research with these data to complete this study.

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Adaptive Lock Escalation in Database Management Systems (데이타베이스 관리 시스템에서의 적응형 로크 상승)

  • Chang, Ji-Woong;Lee, Young-Koo;Whang, Kyu-Young;Yang, Jae-Heon
    • Journal of KIISE:Databases
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    • v.28 no.4
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    • pp.742-757
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    • 2001
  • Since database management systems(DBMSS) have limited lock resources, transactions requesting locks beyond the limit mutt be aborted. In the worst carte, if such transactions are aborted repeatedly, the DBMS can become paralyzed, i.e., transaction execute but cannot commit. Lock escalation is considered a solution to this problem. However, existing lock escalation methods do not provide a complete solution. In this paper, we prognose a new lock escalation method, adaptive lock escalation, that selves most of the problems. First, we propose a general model for lock escalation and present the concept of the unescalatable look, which is the major cause making the transactions to abort. Second, we propose the notions of semi lock escalation, lock blocking, and selective relief as the mechanisms to control the number of unescalatable locks. We then propose the adaptive lock escalation method using these notions. Adaptive lock escalation reduces needless aborts and guarantees that the DBMS is not paralyzed under excessive lock requests. It also allows graceful degradation of performance under those circumstances. Third, through extensive simulation, we show that adaptive lock escalation outperforms existing lock escalation methods. The results show that, compared to the existing methods, adaptive lock escalation reduces the number of aborts and the average response time, and increases the throughput to a great extent. Especially, it is shown that the number of concurrent transactions can be increased more than 16 ~256 fold. The contribution of this paper is significant in that it has formally analysed the role of lock escalation in lock resource management and identified the detailed underlying mechanisms. Existing lock escalation methods rely on users or system administrator to handle the problems of excessive lock requests. In contrast, adaptive lock escalation releases the users of this responsibility by providing graceful degradation and preventing system paralysis through automatic control of unescalatable locks Thus adaptive lock escalation can contribute to developing self-tuning: DBMSS that draw a lot of attention these days.

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Clinical Characteristics and Prognosis of Fuchs Dystrophy According to COL8A2 Gene Mutation Status (COL8A2 유전자 돌연변이 유무에 따른 푹스이상증의 임상적 특징 및 예후)

  • Kim, Hyun-Ah;Whang, Woong-Joo;Lee, Jee Hye;Chae, Hyojin;Kim, Myungshin;Kim, Man Soo
    • Journal of The Korean Ophthalmological Society
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    • v.58 no.4
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    • pp.380-386
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    • 2017
  • Purpose: To compare the clinical characteristics and prognosis of Fuchs dystrophy patients according to COL8A2 gene mutation status. Methods: Eighty-one patients (162 eyes) initially diagnosed with Fuchs dystrophy from 1996 to 2015 were divided into two groups according to COL8A2 gene mutation status. Retrospective analysis was performed comparing gender, age at diagnosis, presence of family history, diabetes mellitus, symptoms of blurred vision in the morning, changes in central corneal thickness and endothelial cell density with time, need for corneal transplantation, and pre-operative corneal status in the two groups. Results: Of the 81 patients, 12 were shown to harbor a COL8A2 gene mutation. Individuals with mutation were significantly associated with presence of family history, diabetes mellitus, and blurred vision in the morning (p = 0.021, p = 0.024, p = 0.044, respectively). They also had significantly thicker central cornea and lower endothelial cell density at the time of diagnosis (p = 0.020, p = 0.005, respectively). The differences in central corneal thickness and endothelial cell density between the two eyes in one patient were significantly smaller in patients with gene mutation (p = 0.043, p = 0.022, respectively). Over a 5-year follow-up period, 60.0% of eyes in patients with gene mutation and 19.2% of eyes in patients without gene mutation underwent corneal transplantation, a significant difference between the two groups (p = 0.014). Conclusions: By testing for COL8A2 gene mutation, early binocular disease progression and the possible need for corneal transplantation in the future can be predicted among patients diagnosed with Fuchs dystrophy.

