• Journal of Chest Surgery
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• v.40 no.4 s.273
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• pp.280-287
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• 2007

Background: We retrospectively evaluated the clinical results of surgically managing patients with Ebstein's anomaly. Material and Method: Between Feb. f 984 and June 2006, 50 patients who underwent surgical treatment for Ebstein's anomaly at Yonsei Cardiovascular Center were retrospectively reviewed. The mean age of the patients was 26.9 years and 19 patients were male, Associated anomalies included atrial septal defect (33), patent ductus arteriosus (2), ventricular septal defect (1), and pulmonary stenosis (4), and 90%, (45/50) of the patients had more than a moderate degree of tricuspid regurgitation. Carpentier type A was present in 6 patients, type B in 26, type C in 14 and type D in 4. Ten patients were associated with WPW syndrome. Conservative surgery was possible in 31 patients (tricuspid annuloplasty, plication of the atrialized RV), Fontan's operation was peformed in 4 patients, tricuspid valve replacement was done in 12 and palliative surgery was done in 2 patients. Thirteen patients were associated with hi-directional cavopulmonary shunt (BCPS: one and a half ventricular repairs): 10 patients with WPW syndrome and 4 patients with atrial fibrillation underwent concomitant ablation. Result: The postoperative median NYHA functional class $(3{\rightarrow}1)$ and the mean cardio-thoracic ratio $(0.65{\rightarrow}0.59)$ were decreased significantly (p<0.001, p=0.014). The mean oxygen saturation $(86.6{\rightarrow}94.1%)$, and median TR grade $(4{\rightarrow}1)$ were also significantly improved (p=0.004, p<0.001). For comparison of BCPS and conservative surgery, the preoperative right ventricular pressure (33.0 vs. 41.3 mmHg), the ICU stay (2.80 vs. 1.89 days), the hospital say (10.6 vs. 16.8 days), and the left ventricular ejection fraction (64.3 vs. 72.8%) were statistically different. Postoperative mortality occurred in 3 patients (6%) due to biventricular failure in 2 patients and sepsis in the other patient. The mean follow up duration was 101.5 months, and one patient died of Fontan failure and 6 patients required reoperation (bioprosthetic degenerative change (2) and Fontan conversion (4)). The overall survival rate at 10 years was 90.2%, the freedom from reoperation rate and rate of cardiac related events were 78.9% and 49.2%, respectively. Conclusion: Surgical management of Ebstein's anomaly can be performed safely, and the associated BCPS may be helpful for high-risk patients. Adequate application of surgical management may increase the long-term survival with a reduced rate of reoperation.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.712-723
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• 2002

Substantial alterations in cerebral blood flow(CBF) are known to occur during cardiopulmonary bypass(CPB). Many investigators have speculated that these changes may be responsible for both minor and major cerebral damages after CPB. More recently, these changes in CBF have been observed to be intimately related to the arterial carbon dioxide tension(Pa$CO_2$) maintained during CPB. The present study was prospectively designed to investigate the clinical effects of normocapnic and hypercapnic CPB on the cerebral oxygen metabolism in cardiac surgery Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to either normocapnic group (Pa$CO_2$35~40 mmHg, n＝18) or hypercapnic group(Pa$CO_2$, 45~55 mmHg, n＝18) with moderately hypothermic nonpulsatile CPB(nasopharyngeal temperature of 29~3$0^{\circ}C$). In each patient, middle cerebral artery blood flow velocity( $V_{MCA}$), cerebral arteriovenous oxygen content difference (C(a-v) $O_2$), cerebral oxygen extraction(COE), cerebral metabolic rate for oxygen(CMR $O_2$), cerebral oxygen transport( $T_{E}$ $O_2$), $T_{E}$ $O_2$/CMR $O_2$ ratio, cerebral desaturation(internal jugular bulb blood oxygen saturation $\leq$ 50%), and arterial and jugular bulb blood gas were evaluated throughout the operation. Postoperative neuropsychologic complications were assessed in all patients. All variables were compared between the two groups. Result: VMCA(169.13 $\pm$ 8.32 vs 153.11 $\pm$8.98%), TE $O_2$(1,911.17$\pm$250.14 vs 1,757.40$\pm$249.56), $T_{E}$ $O_2$,/CMR $O_2$ ratio(287.38$\pm$28.051 vs 246.77$\pm$25.84), $O_2$ tension in internal jugular bulb (41.66$\pm$9.19 vs 31.50$\pm$6.09 mmHg), and $O_2$saturation in internal jugular bulb(68.97$\pm$10.96 vs 58.12$\pm$12.11%) during CPB were significantly lower in normocapnic group(p＝0.03), whereas hypercapnic group had lower C(a-v) $O_2$(3.9$\pm$0.3 vs 4.9$\pm$0.3 mL/dL), COE(0.3$\pm$0.03 vs 0.4$\pm$0.03), CMR $O_2$(5.8 $\pm$0.5 vs 6.8$\pm$0.6), and arterial blood pH(7.36$\pm$0.09 vs 7.46$\pm$0.07, p＝0.04) during CPB. Hypercapnic group had lower incidence of cerebral desaturation than normocapnic group(3 vs 9 patients, p=0.03). Duration of the neuropsychologic complication(delirium) were shorter in hypercapnic group than in normocapnic group(36 vs 60 hrs, p＝0.009). Conclusion: These findings suggest that hypercapnic CPB may have salutary effects on the cerebral oxygen metabolism and postoperative neurologic outcomes in cardiac surgery.surgery.

