• Journal of Chest Surgery
• /
• v.32 no.2
• /
• pp.108-118
• /
• 1999

Background: To evaluate the risk factor and long-term result of arterial switch operation , a retrospective study was done. Material and Method: A retrospective analysis was done to evaluate the early and long-term results on 58 patients who underwent an arterial switch operation(ASO) for transposition of the great arteries(TGA) with intact ventricular septum, between January 1988 and December 1996. Beforesurgery, 36 patients(62.1%) underwent balloon atrial septostomy, 32 patients(51.7%) received PGE1 infusion, and preparatory banding of pulmonary artery was performed on 6 patients(mean LV/RV pressure ratio 0.53$\pm$0.11). Result: The age at operation ranged from 1 to 137 days(mean 24$\pm$26 days) and the weights ranged from 1.8 to 6.8 kg (mean 3.5$\pm$0.8 kg). There were 14 early deaths(24.1%), but of the last 24 patients operated on since 1994, there were only 2 early deaths(8.3%). In the risk factor analysis, the date of operation was the only risk factor for early death(p-value < 0.01). Eight of the 14 early deaths were due to acute myocardial failure(mainly inadequate coronary blood flow). The length of follow-up ranged from 2 months to 8 years, average of 36$\pm$27 months. The follow-up included sequential noninvasive evaluations and 21 catheterizations and angiographic studies performed 5 to 32 months postoperatively with particular attention to the great vessel and coronary anastomosis, ventricular function, valvular competence, and cardiac rhythm. There were 5 late deaths(11.4%), one of thesedeaths was related to the late coronary problems, two to aspiration, one to uncontrolled chronic mediastinitis, and one to progressive aortic insufficiency and heart failure. The most frequent postoperative hemodynamic abnormality was supravalvular stenosis and the degree of pulmonary or aortic obstruction had slowly progressed in some cases, however there were no children who had to undergo a reoperation for supravalvular pulmonary or aortic stenosis. Aortic regurgitation was identified in 9 patients, which was mild in 7 and moderate in 2 and had progressed in some cases. Two patients who had an unremarkable perioperative course were identified as having coronary artery obstructions. The other late survivors were in good condition, were in sinus rhythm, and had normal LV functions. Actuarial survival rate at 8 years was 68.8%. Conclusion: We concluded that anatomic correction will be established as the optimal approach to the TGA with intact ventricular septum, though further long-term evaluations are needed.

• Journal of Chest Surgery
• /
• v.32 no.6
• /
• pp.510-517
• /
• 1999

Background: Total anomalous pulmonary venous connection (TAPVC) is still one of the more challenging congenital heart defects in newborns and young infants. The purpose of the study is to evaluate the early and midterm results of the surgical corrections for patients in early infancy with isolated TAPVC. Material and Method: Hospital records of 15 consecutive patients in early infancy (January 1993 to August 1998) were retrospectively reviewed. There were 8 boys and 7 girls whose ages ranged from 4 days to 3.5 months (median age 22 days). Their body weight ranged from 1.75 kg to 4.9 kg (mean 3.54 kg). The abnormal anatomical connections were supracardiac in 11, cardiac in 3, and infracardiac in 1. In 6 patients (40%), the pulmonary venous drainage was obstructive. Total circulatory arrest was used in 13 patients. Anastomosis between the common pulmonary vein and the left atrium was performed with a continuous suture technique using a fine nonabsorbable polypropylene suture through a lateral approach behind the right atrium. Result: There was one hospital death (6.5%) caused by a sepsis 17 days after the operation in a neonate who had supracardiac drainage and was dependent on a ventilator preoperatively. There were 2 late deaths. One died sudde`nly of an unknown cause at home 2.5 years after the operation and the other died of a recurrent pulmonary hypertension 3 months after the reoperation due to pulmonary venous obstruction (PVO). Two patients required reoperations because of PVO 5 months and 10 months respectively after the initial operation. Of these patients, one patient is alive at the present time with persistent pulmonary hypertension. All survivors without postoperative PVO (78.6%) were in NYHA functional class I at mean follow-up of 25.8 months (0.5∼67 months). Conclusion: Surgical correction of TAPVC in early infancy can be performed at low risk. However, there were 2 postoperative PVOs (14.3%) which had bad results. The survivors without postoperative PVO had excellent functional status.

