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A Clinical Study of the Acute Respiratory Distress Syndrome in Children (소아에서의 급성 호흡 곤란 증후군에 대한 임상적 고찰)

  • Lee, Taek Jin;Kim, Dong Soo;Shin, Dong Hwan
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.42-50
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    • 2003
  • Purpose : The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. Methods : Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994. Results : A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune compromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, $PaO_2$, $PaCO_2$, PEEP, and $PaO_2/FiO_2$ on the seventh day after the onset of the ARDS. Conclusion : According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.

Mucilage Separation of Korean Yam Using Microparticulation/Air Classification Process (초미세분쇄/공기분급을 이용한 마의 점질물 분리)

  • Lee, Boo-Yong;Park, Dong-June;Ku, Kyung-Hyung;Kim, Hyun-Ku;Mok, Chul-Kyoon
    • Korean Journal of Food Science and Technology
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    • v.26 no.5
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    • pp.596-602
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    • 1994
  • To separate and concentrate mucilage from yam(Dioscorea batatas DECNE), yam was dried, microparticulated using impact mill and air-classified at different air classifying wheel speed(ACWS) in classifier. As ACWS increased from 5,000 rpm to 22,500 rpm, the contents of dietary fiber, protein and lipid of air classified microparticles(ACM) increased remarkably. Especially the ACM with ACWS over 15,000 rpm showed 36.41% dietary fiber and 16.66% protein. The dietary fiber and protein components were concentrated to $2.5{\sim}9.0$ times as compared with whole yam powder. Concomitantly the non-fibrous carbohydrate decreased from 88.31% to 16.84. The damaged starch(%), WSI and WAI of ACM of ACWS over 15,000 rpm were $1.5{\sim}3.0$ times higher than those of ACM under ACWS 15,000 rpm. The apparent viscosity of ACM was 0.0800 Pa s over ACWS 15,000 rpm and 0.0080 Pa s under ACWS 15,000 rpm. Judging from viscosity of ACM, the mucilage component of yam was concentrated to 10 times. In conclusion, the optimum process to separate and concentrate the mucilage from yam consisted of the microparticulation to $5{\sim}30{\mu}m$ and the air-classification at ACWS over 15,000 rpm.

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The National Survey of Open Lung Biopsy and Thoracoscopic Lung Biopsy in Korea (개흉 및 흉강경항폐생검의 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.5-19
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    • 1998
  • Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.

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Long-Term Effects of ACE Inhibitors in Post-Tuberculosis Emphysema

  • Kim, Myung-A;Lee, Chang-Hoon;Kim, Deog-Kyeom;Chung, Hee-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.418-425
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    • 2010
  • Background: Little is known about the long-term effects of angiotensin-converting enzyme (ACE) treatment on post-tuberculosis emphysema. This study evaluated the effects of ACE inhibition on cardiac function and gas exchange in patients with post-tuberculosis emphysema. Methods: At baseline and at 6 months after initiation of ACE inhibition therapy, patients underwent pulmonary function testing, arterial blood gas analysis, and echocardiography, both at rest and post exercise. Cardiac output (CO) and right ventricular ejection fraction (RVEF) were measured at those time points as well. Results: After ACE inhibition; resting and post-exercise RVEF ($Mean{\pm}SEM,\;61.5{\pm}1.0,\;67.6{\pm}1.2%$, respectively) were higher than at baseline ($56.9{\pm}1.2,\;53.5{\pm}1.7%$). Resting and post-exercise CO ($6.37{\pm}0.24,\;8.27{\pm}0.34L/min$) were higher than at baseline ($5.42{\pm}0.22,\;6.72{\pm}0.24L/min$). Resting and post-exercise $PaO_2$ ($83.8{\pm}1.6,\;74.0{\pm}1.2mmHg$, respectively) were also higher than at baseline ($74.2{\pm}1.9,\;66.6{\pm}1.6mmHg$). Post-exercise $PaCO_2$($46.3{\pm}1.1mmHg$) was higher than at baseline ($44.9{\pm}1.1;\; Resting\;42.8{\pm}0.8\;vs.\;42.4{\pm}0.9mmHg$). Resting and post-exercise A-a $O_2$ gradient ($12.4{\pm}1.4,\;17.8{\pm}1.5 mmHg$) were lower than at baseline ($22.5{\pm}1.5,\;26.9{\pm}1.6mmHg$). Conclusion: In post-tuberculosis emphysema, RVEF and CO were augmented with a resultant increase in peripheral oxygen delivery after ACE inhibition. These findings suggest that an ACE inhibitor may have the potential to alleviate co-morbid cardiac conditions and benefit the patients with post-tuberculosis emphysema.