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.24-33
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• 2002

Objectives: Nasal continuous positive airway pressure (CPAP) corrected elevated blood pressure (BP) in some studies of obstructive sleep apnea syndrome (OSAS) but not in others. Such inconsistent results in previous studies might be due to differences in factors influencing the effects of CPAP on BP. The factors referred to include BP monitoring techniques, the characteristics of subjects, and method of CPAP application. Therefore, we evaluated the effects of one night CPAP application on BP and heart rate (HR) reactivity using non-invasive beat-to-beat BP measurement in normotensive and hypertensive subjects with OSAS. Methods: Finger arterial BP and oxygen saturation monitoring with nocturnal polysomnography were performed on 10 OSAS patients (mean age $52.2{\pm}12.4\;years$; 9 males, 1 female; respiratory disturbance index (RDI)>5) for one baseline night and another CPAP night. Beat-to-beat measurement of BP and HR was done with finger arterial BP monitor ($Finapres^{(R)}$) and mean arterial oxygen saturation ($SaO_2$) was also measured at 2-second intervals for both nights. We compared the mean values of cardiovascular and respiratory variables between baseline and CPAP nights using Wilcoxon signed ranks test. Delta ($\Delta$) BP, defined as the subtracted value of CPAP night BP from baseline night BP, was correlated with age, body mass index (BMI), baseline night values of BP, BP variability, HR, HR variability, mean $SaO_2$ and respiratory disturbance index (RDI), and CPAP night values of TWT% (total wake time%) and CPAP pressure, using Spearman's correlation. Results: 1) Although increase of mean $SaO_2$ (p<.01) and decrease of RDI (p<.01) were observed on the CPAP night, there were no significant differences in other variables between two nights. 2) However, delta BP tended to increase or decease depending on BP values of the baseline night and age. Delta systolic BP and baseline systolic BP showed a significant positive correlation (p<.01), but delta diastolic BP and baseline diastolic BP did not show a significant correlation except for a positive correlation in wake stage (p<.01). Delta diastolic BP and age showed a significant negative correlation (p<.05) during all stages except for REM stage, but delta systolic BP and age did not. 3) Delta systolic and diastolic BPs did not significantly correlate with other factors, such as BMI, baseline night values of BP variability, HR, HR variability, mean SaO2 and RDI, and CPAP night values of TWT% and CPAP pressure, except for a positive correlation of delta diastolic pressure and TWT% of CPAP night (p<.01). Conclusions: We observed that systolic BP and diastolic BP tended to decrease, increase or remain still in accordance with the systolic BP level of baseline night and aging. We suggest that BP reactivity by CPAP be dealt with as a complex phenomenon rather than a simple undifferentiated BP decrease.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.153-168
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• 1998