Outcomes of Combined Mitral Valve Repair and Aortic Valve Replacement (대동맥판막 치환술과 동반시행한 승모판막 성형술 결과)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Soo-Cheol;Lim, Cheong;Kim, Wook-Sung;Lee, Young-Tak;Choi, Hyun-Seok;Moon, Hyun-Soo;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.463-471
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    • 2003
  • The long-term results of combined mitral valve repair and aortic valve replacement (AVR) have not been well evaluated. This study was performed to investigate the early and long-term results of mitral valve repair with AVR. Material and Method: We retrospectively reviewed 45 patients who underwent mitral valve repair and AVR between September 1990 and April 2002. The average age was 47 years: 28 were men and 17 women. Twelve patients had atrial fibrillation and three had a previous cardiac operation. The mitral valve disease consisted of pure insufficiency (MR) in 34 patients, mitral stenosis (MS) in 3, and mixed lesion in 8. Mitral valve disease was due to rheumatic origin in 24 patients, degenerative in 11, annular dilatation in 8, and ischemia or endocarditis in 2. The functional anatomy of mitral valve was annular dilatation in 31 patients, chordal elongation in 19, leaflet thickening in 19, commissural fusion in 13, chordal fusion in 10, chordal rupture in 6, and so on. Aortic prostheses used included mechanical valve in 32 patients, tissue valve in 12, and pulmonary autograft in one. The techniques of mitral valve repair included annuloplasty in 32 patients and various valvuloplasty of 54 techniques in 29 patients. Total cardiopulmonary bypass and aortic cross clamp time were 204$\pm$62 minute and 153$\pm$57 minutes, respectively. Result: Early death was in one patient due to low output syndrome (2.2%). After follow up of 57$\pm$37 months, late death was in one patient and the actuarial survival at 10 years was 96$\pm$4%. Recurrent MR developed grade II or III in 11 patients and moderate MS in 3. Three patients required reoperation for valve-related complications. The actuarial freedom from recurrent MR, MS, and reoperation were 64$\pm$11%, 86$\pm$8%, and 89$\pm$7% respectively. Conclusion: Combined mitral valve repair with AVR offers good early and long-term survival, and adequate techniques and selection of indication of mitral valve repair, especially in rheumatic disease, are prerequisites for better long-term results.

Immediate Reoperation for Failed Mitral Valve Repair (승모판막성형술 실패 직후에 시행한 재수술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Wook-Sung;Lee, Young-Tak;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.929-936
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    • 2003
  • We analysed the surgical outcomes of immediate reoperations after mitral valve repair. Material and Method: Eighteen patients who underwent immediate reoperation for failed mitral valve repair from April 1995 through July 2001 were reviewed retrospectively. There were 13 female patients. The mitral valve disease was regurgitation (MR) in 12 patients, stenosis (MS) in 3, and mixed lesion in 3. The etiologies of the valve disease were rheumatic in 9 patients, degenerative in 8, and endocarditis in 1. The causes of reoperation was residual MR in 13 patients, residual MS in 4, and rupture of left ventricle in 1. Fourteen patients had rerepair for residual mitral lesions (77.8%) and four underwent replacement. Result: There was no early death. After mean follow-vp of 33 months, there was one late death. Echocardiography revealed no or grade 1 of MR (64.3%) in 9 patients and no or mild MS in 11 patients (78,6%). Reoperation was done in one patient. The cumulative survival and freedom from valve-related reoperation at 6 years were 94% and 90%, respectively. The cumulative freedom from recurrent MR and MS at 4 years were 56% and 44%, respectively. Conclusion: This study suggests that immediate reoperation for failed mitral valve repair offers good early and intermediate survival, and mitral valve rerepair can be successfully performed in most of patients. However, because mitral rerepair have high failure rate, especially in rheumatic valve disease, adequate selections of valvuloplasty technique and indication are important to reduce the failure rate of mitral rerepair.