Effects of PEG (Polyethylene Glycol) Concentration and Mixing Ratio of PEG/Gly (Glycerol) on the Physical Properties of Silk Fibroin Films (PEG(polyethylene glycol) 농도와 PEG/Gly(glycerol) 흔합비에 따른 견 피브로인 필름의 물성)

  • Ma, Yu-Hyun;Song, Kyung-Bin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.1
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    • pp.121-125
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    • 2006
  • To study the effects of plasticizer concentration and its ratio on the physical properties of silk fibroin films, polyethylene glycol (PEG) was used at 4 different concentrations; 1, 2, 3, $4.5\%$ (w/v). Tensile strength (TS) and water vapor permeability (WVP) increased with the increase of PEG concentration, while opposite trend was observed for percent elongation of silk fibroin films. WVP of silk fibroin films increased from $2.54\;ng{\cdot}m/m^2spa$ for $1\%$ of PEG to $5.41\;ng{\cdot}m/m^2sPa$ for $4.5\%$. In addition, a mixture of PEG and glycerol (Gly) as a plasticizer was used at the ratio of 100:0, 75:25, 50:50, 25:75, and 0:100 (w/w). Percent elongation of the films was improved to $130.95\%$ when the ratio of 75:25 was used. On the contrary, WVP of silk fibroin films increased with the decrease of the ratio of PEG:Gly. Effect of the plasticizer concentration and its ratio on the color of silk fibroin films was negligible. These results suggest that mixture of PEG and Gly as a plasticizer provide more flexible than PEG alone in silk fibroin films, and the best ratio of PEG to Gly was 75:25.

Mathematical Description of Soil Loss by Runoff at Inclined Upland of Maize Cultivation (옥수수 재배 경사지 밭에서 물 유출에 따른 토양유실 예측 공식)

  • Hur, Seung-Oh;Jung, Kang-Ho;Ha, Sang-Keon;Kwak, Han-Kang;Kim, Jeong-Gyu
    • Korean Journal of Soil Science and Fertilizer
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    • v.38 no.2
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    • pp.66-71
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    • 2005
  • Soil loss into stream and river by runoff shall be considered for non-point source pollution management as national land conservation. The purpose of this study was to develop the mathematical equation to predict soil loss from inclined uplands of maize cultivation due to the runoff by rainfall which mainly converges on July and August. Soil loss was concentrated on May because of low canopy over an entire field in 2002 and on June and July because of heavy rainfall in 2003. By regression analysis the relation between runoff and soil loss can be represented by a linear equation of y =1.5291x - 3.4933, where y is runoff ($Mg\;ha^{-1}$) and x is soil loss ($kg\;ha^{-1}$). The determination coefficient of this equation was 0.839 (P<0.001). Therefore, the mathematical equation derived from the practical experiment at the inclined upland can be applicable to predict soil loss accompanied by runoff due to periodic rainfall converging on short periods within a couple of months.

Role of Neurosurgeons in the Treatment of Acute Ischemic Stroke in the Emergency Room

  • Sang Hyuk, Lee;Taek Min, Nam;Ji Hwan, Jang;Young Zoon, Kim;Kyu Hong, Kim;Kyeong Hwa, Ryu;Do-Hyung, Kim;Byung Soo, Kwan;Hyungon, Lee;Seung Hwan, Kim
    • Journal of Korean Neurosurgical Society
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    • v.66 no.1
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    • pp.24-32
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    • 2023
  • Objective : With the recent increase in mechanical thrombectomy (MT) for acute ischemic stroke (AIS), the role of neurosurgeons in AIS treatment has become increasingly important. This study aimed to assess the outcomes of patients with AIS treated by neurosurgeons and neurologists in the emergency room (ER) of a tertiary hospital in South Korea. Methods : From January 2020 to June 2021, 536 patients with AIS within 24 hours of symptom onset were admitted to our hospital via the ER. Based on the type of doctors who provided initial care for AIS in the ER, patients were divided into two groups : (a) neurosurgeon group (n=119, 22.2%) and (b) neurologist group (n=417, 77.8%). Results : Intravenous tissue plasminogen activator (tPA) was administered in 82 (15.3%) of 536 patients (n=17 [14.3%] in the neurosurgeon group and n=65 [15.6%] in the neurologist group). The door-to-tPA time was not significantly different between both groups (median, 53 minutes; interquartile range [IQR], 45-58 vs. median, 54 minutes; IQR, 46-74; p=0.372). MT was performed in 69 patients (12.9%) (n=25, 36.2% in the neurosurgeon group and n=44, 63.8% in the neurologist group). The neurosurgeon group achieved a shorter door-to-puncture time than the neurologist group (median, 115 minutes; IQR, 107-151 vs. median, 162 minutes; IQR, 117-189; p=0.049). Good clinical outcomes (3-month modified Rankin Scale 0-2) did not differ significantly between the two groups (96/119 [80.7%] vs. 322/417 [77.2%], p=0.454). Conclusion : The neurosurgeon group showed similar door-to-treatment time and clinical outcomes to the neurologist group in patients with AIS in the ER. This study suggests that neurosurgeons have comparable abilities to care for patients with AIS in the ER.

