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Mitral valve Replacement (승모판막 치환술)

  • Sin, Dong-Geun;Kim, Min-Ho;Jo, Jung-Gu
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.137-145
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    • 1997
  • From July 1983 to December 1993, total 112 consecutive mitral valve replacements in 107 patients were performed in patient with mitral valvular abnormalities. To estimate the risk factor related to operative death, all patient's perioperative data were reviewed retrospectively. Except 20 patients received concomitant aortic valve replacement and 2 patients had incomplete data, 85 patients were included in this study. Mean age were $37.3\pm$ 13.1 years ranging from 13 to 72 years. Thirty-seven patients were male and fourty-eight patients were female. Mean follow-up durations were $51.1\pm33.8$ months ranging from 6 months t 11 years. Patients in this study showed improvement in mean NYHA functional clssification, from $3.02\pm0.73$ to 1 $78\pm0.55,$ and also in cardiothoracic ratio, from 0.61 $\pm0.09$ to $0.58\pm0.08$ at 6 months follow-up after operation. Operative complications were detected in 23 patients(27.1 %) and common postoperative complications were rhythm disturbance in 7 cases, pulmonary complications in 6 cases and low cardiac output syndrome in 6 cases. Early mortality was 10.6%(n=9) and the most common cause of death was a congestive heart failure due to low cardiac output syndrome. Main cause of our higher operative mortality than other study was that operative mortality in the initial period of our mitral surgery was high(5 operative deaths among 19 mitral valve replacement from July 1983 to December 1985). Actuarial survival was 80.8% at 5 years, 71.8% at 11 years including operative deaths. Actuarial freedom from anticoagulant-related bleeding was 85.3% at 5 years, 78.3% at 11 years. 95.1% at 5 years and 88.8% at 11 years among the patient in this study were free from thromboembolism, and 97.5% at 5 years and 75.1% at 11 years were free from reoperation. Preoperative cardiothoracic ratio and patient's age were statistically significant operative risk factors.

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Adsorption and movement of Alachlor and Chlorothalonil in the representative soil of Cheju Island (제주도 대표 토양에서 Alachlor와 Chlorothalonil의 흡착과 이동 연구)

  • Hyun, Hae-Nam;Oh, Sang-Sil;Yoo, Sun-Ho
    • Korean Journal of Environmental Agriculture
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    • v.14 no.2
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    • pp.135-143
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    • 1995
  • This study was conducted to investigate the adsorption characteristics, distribution coefficients, and movement of alachlor(2-chloro-2', 6'-dimethyl-N-(methoxymethyl) acetanilide) and chlorothalonil(tetrachloroisophthalonitrile) for the 3 soils sampled from major soil groups in Cheju Island. Namwon, Jeju, and Mureng soils used in this study were classified as black volcanic ash soil, dark brown volcanic ash soil and dark brown nonvolcanic soil, respectively. Organic carbon content and CEC of Namwon soil were very high and those of Mureung soil were very low. Linear and Freundlich adsorption isotherms were the best to fit the adsorption of alachlor and chlorothalonil in the soils. K value, Freundlich coefficient, of alachlor for Namwon soil was 21.38, being 5.4 and 97.2 times higher than that for Jeju and Mureung soils respectively. The values of chlorothalonil for the soils were similar to those of alachlor but were much higher than them. When Mureung, Jeju and Namwon soil columns were leached with a solution containing 10.25 mg/l of alachlor and 1.50 mg/l of chlorothalonil, alachlor was first detected at 0.265, 0.47, and 1.86 pore volume (PV) and chlorothalonil was 3.71, 4.7 and 17.5 PV, respectively. The pore volumes at $C/C_o=1$ of alachlor in the leachates from Mureung, Jeju and Namwon soil columns were 1.1, 3.7 and 6.6 PV and those at $C/C_o=0.2$ of chlorothalonil were 7.5, 8.5 and 27.5, respectively. This means that the deceasing order of the mobility of the chemicals in soils was Mureung soil>Jeju soil${\gg}$Namwon soil. The pore volumes detecting $C/C_o=0.5$ of alachlor and $C/C_o=0.05$ of chlorothalonil in leachate were positively correlated with the distribution coefficients for the soils.