• Journal of Chest Surgery
• /
• v.32 no.6
• /
• pp.536-542
• /
• 1999

Background: The purpose of this study is to improve the quality of the diagnostic procedures in the preoperative evaluation so as to reduce the unnecessary thoracotomy and to ensure resectability in non-small cell lung cancer. Material and Method: Of 616 patients who underwent thoracotomy for primary lung cancer from January 1990 to December 1996, 59 patients(9.6%) turned out to have inoperable lesions after the thoracotomy. We reprospectively reviewed the bronchoscopic findings, methods of tissue diagnosis, CT scans, pulmonary function test and lung perfusion scan, reasons for nonresectability, and adjuvant therapy, and then followed up on the survival rate after exploratory thoracotomy. Result: The cell types were squamous cell carcinoma in 38, adenocarcinoma in 15, large cell carcinoma in 3 and others in 3. Primary loci were RUL in 20, RML in 6, RLL in 8, LUL in 13, LLL in 4 and others in 8. The reasons for non-resectability were various; direct tumor invaison to mediastinal structures(n=41), seeding on pleural cavity(n=8), poor pulmonary function(n=2), invasions to extranodal mediastinal lymph node(n=2), technical non- resectability due to extensive chest wall invasion (n=3), small cell carcinoma (n=1), malignant lymphoma(n=1), and multiple rib metastases(n=1). In the follow-up of 58 patients, 1-year survival rate was 55.2% and 2-year survival rate was 17.2% and the mean survival time was 14 months. When compared according to cell types or postoperative adjuvant therapeutic modalities, no significant difference in the survival rates were found. The squamous cell carcinoma was frequently accompanied by local extension to contiguous structures and was the main cause of non-resectability. In adenocarcinoma, pleural seeding with malignant effusion was frequently encountered, and was the major reason for non-resectability. Conclusion: These data revealed that if appropriate preoperative diagnostic tools had been available, many unnecessary thoracotomies could have been avoided. Both the use of thoracoscopy in selected cases of adenocarcinoma and the more aggressive surgical approach to the locally advanced tumor could reduce the incidence of unnecessary thoracotomies for non-small cell lung cancers.

• Journal of Chest Surgery
• /
• v.37 no.4
• /
• pp.322-327
• /
• 2004

Coronary artery bypass grafting on the beating heart is no longer a new methods for any cardiac surgeon. We evaluated the application of the off-pump coronary artery bypass procedure relative to safety and efficiency as measured by postoperative complication and operative mortality. Material and Method: We used our retrospective database to compare the patients having off-pump coronary surgery (n=100) with those having on-pump coronary surgery (n=100) between June, 1999 and August, 2002. Patients whom underwent associated valvular or aortic aneurysmal operation were excluded. Result: Neither groups showed any differences in the patient's risk factors and extent of coronary disease. Off-pump CABG group did not have significantly less mean operation time (295$\pm$73 min vs 323$\pm$83 min, p=ns) and mean hospital day (15.34$\pm$6.02 day vs 13.80$\pm$4.95 day, p=ns). However, off-pump CABG group had significantly shorter mean ventilation time (17.3$\pm$11.27 hour vs 24.98$\pm$16.1 hour, p＜0.05). No patients were converted to on-pump CABG in off-pump CABG. Intraoperative hemodynamic instability in off-pump CABG were 6 cases, of whom 2 cases were in lateral wall approach and 4 cases in right coronary anastomosis. Postoperative mortality was 1 case in off-pump CABG and 2 cases in on-pump CABG. Intra-aortic ballon pump (IABP) was applied in 1 case with off-pump CABG and in 2 cases with on-pump CABG. No patients presented postoperative cerebral infarction ＆ stroke in off-pump CABG but 2 patients in on-pump CABG. Postoperative arrhythmia presented in 4 cases with off-pump CABG and in 6 cases with on-pump CABG. Acute renal failure (ARF) was complicated in 3 cases with off-pump CABG and in 2 cases with on-pump CABG. Conclusion: This study documented the immediate safety and efficiency of the off-pump CABG procedure.