National Survey of Sarcoidosis in Korea (유육종증 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.453-473
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    • 1992
  • Background: National survey was performed to estimate the incidence of sarcoidosis in Korea. The clinical data of confirmed cases were analysed for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1991 to December 1992. Data were retrospectively collected by correspondence with physicians in departments of internal medicine, dermatology, ophthalmology and neurology of the hospitals having more than 100 beds using returning postcards. In confirmed and suspicious cases of sardoidosis, case record chart for clinical and laboratory findings were obtained in detail. Results: 1) Postcards were sent to 523 departments in 213 hospitals. Internal medicine composed 41%, dermatology 20%, ophthalmology 20% and neurology 19%. 2) Postcards were returned from 241 departments (replying rates was 48%). 3) There were 113 confirmed cases from 50 departments and 10 cases. The cases were composed from internal medicine (81%), dermatology (13%), ophthalmology (3%) and neurology (3%). 78 confirmed cases were analysed, which were composed from department of internal medicine (92%), dermatology (5%), and neurology (3%). 4) The time span for analysed cases was 1980 to 1992. one case was analysed in 1980 and the number gradually increased to 18 cases in 1991. 5) The majority of patients (84.4%) were in the age group of 20 to 49 years. 6) The ratio of male to female was 1 : 1.5. 7) The most common chief complains were respiratory symptoms, dermatologic symptoms, generalized discomforts, visual changes, arthralgia, abdominal pains, and swallowing difficulties in order. 16% of the patients were asymptomatic. 8) Mean duration between symptom onset and diagnosis was 2 months. 9) The most common symptoms were respiratory, general, dermatologic, ophthalmologic, neurologic and cardiac origin in order. 10) Hemoglobin, hematocrits and platelet were in normal range. 58% of the patients had lymphopenia measuring less than 30% of white cell count. The ratio of CD4 to CD8 lymphocytes was $1.73{\pm}1.16$ with range of 0.43 to 4.62. ESR was elevated in 43% of the cases. 11) Blood chemistry was normal in most cases. Serum angiotensin converting enzyme (S-ACE) was $66.8{\pm}58.6\;U/L$ with the range of 8.79 to 265 U /L. Proteinuria of more than 150 mg was found in 42. 9% of the patients. 12) Serum IgG was elevated in 43.5%, IgA in 45.5%, IgM in 59.1% and IgE in 46.7%. The levels of complement C3 and C4 were in the normal range. Anti-nuclear antibody was detected in 11% of the cases. Kweim test was performed in 3 cases, and in all cases the result was positive. 13) FVC was decreased in 17.3%, FEV1 in 11.5%, FEV1/FVC in 10%, TLC in 15.2%, and DLco in 64.7%. 14) PaO2 was decreased below 90 mmHg in 48.6% and PaCO2 was increased above 45 mmHg in 5.7%. 15) The percentage of macrophages in BAL fluid was $51.4{\pm}19.2%$, lymphocytes $44.4{\pm}21.1%$, and the ratio of CD4 to CD8 lymphocytes was $3.41{\pm}2.07$. 16) There was no difference in laboratory findings between male and female. 17) Hilar enlargement on chest PA was present in 87.9% (bilaterally in 78.8% and unilaterally in 9.1%). 18) According to Siltzbach's classification, stage 0 was 5%, stage 158.3%, stage 228.3%, and stage 38.3%. 19) Hilart enlargement on chest CT was present in 92.6% (bilaterally 76.4% and unilaterally in 16.2%). 20) HRCT was done in 16 cases. The most common findings were nodules, interlobular thickening, focal patchy infiltrations in order. Two cases was normal finding. 21) Other radiologic examinations showed bone change in one case and splenomegaly in two cases. 22) Gallium scan was done in 12 cases. Radioactivity was increased in hilar and mediastinal lymph nodes in 8 cases and in parenchyme in 2 cases. 23) The pathologic diagnosis was commonly performed by transbrochial lung biopsy (TBLB, 47.3%), skin and mediastinal lymph nodes biopsy (34.5%), peripheral lymph nodes biopsy (23.6%), open lung biopsy (18.2%) and bronchial biopsy in order. 24) The most common findings in pathology were non·caseating granuloma (100%), multi-nucleated giant cell (47.3%), hyalinized acellular scar (34.5%), reticulin fibrin network (20%), inclusion body (10.9%), necrosis (9.1%), and lymphangitic distribution of granuloma (1.8%) in order. Conclusion: Clinical, laboratory, radiologic and pathologic findings were summarized. This collected data will assist in finding a test for detection and staging of sarcoidosis in Korea in near future.