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On the Spatio-temporal Distributions of Nutrients and Chlorophyll a Concentration, and the Environmental Factors on the Variation of Phytoplankton Biomass in the Shiahae, Southwestern Part of Korean Peninsula (시아해의 수질환경과 식물플랑크톤 생물량의 시ㆍ공간적 분포특성과 기초생물량변동에 영향을 미치는 환경특성)

  • 윤양호
    • Korean Journal of Environmental Biology
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    • v.18 no.1
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    • pp.77-93
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    • 2000
  • Field survey on the spatio-temporal distribution of water quality and chlorophyll a concentration, and the environmental factors on the variation of phytoplankton biomass were carried out at the 23 stations for four seasons in the Shiahae, southwestern coast of Korean Peninsula from February to October in 1995. I made an analysis on biological factor as chlorophyll a concentration as well as environmental factors such as water temperature, salinity and nutrients; ammonia, nitrite, nitrate, dissolved inorganic nitrogen, phosphate, N/P ratio, silicate and Si/P ratio. The waters in the Shiahae were not stratified due to the tidal mixing and high velocity of tidal current. And the high productivity in photic layer were supported by high nutrients concentration from freshwater on lands and bottom waters The low depth of transparency in the Shiahae had a bad influence upon primary production and marine biology. In Shiahae had a sufficient nutrients for primary production during a year. Especially dissolved inorganic nitrogen and silicate were high, the other side, phosphate was low. The source of nutrients in summer and silicate supply depend on input of freshwater from lands, the other side, dissolved inorganic nitrogen and phosphate were depend on rather supplied from bottom layer by the mixing and input of seawater from outside than input of freshwater from lands. Phosphate seemed to become a limiting nutrient for the primary production at all area of Shiahae in winter and at the northern parts in other seasons. However, dissolved inorganic nitrogen seemed to do it at the southern parts in other seasons except winter. Silicate didn't become a limiting nutrient for diatoms in Shiahae. Phytoplankton biomass as measured by chlorophyll a concentration was very high all the year round, it was controlled by the combination of the several environmental factors, especially of nitrogen, phosphorus and the physical factors such as light intensity. [Spatio-temporal distribution, Seasonal fluctuation, Nnutrients, Chlorophyll a, Environmental factors, Nutrient source, Limiting Nutrient, Light, Shiahae] .

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Effect of Thresher Drum-Speed on the Quality of the Milled Rice (탈곡기의 급동 속도가 도정 손실에 미치는 영향)

  • Chung, Chang Joo;Koh, Hak Kyun;Lee, Chong Ho;Kang, Hwa Seug
    • Journal of Biosystems Engineering
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    • v.4 no.2
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    • pp.9-9
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    • 1979
  • It is understood that drum speed of threshers and the moisture content of paddy grains to be threshed, respectively, have a signific:mt effect upon rice recoveries. Threshing under an increased drum speed would give a high performance rate, which is the general practice in custom work threshing in association with the use of semiauto-t hreshers. In the connection, however, it may result in the promotion of grain cracks and brokens of the rice product after milling. No reference or determination for an opti mum drum speed of the thresher is made available for various grain moisture contents at the time of the threshing operation and for different rice varieties especially for the Tongil rice varieties. This study was Conducted to find out and determine effects of the drum speeds on grain losses. The grain loss was quantified in terms of recovery rates of rice grains after treatments. Samples of each of all treatments were taken from the grain sampling plate placed in the grain conveyor of threshers. The grain sample plate was specially provided for this experiment. The brown-rice, milling, and head-rice recJveries were tes ted in the laboratory mill, respectively. Two rice varieties, Akibare and Suweon 251, each with five levels of different moist?ure contents at harvest and six levels of different drum speeds of threshers, were selected and used for treatments in this experiment. Two conditions of materials were tested in the thresher. One condition was to thresh the experimental material immediately after cutting, referred to as the wet-material thr eshing in this study. The other was to thresh the experimental :material, dried to contain about 15-16 percent of the grain moisture under the shocking operation. This is referred to as the dry-material threshing in this study. In additioon, field measurements for the grain moistures and drum-sdeeds under actual operation practices of the traditional field threshing, were conducted with a view to comparing with results of the experimental treatments. The results of the study may be summarized as follows: 1. For threshing treatments of Japonica-type rice variety (Akibare) , the effect of drum speeds and levels of grain moisture at cutting upon brown-rice, milling, and head-rice recoveries were found statistically significant. No significant difference in these recovery rates was noticed regardless of whether the material was threshed right after cutting or after drying by the shocking operation. 2. For the Tongil-sister rice variety(Suweon 251), milling recovery for the varied drum-speed and the grain~moisture level at cutting was found statististically significant. Th milling recovery was much significant when associated with the wet-material thres?hing compared to the dry-material threshing. 3. The optimum peripheral velocity to be maintained at the edge of teeth on the thr?esher drum was determined and may be recommanded as that of about 12 to 13 meters per second in view of the maximum recovery rate of the milled rice. 4. The effect of the drum speed on the qualitative loss of the milled rice was much greater in the case of the Tongil variety than Japonica. This effect was also greater by the wet-material threshing than by the dry-material threshing. Therefore, to apply the wet-material threshing operation for the Tongil variety, in particular, it should be very important to introduce the kind of threshing technology which would maintain the drum speed at optimum. 5. A field survey for the actual drum speed of threshing operations for 50 threshers indicated that average peripheral velccity was 12.76m/sec., and that the range was from 10.50 to 14.90m/sec. Approximately, more than 30% of the experimented and measured threshers were being operated at speeds which exceeded the optimum speed determined and assessed in this study. Accordingly, it should be highly desirable and important to take counter-measures against these threshing practices of operational overspeed.