Background: The existing data indicate that obstructive sleep apnea syndrome contributes to the development of cardiovascular dysfunction such as systemic hypertension and cardiac arrhythmias, and the cardiovascular dysfunction has a major effect on high long-term mortality rate in obstructive sleep apnea syndrome patients. To a large extent the various studies have helped to clarify the pathophysiology of obstructive sleep apnea, but many basic questions still remain unanswered. Methods: In this study, the influence of obstructive sleep apnea on systemic blood pressure, cardiac rhythm and urinary catecholamines concentration was evaluated. Over-night polysomnography, 24-hour ambulatory blood pressure and ECG monitoring, and measurement of urinary catecholamines, norepinephrine (UNE) and epinephrine (UEP), during waking and sleep were undertaken in obstructive sleep apnea syndrome patients group (OSAS, n=29) and control group (Control, n=25). Results: 1) In OSAS and Control, UNE and UEP concentrations during sleep were significantly lower than during waking (P<0.01). In UNE concentrations during sleep, OSAS showed higher levels compare to Control (P<0.05). 2) In OSAS, there was a increasing tendency of the number of non-dipper of nocturnal blood pressure compare to Control (P=0.089). 3) In both group (n=54), mean systolic blood pressure during waking and sleep showed significant correlation with polysomnographic data including apnea index (AI), apnea-hypopnea index (AHI), arterial oxygen saturation nadir ($SaO_2$ nadir) and degree of oxygen desaturation (DOD). And UNE concentrations during sleep were correlated with AI, AHI, $SaO_2$ nadir, DOD and mean diastolic blood pressure during sleep. 4) In OSAS with AI>20 (n==14), there was a significant difference of heart rates before, during and after apneic events (P<0.01), and these changes of heart rates were correlated with the duration of apnea (P<0.01). The difference of heart rates between apneic and postapneic period (${\Delta}HR$) was significantly correlated with the difference of arterial oxygen saturation between before and after apneic event (${\Delta}SaO_2$) (r=0.223, P<0.001). 5) There was no significant difference in the incidence of cardiac arrhythmias between OSAS and Control In Control, the incidence of ventricular ectopy during sleep was significantly lower than during waking. But in OSAS, there was no difference between during waking and sleep. Conclusion : These results suggested that recurrent hypoxia and arousals from sleep in patients with obstructive sleep apnea syndrome may increase sympathetic nervous system activity, and recurrent hypoxia and increased sympathetic nervous system activity could contribute to the development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac function.

• Journal of Korean Society of Forest Science
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• v.77 no.1
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• pp.92-99
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• 1988

The dark respiration, photosynthesis($CO_2$ refixation), $CO_2$ balance and chlorophyll content of 1st-year conelets and 2nd-year cones of Korean pine(Pinus koraiensis S.et.Z.) were investigated after pollination up to the end of maturation. The results obtained are as follows : 1. The growth of 1st-year conelet was 3.6cm in length. 2.4cm in diameter and 3.058 in dry weighs during the first year. The growth of 2nd-year mature cone was 13.5cm in length, 9.3cm in diameter and 141.0g in dry weight in the late of 2nd-year. 2. The refixation of carbon dioxide released from a cone by the dark respiration was less than 50 percent at light saturation through the growing period. The refixation of carbon dioxide released by dark respiration for one year was 7.3 percent in 1st-year conelets and 8.7 percent in 2nd-year cones. 3. The dark respiration rate of cones by increasing temperature was rapidly increased with increasing temperature up to $25^{\circ}C$. The dark respiration rate of cones was much higher in non-growing season than that in growing season at the same temperature. 4. The rates of dark respiration and $CO_2$ refixation, based on the dry weight, were much higher in 1st-year conelet than that in 2nd-year cone. 5. The $CO_2$ balance for a cone was negative from pollination to the end of maturation. The net dark respiration loss for a cone was 7.23g $CO_2$/year in 1st-year conelet and 164.8g $CO_2$/year in 2nd-year cone. 6. The respiratory loss efficiency for a cone(=$CH_2O$ weight calculated by net dark respiration/dry weight of cone) for one year was 1.61 in 1st-year conelet and 0.81 in 2nd-year cone for one year. 7. The total chlorophyll content of surface scale of the cone was lower than 2mg/g dw through the growing period, and chl. a/b ratio was 2 to 3.

