• Journal of Chest Surgery
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• v.12 no.3
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• pp.289-296
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.508-513
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• 2018

Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes $PaCO_2$ to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane. Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein. In a deeply sedated state, the average amount of pH of the entire patients was measured as $7.36{\pm}0.06$. The average amount of $PvCO_2$ of the entire patients was measured as $48.8{\pm}8.50mmHg$. The average amount of $HCO_3{^-}$ of the entire patients was measured as $27.2{\pm}3.0mmol/L$. In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.4
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• pp.78-95
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• 2023

Objectives: This study aims to analyze the results of the 2022 Gyeonggi-do Oriental Medicine Fertility Treatment Support Project, review the outcomes and satisfaction of Oriental Medicine fertility support initiatives, and propose progressive fertility treatment support strategies by comparing them with the results of the past three years. Methods: Total of 242 women and 205 spouses participated in the Korean Medicine fertility treatment support project, which encompassed herbal medicine, acupuncture, and counseling treatments over a 3-month period, followed by a 3-month post-treatment follow-up. Data pertaining to patients' general, demographic, and fertility-related characteristics were collected before treatment initiation. During treatment, information regarding the treatments administered by Korean medical doctors was recorded, along with post-treatment outcomes and satisfaction levels. Safety assessments included pre- and post-treatment blood tests and monitoring for adverse events. Results: Among the 242 female subjects, 209 successfully completed the treatment program. Of these, 35 (16.7%) achieved pregnancy, with 30 (15%) attaining pregnancy through herbal monotherapy. Out of the 35 pregnancies, 17 were maintained, while 10 resulted in miscarriage. Notably, 83.8% of patients expressed satisfaction with the treatment outcomes. An analysis spanning three years revealed a continuous increase in the average age of patients, surpassing 38 years in 2022, a critical point in fertility decline age. Additionally, there was a notable rise in the prevalence of patients with a history of gynecological issues, advanced spouse age, and semen abnormalities, which is assumed to have contributed to the decrease in the pregnancy success rate. Conclusions: This study compares the clinical results of the 2022 Gyeonggi-do Korean Medicine Fertility Treatment Support Project with those of the past three years. Based on these findings, recommendations are made to enhance the project, including stricter age criteria for patient selection, enhanced specialized treatment tools for medical doctors, and combining Korean Medicine treatment and medical assisted reproductive technologies, all aimed at increasing pregnancy success rates. These results provide a foundation for the development of fertility support projects and related policies.

• Geomechanics and Engineering
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• v.21 no.5
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• pp.433-445
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• 2020

The weakening and softening behavior of soft clay subjected to cyclic loading due to the build-up of excess pore water pressure is well-known. During the design stage of the foundation of highways and coastal high-rise buildings, it is important to study the mechanical behavior of marine soils under cyclic loading as they undergo greater settlement during cyclic loading than under static loading. Therefore, this research evaluates the cyclic stress-strain and shear strength of untreated and treated marine clay under the effects of wind, earthquake, and traffic loadings. A series of laboratory stress-controlled cyclic triaxial tests have been conducted on both untreated and treated marine clay using different effective confining pressures and a frequency of 0.5 and 1.0 Hz. In addition, treated samples were cured for 28 and 90 days and tested under a frequency of 2.0 Hz. The results revealed significant differences in the performance of treated marine clay samples than that of untreated samples under cyclic loading. The treated marine clay samples were able to stand up to 2000 loading cycles before failure, while untreated marine clay samples could not stand few loading cycles. The untreated marine clay displayed a higher permanent axial strain rate under cyclic loading than the treated clay due to the existence of new cementing compounds after the treatment with recycled tiles and low amount (2%) of cement. The effect of the effective confining pressure was found to be significant on untreated marine clay while its effect was not crucial for the treated samples cured for 90 days. Treated samples cured for 90 days performed better under cyclic loading than the ones cured for 28 days and this is due to the higher amount of cementitious compounds formed with time. The highest deformation was found at 0.5 Hz, which cannot be considered as a critical frequency since smaller frequencies were not used. Therefore, it is recommended to consider testing the treated marine clay using smaller frequencies than 0.5 Hz.