A Study in an Effective Programs for Emergency Care Delivery System (응급의료 전달체계의 충실 방안)

  • Kwon Sook Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.1
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    • pp.83-102
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    • 1995
  • As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

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Effect of Feeding Rare Earth on Egg Production and Hatchability Broiler Growth (희토(稀土)의 급여가 종계의 산란율 및 부화율에 미치는 영향)

  • Ham, S.K.;Song, T.H.;Zhang, G.Q.;Hur, S.N.;Park, H.S.
    • Korean Journal of Poultry Science
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    • v.33 no.3
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    • pp.225-231
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    • 2006
  • To investigate the effect of feeding rare earth (RE) on the performance of breeder hens a feeding trial with sixteen thousands of 158 day old Ross broiler breeder hens was conducted for thirty weeks. A mixture of RE- chlorides containing mainly La, Ce, and Pr was mixed into corn-soy based diet at two levels, 300 and 600 mg/kg, All the hens were housed in flat layer houses and the ratio of male to female was maintained at one to ten. Dietary supplementation of the of RE at a level of 300 mg/kg made the hens reach egg production peak higher by about 6% and earlier by about two weeks. As a result, it made higher hatchable egg production by 3.5%. It also reduced dramatically the mortality of both male and female breeders(P<0.05). Egg weight was slightly increased but egg qualify was not much influenced by dietary supplementation of RE. Egg albumin hight and Haugh unit were significantly improved while egg shell thickness, egg breaking strength and yolk color were similar to those of the control. Experimental results appeared to show a good possibility that egg fertility and hatchability were improved by feeding RE. Dietary supplementation of RE at a level of 300 mg/kg should be acceptable but not the 600 mg/kg level for breeder hens. Further studies on the effect of RE on egg fertility and hatchability appears to be necessary.

Rare Earth as a Feed Additive for Broiler Growth (육계의 성장 촉진을 위한 사료 첨가제로서의 희토(稀土))

  • Ham, S.K.;Song, T.H.;Zhang, G.Q.;Hur, S.N.;Park, H.S.
    • Korean Journal of Poultry Science
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    • v.33 no.3
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    • pp.233-238
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    • 2006
  • In order to study the effect of feeding rare earth(RE) on growth of broiler chicks, feed conversion ratio, and probable harmfulness of feeding high levels of RE, two feeding trials with broiler chicks were conducted; one using a commercial broiler compound feed and the other using a self mixed feed excluding any growth stimulating feed additives. The the first trial used three hundred sixty of one day old Cobb broiler chicks for six levels of dietary supplementation of RE : 0, 100, 200, 400, 800 and 1,600 mg/kg. There were significant effect of RE stimulating broiler chick growth and improving feed conversion ratio, The dietary supplementation of RE at a level of 100 mg/kg was the best of all and increased body weight gain by 8.9% (p<0.05). Chicks fed RE at a level of 1,600 mg/kg grew as good as chicks fed feeds without RE and did not show my abnormalities. The second feeding trial was conducted in the same manner as the first trial using Ross broiler chicks and self-mixed experimental diets supplemented with RE at levels of 0, 50, 100 and 150 mg/kg. Differently from Results of the first trial, body weight gain and feed conversion ratio of were the best at the level of 50 mg/kg RE supplementation(p<0.05). In this trial all the birds fed RE showed significantly lower ratio of abdominal fat against live weight than those of the control group birds. Overall, it can be said that dietary supplementation of RE will improve broiler growth and feed conversion ratio and the proper dietary level would be $50\sim100mg/kg$. These results suggested that the proper level of RE for broiler chicks would be 50 to 100 mg/kg and its effectiveness is varied depending upon RE mixture. There appears abdominal fat of broiler chicks is decreased by feeding RE but further investigation is in need.