• Journal of the Korean Geographical Society
• /
• v.28 no.3
• /
• pp.213-226
• /
• 1993

In Korea, the urban studies of geography have mainly dealt with such a series of research as system of urban place and internal structure of urban area. The existing studies have been carried out with ecological approach. Ecologists, now a days, regard organiation and transfor-mation of the urban space as the process of invasion, succession, and segregation. However it is more proper that cities should be considered not as fragmantary objects, as some ecologists insist, but as synthetic ones in social structure. This research, with adopting a case of the renewasl of central area in Seoul, tried to make it clear that the formation and transition of the city is a product of social structure and examined polical and economic logic which exists in variation of urban space in detail. The results of this study are as follows; Urban renewal of central area is closely related with production and reproduction in capitalist society. In urban center, as business activities had increased since 1973 due to decen-tralization of production process, the necessity of reorganizing the land use in existing central area accordingly increased. The urban renewal program of central area in Seoul was inrroduced under such situation. The urban renewal of central area reflecting the capital logic has changed the central area with six hundred year's tradition. From the urban renewal of central area, not only was the central area, which traditionally had been mixed with various fun-ctions, simplified into the unitary area of busi-ness, but also physical landscape changed. As the land lot in renewal area expanded into regular shape, buildings became larger and taller. The program tremendously raised the price of related area. Aiming at these profits caused by the raised price, a great number of capitalists participated in the program. And as the benefit ratio of the manufacture sector continuously dropped with the economic recession, the pro-gram was carried out much more vigorously. That was because the idle capital accumulated during the recession was invested in property sector and was self-proliferated. The urban renewal raised the land value of central area and drove out the people living in this area. The people moved into the whole parts of the city resulting diffused squatter settlements. And the urban changes in central area were results of the policy of municipal authorities, who supported and systematized the changes lawfully and administratively, as well as reali-zation of capital logic. Due to the renewal policies of central area in Seoul, much more renewals by the only capitalists were carried out than those by the people themselves living in that area. The integration of land ownership in the law of urban renewal shows the reason of that. Moreover, the law allows the third deve-loper to participate in the tasks and admits the land expropriation rights. The municipal autho-rities guaranteed the profitability of the tasks through finacial aid, tax benifit, and relaxation of regulations for construction. As examined above, the changes in the land use of urban space have been led not by the ecological process of development of the city itself, but by the restructuring of capitalism and the intervention of the government authorities.