• Korean Journal of Medicinal Crop Science
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• v.3 no.3
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• pp.181-186
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• 1995

This study was carried out to know the effect of temperature, light intensity and $CO_2$ con­centration on photosynthesis and respiration in Wasabi (Wasabia japonica Matsum). The optimum temperature for photosynthesis in Wasabi was $17{\sim}20^{\circ}C$ and dark respiration rate was increased with the increasing of tem­perature from, $15 ^{\circ}C\;to\;30^{\circ}C$. Light compensation point was $6.0\;{\mu}E\;m^{-2}s^{-1}$ in Wasabi and $36.7\;{\mu}E\;m^{-2}s^{-1}$ in Corn, and light saturation point was $600{\mu}E\;m^{-2}s^{-1}$, similar in Wasabi and Corn. $CO_2$, compensation point was 67.3ppm in Wasabi and 11.6 ppm in Corn. Photorespiration rate in Wasabi leaf at $l000{\mu}E\;m^{-2}s^{-1}$ light intensity was 3.3 mg$CO_2$, $dm^{-2}hr^{-1}$, and then was gradually decreased as light intensity decreased. Stomatal frequency was about $76\;mm^{-2}$ on the adaxial surface and $623\;mm^{-2}$ on the abaxial surface, and the size of stomata was about 1$12{\mu}m$ on the adaxial surface and $17{\mu}m$ on the abaxial surface of the leaf.

• Korean Journal of Microbiology
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• v.51 no.4
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• pp.355-363
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• 2015

The present work quantified the growth of young biofilm in a model distribution system that was fed with chlorinated drinking water at a hydraulic retention time of 2 h. Bacterial biofilms grew on the surface of polyvinyl chloride (PVC) slides at a specific growth rate of $0.14{\pm}0.09day^{-1}$ for total bacteria and $0.16{\pm}0.08day^{-1}$ for heterotrophic bacteria, reaching $3.1{\times}10^4cells/cm^2$ and $6.6{\times}10^3CFU/cm^2$ after 10 days, respectively. The specific growth rates of biofilm-forming bacteria were found to be much higher than those of bulk-phase bacteria, suggesting that biofilm bacteria account for a major part of the bacterial production in this model system. Biofilm isolates exhibited characteristic kinetic properties, as determined by ${\mu}_{max}$ and $K_S$ values using the Monod model, in a defined growth medium containing various amounts of acetate. The lowest ${\mu}_{max}$ value was observed in bacterial species belonging to the genus Methylobacterium, and their slow growth seemed to confer high resistance to chlorine treatment (0.5 mg/L for 10 min). $K_S$ values (inversely related to substrate affinity) of Sphingomonas were two orders of magnitude lower for acetate carbon than those of other isolates. The Sphingomonas isolates may have obligate-oligotrophic characteristics, since the lower $K_S$ values allow them to thrive under nutrient-deficient conditions. These results provide a better understanding and control of multi-species bacterial biofilms that develop within days in a drinking water distribution system.

• Journal of Forest and Environmental Science
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• v.19 no.1
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• pp.18-24
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• 2003

This study was made on the physiological reactions of photosynthesis. stomatal transpiration. stomatal conductance of Acanthopanax senticosus of leaves. The results obtained are as follows 1. The light compensation points were approximately $30{\mu}molm^{-2}S^{-1}$ in sun leaves and $15{\mu}molm^{-2}S^{-1}$ in shade leaves. 2. The light saturation points were approximately $1,000{\mu}molm^{-2}S^{-1}$ in sun leaves and $300{\mu}molm^{-2}S^{-1}$ in shade lea ves. 3. There was no significant between various mountains distributed. net photosynthetic rates were approximately 8.0 to $8.8{\mu}molm^{-2}S^{-1}$ in upper leaves. However. net photosynthetic rate in upper leaves of Acanthopanax koreanum in Jeju island was slightly low about $6.9{\mu}molm^{-2}S^{-1}$. 4. Net photosynthetic rate in middle leaves of all mountains was ranged from 40% to 65% of upper leaves. and that in lower leaves was approximately 30% of upper leaves. But the net photosynthesis in lower leaves of Acanthopanax koreanum in Jeju island was slightly high about 71 % of upper leaves. 5. There was no significant between various mountains distributed, stomatal transpirations were ranged from 1.1 to $1.4mmolH_2Om^{-2}S^{-1}$ in upper leaves, 0.7 to $1.0mmolH_2Om^{-2}S^{-1}$ in middle leaves, and 0.5 to $0.6mmolH_2Om^{-2}S^{-1}$ in lower leaves. respectively. 6. There was no significant between various mountains distributed. the stomatal conductance in upper 1eaves was ranged from 70 to $90mmolH_2Om^{-2}S^{-1}$. However, stomatal conductance in upper leaves of Acanthopanax koreanum in Jeju island was approximately $380mmolH_2Om^{-2}S^{-1}$, its remarkedly higher than any other mountain.