• Korean Journal of Construction Engineering and Management
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• v.16 no.4
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• pp.70-79
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• 2015

With the rise of the interest in a renewable system, the importance of the Life Cycle Cost Analysis(LCCA), an economic evaluation tool, has been increasing. However, there is an inevitable gap between a real cost and an estimation from LCCA because of the uncertainty of the external environment in real world. As the input variables in an analysis, such as a real discount rate and an energy cost, ares subject to change as time goes by, strategic decision on the current operating system is made depending on the real cost. Current economic evaluation approaches have treated only the fluctuation of input variables without consideration of the flexibility in operation, which has consequently led to the impairment on the reliability of LCCA. Therefore, new approach needs to be proposed to consider both the uncertainty of input variables and operational flexibility. To address this issue, the application of the Real Option to LCCA is presented in this study. Through a case analysis of LCCA of a solar heating system, the limits and current status of LCCA are identified. As a result, quantitative presentation of strategic decisions has been added in the new approach to implement the traditional approach.

• Journal of Environmental Health Sciences
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• v.42 no.1
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• pp.41-52
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• 2016

Objectives: Scrub typhus is one of the most prevalent vector-borne diseases. It is caused by Orientia tsutsugamushi, which is transmitted when people are bitten by infected chigger mites. This study aims at quantifying the association between the incidence of scrub typhus and meteorological factors in Jeollabuk-do Province over the period 2001-2015. Methods: Reported cases of scrub typhus were collected from the website of the Disease Web Statistical System supported by the Korea Centers for Disease Control and Prevention (KCDC). Simultaneous meteorological data, including temperature, rainfall, relative humidity, and sunshine duration were collected from the website of the National Climate Data Service System by the Korea Meteorological Administration. Correlation and regression analyses were applied to identify the association between the incidence of scrub typhus and meteorological factors. Results: The general epidemiological characteristics of scrub typhus in Jeollabuk-do Province were similar to those nationwide for sex, age, and geographical distribution. However, the annual incidence rate (i.e., cases per 100,000) of scrub typhus in Jeollabuk-do Province was approximately four times higher than all Korea's 0.9. The number of total cases was the highest proportion at 13.3% in Jeonbuk compared to other regions in Korea. The results of correlation analysis showed that there were significant correlations between annual cases of scrub typhus and monthly data for meteorological factors such as temperature and relative humidity in late spring and summer, especially in the case of temperature in May and June. The results of regression analysis showed that determining factors in the regression equation explaining the incidence of scrub typhus reached 46.2% and 43.5% in May and June. Using the regression equation, each 1oC rise in the monthly mean temperature in May or June may lead to an increase of 38 patients with scrub typhus compared to the annual mean of incidence cases in Jeollabuk-do Province. Conclusion: The result of our novel attempts provided rational evidence that meteorological factors are associated with the occurrence of scrub typhus in Jeollabuk-do. It should therefore be necessary to observe the trends and predict patterns of scrub typhus transmission in relation to global-scale climate change. Also, action is urgently needed in all areas, especially critical regions, toward taking steps to come up with preventive measures against scrub typhus transmission.

• The Korean Journal of Physiology
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• v.23 no.2
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• pp.277-289
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• 1989