• Journal of Home Health Care Nursing
• /
• v.4
• /
• pp.5-22
• /
• 1997

The purpose of the study was to development an information delivery system for the home nursing service, to demonstrate and to evaluate the efficiency of it. The period of research conduct was from September 1996 to August 31, 1997. At the 1st stage to achieve the purpose, Firstly Assessment tool for the patients with cerebral vascular disease who have the first priority of HNS among the patients with various health problems at home was developed through literature review. Secondly, after identification of patient nursing problem by the home care nurse with the assessment tool, the patient's classification system developed by Park (1988) that was 128 nursing activities under 6 categories was used to identify the home care nurse's activities of the patient with CAV at home. The research team had several workshops with 5 clinical nurse experts to refine it. At last 110 nursing activities under 11 categories for the patients with CVA were derived. At the second stage, algorithms were developed to connect 110 nursing activities with the patient nursing problems identified by assessment tool. The computerizing process of the algorithms is as follows: These algorithms are realized with the computer program by use of the software engineering technique. The development is made by the prototyping method, which is the requirement analysis of the software specifications. The basic features of the usability, compatibility, adaptability and maintainability are taken into consideration. Particular emphasis is given to the efficient construction of the database. To enhance the database efficiency and to establish the structural cohesion, the data field is categorized with the weight of relevance to the particular disease. This approach permits the easy adaptability when numerous diseases are applied in the future. In paralleled with this, the expandability and maintainability is stressed through out the program development, which leads to the modular concept. However since the disease to be applied is increased in number as the project progress and since they are interrelated and coupled each other, the expand ability as well as maintainability should be considered with a big priority. Furthermore, since the system is to be synthesized with other medical systems in the future, these properties are very important. The prototype developed in this project is to be evaluated through the stage of system testing. There are various evaluation metrics such as cohesion, coupling and adaptability so on. But unfortunately, direct measurement of these metrics are very difficult, and accordingly, analytical and quantitative evaluations are almost impossible. Therefore, instead of the analytical evaluation, the experimental evaluation is to be applied through the test run by various users. This system testing will provide the viewpoint analysis of the user's level, and the detail and additional requirement specifications arising from user's real situation will be feedback into the system modeling. Also. the degree of freedom of the input and output will be improved, and the hardware limitation will be investigated. Upon the refining, the prototype system will be used as a design template. and will be used to develop the more extensive system. In detail. the relevant modules will be developed for the various diseases, and the module will be integrated by the macroscopic design process focusing on the inter modularity, generality of the database. and compatibility with other systems. The Home care Evaluation System is comprised of three main modules of : (1) General information on a patient, (2) General health status of a patient, and (3) Cerebrovascular disease patient. The general health status module has five sub modules of physical measurement, vitality, nursing, pharmaceutical description and emotional/cognition ability. The CVA patient module is divided into ten sub modules such as subjective sense, consciousness, memory and language pattern so on. The typical sub modules are described in appendix 3.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.1
• /
• pp.1-10
• /
• 2004

The habit of finger sucking is a reflex occurring in the oral stage, due to nutritive and psychological desire. The habit of finger sucking is considered to be normal till 3 years of age. Dento-skeletal effect on maxillo-mandibular complex including occlusion is naturally correction, when habit stopped before 3 years. If finger sucking continues till $3{\sim}4$ years, Finger sucking leads to severe malocclusion and remarkable discrepancy maxillo-mandibular complex, which is difficult in expectation of natural correction. It is necessary to positive treatment. Treatment of malocclusion, as related to finger sucking is classified two methods. (psychological approach and orthodontic appliance) To stop a habit and to correct severe skeletal discrepancy and malocclusion, $fr\ddot{a}nkel$ appliance is very effective device. This study is to report two cases of treatment of malocclusion, as related to finger sucking. 2 years 10 months old girl with severe overjet, maxillo-mandibular skeletal discrepancy and severe convex facial profile was treated with a FR-II appliance. Finger sucking habit stopped immediately After 16 months, severe overjet, maxillo-mandibular skeletal discrepancy and severe convex facial profile was corrected. 4 years 2 months old girl with midline deviation, mandibular right shift, collateral posterior crossbite and facial asymmetry was treated with a FR-III appliance. Finger sucking habit stopped immediately. After 10 month, Midline deviation, mandibular right shift, collateral posterior crossbite and facial asymmetry were corrected. FR-appliance is a recommendable appliance for a habit breaker and correction of skeletal discrepancy.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.39 no.6
• /
• pp.76-85
• /
• 2011

This research explores the Korean perspective on parks and the beginning of urban parks in the port opening period. The purpose of the study is to understand how Koreans viewed and accepted the idea of a park as imported from western culture and with what attitudes. Analyzed sources included: "Susinsa's Record"(修信使記錄) by Susinsa(修信使) who wrote the inspection records of foreign modern cultures for the first time after the port opening, "Seoyukyunmun"(西遊見聞) by Yu Kil-jun(兪吉濬) and "Yun Chi-ho's Diary"(尹致昊日記) by Yun Chi-ho(尹致昊), which are representative works by students sent abroad, as well as some records of Seo Jae-pil(徐載弼) and The Independence Club(獨立協會) such as "The Independent"(獨立新聞), which contains the records of 'IndependencePark'. This research is focused on the literature that reexamins and interprets the related data from primary sources. As a result, it was found that the people who led the modern reformation in the Port Opening period adopted and developed social thinking regarding parks. Indeed, it was possible to witness the gradual sophistication of the concept of a park from the time of Susina's thoughts on parks to that of Yu Kil-jun's support for the need and importance of parks and Yun Chi-ho's cultural and artistic interest in parks. Also, Seo Jae-pil and the Independence Club drove the development of Independence Park, which was designed to incorporate social values and symbols while also serving to meet the needs of recreation, leisure, hygiene, and enlightenment. The Independence Club consistently advocated for the necessity of open spaces and delivered this message to the public via article writing. In short, even prior to the Japanese colonial period, Koreans shared thoughts and exchanged opinions on parks. Parks were to be created not just as a copy or transplant of western parks, but were constructed based on social demands and necessity. As few studies have taken the approach of identifying this origin of Korean parks, thus, this research which traces back the origin of Korean parks, is significant.