• Journal of Plant Biology
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• v.37 no.3
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• pp.387-394
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• 1994

Effects of environmental factors of light, temperature, nitrogen sources and water stress were analyzed quantitatively on the nodule formation and nitrogen fixation activity of autumn olive plant (Elaeagnu$ umbellala Thunb.) during the seedling growth. Seedlings showed the maximum nitrogenase activity of $72.5\;\mu\textrm{M}\;C_2H_4{\cdot}g\;fr\;wt\;nodule^{-1}{\cdot}h^{-1}$ in the early nodulation stage. The relative growth rate and T/R ratio changed from $1.60%{\cdot}d^{-1}$ and 1.12 in the earlier stage to $3.75%{\cdot}d^{-1}$ and 2.31 in the later stage, respectively. light conditions of 20-25, 1015 and 4-6% resulted in decreases of 41, 54 and 71% of the nitrogenase activity, respectively. Nodules incubated in 15, 20, 25 and $30^{\circ}C$ showed the activities of 5.4, 24.7, 51.6 and $58.5\;\mu\textrm{M}\;C_2H_4{\cdot}g\;fr\;wt\;nodule^{-1}{\cdot}h^{-1}$ respectively. Pretreatment with low temperature ($15^{\circ}C$) followed incubation at $30^{\circ}C$ attained higher nitrogenase activity ($66.5\;\mu\textrm{M}\;C_2H_4{\cdot}g\;fr\;wt\;nodule^{-1}{\cdot}h^{-1}$) than that with higher temperature ($35^{\circ}C$). The oxygen pressure above 16 kPa is necessary for saturation of the nodule activity, but the activity was inhibited severely by physical impact such as the exision or isolation of nodules from the root. The relative activities of early nodules grown in pH 5.5, 6.5 and 8.0 were 89, 100 and 40% and those grown in 1 and 3 mM of $NO_3\;and\;NH_4$ were 6, 1 and 68, 50%, respectively. Watering levels of 20, 50 and 100 mL during the seedling growth resulted in 35, 120 and 8 mg of nodule formation and 33.6, 58.4 and $8.4\;\mu\textrm{M}\;C_2H_4{\cdot}g\;fr\;wt\;nodule^{-1}{\cdot}h^{-1}$ of the nitrogenase activity, respectively. Water stress with 86% decrease of soil water content caused temporary wilting point of leaf and a complete disappearance of nitrogenase activity of nodules, though the water content and transpiration rate in plant were reduced to 90 and 53%, respectively.tively.

• Journal of the Korean Wood Science and Technology
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• v.32 no.2
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• pp.19-25
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• 2004

This study was carried out to investigate a radial distribution of moisture contents (MCs) within a log cross section (LC) during oven-drying of 3 mm-thick circumferential slices cut from several domestic softwoods LCs.For Korean red pine, drying rate of sapwood slices during oven-drying represented much higher values than that of heartwood slices, and so sapwood with higher green MC early reached below fiber saturation point (FSP) rather than heartwood did. However, this distribution of moistures did not last for long duration. For Japanese larch, green MC of sapwood was approximately three times higher than that of heartwood. This similar distribution in MC was lasted until about 20% average MC. The MC was around uniform throughout the sapwood of Ginkgo when green and during oven-drying, although it was somewhat fluctuated. For Japanese cedar, the heartwood with so low moistures around FSP would begin to shrink from the beginning stage of drying, but the sapwood above hygroscopic MC prevents the heartwood from shrinking, and consequently, the heartwood or the transition wood goes into tension stress. The results for Japanese cypress showed that the green MCs of the sapwoods were much lower than those for heartwoods, and then this trend was continued until about 20% in average MC. For Chinese thuja, the green MCs of sapwoods were about 2 times as high as those of heartwood, but this along the radial gradient in MC rapidly became gentle during oven-drying.