The effects of noradrenaline on the contractile and electrical activities were investigated using the circular muscle strips with intact mucosa prepared from the antrum and fundus of guinea-pig stomach. Electrical responses of circular muscle cells were recorded using glass capillary microelectrodes filled with 3 M KCI. All experiments were performed in tris-buffered Tyrode solution which was aerated with 100% $O_2\;and\;kept\;at\;35^{\circ}C$. The results obtained were as follows: 1) The spontaneous contractions recorded from the antral and fundic circular muscle strips with intact mucosa were suppressed dose-dependently by the application of noradrenaline, whereas those recorded from the mucosa-free strips were potentiated in a dose-dependent manner. 2) The inhibitory influences on the contractile activities in the normal intact strips were developed via both ${\alpha}-adrenoceptors\;and\;{\beta}-adrenoceptors$, while the excitatory influences in the mucosa-free strips resulted from the strong excitatory effect via ${\alpha}-adrenoceptors$ and the weak inhibitory effect via ${\beta}-adrenoceptors$. 3) Noradrenaline produced hyperpolarization of membrane potential, and increased the amplitude and the maximum rate of rise of slow waves in the mucosa-free strips of antral and fundic circular muscle. 4) Apamin blocked the appearance of the component of initial suppression of spontaneous phasic contractions observed in the mucosa-free strips of antral circular muscle after the application of noradrenaline. 5) The inhibitory influences on the contractile activities in the normal strips with intact mucosa remained unaffected even in the strip with separate mucosa, in which mucosa and muscle layer were mechanically disconnected . From the above results, following conclusions could be made. (1) There are no regional differences between the effects of noradrenaline on the antral circular muscle and those on the fundic circular muscle. (2) Excitatory responses to noradrenaline observed in the mucosa-free strip result from the dominant ${\alpha}-excitatory$ and tile weak ${\beta}-inhibitory$ action of noradrenaline. (3) Inhibitory responses to noradrenaline in the normal strips with intact mucosa develop via both ${\alpha}-inhibitory\;and\;{\beta}-inhibitory$ actions.

• Journal of Mushroom
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• v.13 no.3
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• pp.250-255
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• 2015

In this study spent mushroom substrate has ingredient raising rice bed soil. spent mushroom substrates are organic content is 60.72% were nitrogen - phosphoric acid - potassium is 1.39 - 0.89 - 0.81% of the chemical characteristics determine. Post-harvested mushroom substrates of the stabilization process, the temperature of the 20 days time progress in the pH of the rise and fall of temperature down were germination index also 77, as identified, Spent mushroom substrate bed soil for raising rice Ingredient to take advantage of the 20 days or more stabilization process needed to be investigated. Rice seed germination characteristic is in the common bed soil for raising rice ingredients manufactured control group and the comparison in spent mushroom substrate is 10% or less of a mixed experimental population of the germination rate is 82% was more than average days to germination and germination energy, even a statistical significant difference is or control group than good level was ok. Growth initial also spent mushroom substrate is 10% or less of a mixed experimental population of shoot dry matter (top) and grave less than control group higher as confirmed spent mushroom substrates are bed soil for raising rice ingredients are likely to take advantage of the high, as was the judge.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.126-132
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• 2014

Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

• Journal of the Korean Geosynthetics Society
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• v.9 no.3
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• pp.87-93
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• 2010

The change of water level in reservoirs is an important factor causing failure of bank slopes, i.e. landslide. The water level of Three Gorges reservoir in China fluctuate between 145 m and 175 m, as a matter of flood control. During its normal operational state, the rate of water level fluctuation is supposed to range from 0.67 m/d to 3.0 m/d. Majiagou slope is located on the left bank of Zhaxi River, 2.1 km up from the outlet. Zhaxi River is a tributary of the Yangtze River within the Three Gorges area, of which the water level changes with the reservoir. At the back of Majiagou slope, a 20 m long and 3~10 cm wide fissure developed just after the reservoir water level rose from 95 m to 135 m in 2003. This big fissure was a full suggestion of potential failure of this slope. In this study, the pore water pressure files obtained from seepage analysis were used to evaluate the change in factor of safety (FS) with reservoir water level. Slope stability analyses then were carried out, with fully specified slip surface and limit equilibrium method. In the limit equilibrium analysis, the contribution of negative pore water pressure to shear strength was considered by the use of Fredlund's shear strength equation for unsaturated soils. On the base of the analyses, the change of FS with reservoir water level was interpreted in detail. It was found that FS against bank slopes decreases with the rise of the reservoir water level and increases with the drawdown of the reservoir water level. The most dangerous state was when the reservoir water level stays at the highest for a long time.