• 한국HCI학회:학술대회논문집
• /
• 2008.02b
• /
• pp.152-157
• /
• 2008

The customer satisfaction of WAP service greatly relies on the usability of the service due to the limited display size of a mobile phone and limitation in realizing UI (User Interface) for function keys, browser, and OS (operating system) Currently, a number of contents providers develop and deliver varying services, and thus, it is critical to control quality level of UI in consistent standards and manner. This study suggests usability index evaluation system to achieve consistent UI quality control of various WAP services. The system adopts both top-down and bottom-up approaches. The former concerns deriving UI design components and evaluation checklists for the WAP, based on the usability attributes and UI principles. The latter concerns deriving usability-related evaluation checklists from the established UI design features, and then grouping them from the viewpoint of usability principles and attributes. This bidirectional approach has two outstanding advantages: it allows thorough examination of potential elements that can cause usability problems from the standpoint of usability attributes, and also derives specific evaluation elements from the perspective of UI design components that are relevant to the real service environment. The evaluation system constitutes a hierarchical structure by networking usability attributes, UI guideline which indicates usability principles for each attribute, and usability evaluation checklist for each UI component that enables specific evaluation. Especially, each evaluation checklist contains concrete contents and format so that it can be readily marked in O/X. The score is based on the ratio of number of items that received positive answer to the number of total items. This enables a quantitative evaluation of the usability of mobile WAP service. The validity of the proposed evaluation system has been proved through comparative analysis with the real usability problems based on the user test. A software was developed that provides guideline for evaluation objects, criteria and examples for each checklist, and automatically calculates a score. The software was applied to evaluating and improving the real mobile WAP service.

• Korean Chemical Engineering Research
• /
• v.49 no.2
• /
• pp.187-194
• /
• 2011

In compliance with an international law about the ocean dumping of the sludge, the proper sewage treatment process which occurs from the wastewater treatment process has been becoming problem. Generally the sewage and the sludge are controlled from anaerobic condition when the sewage is treated and land filled, where the methane$(CH_{4})$ and the nitrous oxide $(N_{2}O)$ from this process are discharged. Because these gases have been known as one of the responsible gases for global warming, the wastewater treatment process is become known as emission sources of green house gases(GHG). This study is to suggest a new approach of estimate and environmental assessment of greenhouse gas emissions and sludge emissions from wastewater treatment processes. It was carried out by calculating the total amounts of GHG emitted from biological wastewater treatment process and the amount of the sludgegenerated from the processes. Four major biological wastewater treatment processes which are Anaerobic/Anoxic/Oxidation$(A_{2}O)$, Bardenpho, Virginia Initiative Plant(VIP), University of Cape Town(UCT)are used and GPS-X software is used to model four processes. Based on the modeling result of four processes, the amounts of GHG emissions and the sludge produced from each process are calculated by Intergovernmental Panel on Climate Change(IPCC) 2006 guideline report. GHG emissions for water as well as sludge treatment processes are calculated for environmental assessment has been done on the scenario of various sludge treatments, such as composting, incineration and reclamation and each scenario is compared by using a unified index of the economic and environmental assessment. It was found that Bardenpho process among these processes shows a best process that can emit minimum amount of GHG with lowest impact on environment and composting emits the minimum amount of GHG for sludge treatment.