• Journal of Chest Surgery
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• v.41 no.5
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• pp.610-618
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• 2008

Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.33 no.1
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• pp.52-64
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• 2015

This research traced the characteristics of the semantic landscape, construction intent, landscape composition, and geomantic conditions of the area subject to the research based on the research methods of 'field investigation, document studies, and interviews,' centering around the entire area of Gokseong Hamheo-pavilion (Jeonnam Tangible Cultural Assets No. 160). The result of the research, specifically revealing the forms and methods by which the reciprocal view of nature and landscape composition appearing in the landscape of the entire area of Hamheo-pavilion, as part of the analysis and interpretation over the view-based construction characteristics and position of the entire area of Gokseong Hamheo-pavilion, can be summarized as follows. First, Hamheo-pavilion is a pavilion built as a resting area and as a venue for educational activities in 1543 in the nearby areas after Gwang-hyeon Sim founded Gunjichon-jeongsa for educational activities and dwelling purposes at Gunchon at the 30th year of King Jungjong. Gunchon, where Hamheo-pavilion and Gunjichon-jeongsa is located, exhibits the typical form having water in the front, facing Sunja-river(present Seomjin-river), and a mountain in the back side. Dongak-mountain, which is a guardian mountain, is in a snail-type form where cows leisurely ruminate and lie on the riverside, and the Hamheo-pavilion area is said to be an area bordering on one's way of enjoying peace and richness as it is a place with plentiful grass bushes available for cows to ruminate and lie down while sheppards may leisurely play their flutes at the riverside. The back hill of Hamheo-pavilion is a blood vessel that enters the water into the underwater palace of the turtle, and the building sitting on the turtle's back is Hamheo-pavilion, and the Guam-jodae(龜巖釣臺) and lava on the southern side below the cliff can be interpreted to be the underwater fairly land wanted by the turtle.6) Second, Hamheo-pavilion is the scenery viewpoint of Sungang-Cheongpung (3rd Scenery) and Seolsan-Nakjo(雪山落照, 9th Scenery) among the eight sceneries of Gokseong, while also the scenery viewpoint of Hamheo-Sunja(2nd Scenery) and Cheonma-Gwiam(天馬歸岩, 3rd Scenery) among the eight sceneries of Ipmyeon. On the other hand, the pavilion is reproduced through the aesthetics of bends through sensible penetration and transcendental landscape viewed based on the Confucian-topos and ethics as the four bends among the five bends of Sunja-river arranged in the 'Santaegeuk(山太極) and Sutaeguek(水太極, formation of the yin-yang symbol by the mountain and water)' form, which is alike the connection of yin and yang. In particular, when based on the description over Mujinjeong (3rd Bend), Hoyeonjeong(4th Bend), andHapgangjeong(2nd Bend) among the five bends of Sunja-river in the records of Bibyeonsainbangan-jido(duringthe 18th century) and Okgwahyeonji(1788), the scenery of the five bends of Sunja-river allow to glimpse into its reputation as an attraction-type connected scenery in the latter period of the Joseon era, instead of only being perceived of its place identity embracing the fairyland world by crossing in and out of the world of this world and nirvana. Third, Hamheo-pavilion, which exhibits exquisite aesthetics of vacancy, is where the 'forest landscape composed of old big trees such as oak trees, oriental oak trees, and pine trees,' 'rock landscape such as Guam-jodae, lava, and layered rocks' and 'cultural landscape of Gunchon village' is spread close by. In the middle, it has a mountain scenery composed of Sunja-river, Masan-peak, and Gori-peak, and it is a place where the scenery by Gori-peak, Masan-peak, Mudeung-mountain, and Seol-mountain is spread and open in $180^{\circ}$ from the east to west. Mangseo-jae, the sarangchae (men's room)of Gunjichon-jeongsa, means a 'house observing Seoseok-mountain,' which has realized the diverse view-oriented intent, such as by allowing to look up Seol-mountain or Mudeung-mountain, which are back mountains behind the front mountain, through landscape configuration. Fourth, the private home, place for educational activities, pavilion, memorial room, and graveyard of Gunji-village, where the existence and ideal is connected, is a semantic connected scenery relating to the life cycle of the gentry linking 'formation - abundance - transcendence - regression.' In particular, based on the fact that the descriptions over reciprocal views of nature regarding an easy and comfortable life and appreciations for a picturesque scene of the areas nearby Sunja-river composes most of the poetic phrases relating to Hamheo-pavilion, it can be known that Hamheo-pavilion is expressed as the key to the idea of 'understanding how to be satisfied while maintaining one's positon with a comfortable mind' and 'returning to nature,' while also being expressed of its pedantic character as a place for reclusion for training one's mind and training others through metaphysical semantic scenery.