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Tuberculous Cervical Lymphadenitis (경부 결핵성 임파선염)

  • Kim Joong-Kyu;Lee Choong-Han
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.3-8
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    • 1995
  • Tuberculous cervical lymphadenitis is one of common cause of neck mass in young adult in Korea. Tuberculous cervical lymphadenitis known as scrofula was being treated by the 'Royal Touch' in the 5th century and by surgery in the 17th century, yet the principle of the treatment is still controversal. We report the clinical evaluation and therapeutic result about 121 tuberculous cervical lymphadenitis. The result were as follows: 1) The annual incidence(1985-1994) was 30.5 % (37 cases: 1985-1986), 17.7 % (21 cases: 1990-1992). 19.8%(24 cases: 1994). 2) The age of highest incidence was 20-29 year old age group in 41.3% (50 cases) and female predominated over male by 1.8 : 1. 3) The duration of disease was less than 6 months, in 85.9% (104 cases). 4) The most commonly involved LN group was superficial cervical group in 69.4% (84 cases), and difference between Rt & Lt, was not significant. 5) The most common symptom and local finding(P/E) were, painless swelling of LN in 74.3 % (90 cases) and single mass in 59.5 % (72 cases). 6) In seasonal variation, 85.9% (104 cases) was spring and summer. 7) Procedures except biopsy for evaluation were chest PA, AFB smear & culture(sputum), Mantoux test, USG, CT and, Associated extracervical tuberculous lesions were lung, axilla, breast. 8) In operation method (involving biopsy), Excision was 68.5 % (83 cases), neck dissection was 6.6% (8 cases). 9) The Modality, Duration and side effect of antituberculous medication: INH-Rifampin­Ethambutol was 66.1 % (88 cases), duration was 1 year in 84.3% (102 cases), side effects were severe GI trouble (24.8%), liver function damage (3.3%). 10) 3 cases recurred on the same site after 2 yrs(2 cases) and 4 months(1 case) and its treatment was curretage or I & D, with antituberculous medication.

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Spatial and temporal distribution of Wind Resources over Korea (한반도 바람자원의 시공간적 분포)

  • Kim, Do-Woo;Byun, Hi-Ryong
    • Atmosphere
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    • v.18 no.3
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    • pp.171-182
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    • 2008
  • In this study, we analyzed the spatial and temporal distribution of wind resources over Korea based on hourly observational data recorded over a period of 5 years from 457 stations belonging to Korea Meteorological Administration (KMA). The surface and 850 hPa wind data obtained from the Korea Local Analysis and Prediction System (KLAPS) and the Regional Data Assimilation and Prediction System (RDAPS) over a period of 1 year are used as supplementary data sources. Wind speed is generally high over seashores, mountains, and islands. In 62 (13.5%) stations, mean wind speeds for 5 years are greater than $3ms^{-1}$. The effects of seasonal wind, land-sea breeze, and mountain-valley winds on wind resources over Korea are evaluated as follows: First, wind is weak during summer, particularly over the Sobaek Mountains. However, over the coastal region of the Gyeongnam-province, strong southwesterly winds are observed during summer owing to monsoon currents. Second, the wind speed decreases during night-time, particularly over the west coast, where the direction of the land breeze is opposite to that of the large-scale westerlies. Third, winds are not always strong over seashores and highly elevated areas. The wind speed is weaker over the seashore of the Gyeonggi-province than over the other seashores. High wind speed has been observed only at 5 stations out of the 22 high-altitude stations. Detailed information on the wind resources conditions at the 21 stations (15 inland stations and 6 island stations) with high wind speed in Korea, such as the mean wind speed, frequency of wind speed available (WSA) for electricity generation, shape and scale parameters of Weibull distribution, constancy of wind direction, and wind power density (WPD), have also been provided. Among total stations in Korea, the best possible wind resources for electricity generation are available at Gosan in Jeju Island (mean wind speed: $7.77ms^{-1}$, WSA: 92.6%, WPD: $683.9Wm^{-2}$) and at Mt. Gudeok in Busan (mean wind speed: $5.66ms^{-1}$, WSA: 91.0%, WPD: $215.7Wm^{-2}$).