Effects of Dietary Levels of Corn Distiller's Dried Grains with Solubles and Phytase on Performance and Nutrient Utilization of Broilers (옥수수 주정박의 수준과 Phytase의 첨가 유무가 육계의 생산성과 영양소 이용률에 미치는 영향)

  • Hong, E.C.;Na, S.H.;Yu, D.C.;Kim, H.K.;Park, M.N.;Jung, K.C.;Choo, H.J.;Park, H.D.;Chung, W.T.;HwangBo, J.
    • Korean Journal of Poultry Science
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    • v.36 no.3
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    • pp.247-255
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    • 2009
  • This work was conducted to investigate the effects of the addition level of Corn distiller's dried grains with solubles (CDDGS) and phytase in broiler diets on the broiler performance and the ileal amino acid digestibility. Three eighty four Ross broiler (one-day-old) were assigned randomly to 8 treatments groups (12 birds/pen, 4 pens/treatment) as $4{\times}2$ complex factors of CDDGS 4 treatments (0, 5, 10 and 15%) and phytase 2 treatments (0, 500 FTU/kg), and fed experimental diets for 6 weeks (starter, 0~2 wk; grower, 2~4 wk; finisher, 4~6 wk). After the feeding trial was finished, 12 broilers (6 weeks) with similar weights were selected from all treatments to investigate the digestibility of nutrients and amino acids for the first week. The experimental diets contained similar ME and CP of all treatments. Body weight gains and feed intakes were high at phytase treatments (P>0.05), but there was no difference in feed intake of the chicks. The amino acid digestibilities of diets were improved for iso-leucine, lysine, threonine, valine, aspartic acid, proline, serine and tyrosine (P<0.05). Finally, this work showed that growth performance and amino acid digestibility were improved by the addition of CDDGS and phytase in broiler diets.

Prediction of Nitrate Contamination of Groundwater in the Northern Nonsan area Using Multiple Regression Analysis (다중 회귀 분석을 이용한 논산 북부 지역 지하수의 질산성 질소 오염 예측)

  • Kim, Eun-Young;Koh, Dong-Chan;Ko, Kyung-Seok;Yeo, In-Wook
    • Journal of Soil and Groundwater Environment
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    • v.13 no.5
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    • pp.57-73
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    • 2008
  • Nitrate concentrations were measured up to 49 mg/L (as $NO_3$-N) and 22% of the samples exceeded drinking water standard in shallow and bedrock groundwater of the northern Nonsan area. Nitrate concentrations showed a significant difference among land use groups. To predict nitrate concentration in groundwater, multiple regression analysis was carried out using hydrogeologic parameters of soil media, topography and land use which were categorized as several groups, well depth and altitude, and field parameters of temperature, pH, DO and EC. Hydrogeologic parameters were quantified as area proportions of each category within circular buffers centering at wells. Regression was performed to all the combination of variables and the most relevant model was selected based on adjusted coefficient of determination (Adj. $R^2$). Regression using hydrogelogic parameters with varying buffer radii show highest Adj. $R^2$ at 50m and 300m for shallow and bedrock groundwater, respectively. Shallow groundwater has higher Adj. $R^2$ than bedrock groundwater indicating higher susceptibility to hydrogeologic properties of surface environment near the well. Land use and soil media was major explanatory variables for shallow and bedrock groundwater, respectively and residential area was a major variable in both shallow and bedrock groundwater. Regression involving hydrogeologic parameters and field parameters showed that EC, paddy and pH were major variables in shallow groundwater whereas DO, EC and natural area were in bedrock groundwater. Field parameters have much higher explanatory power over the hydrogeologic parameters suggesting field parameters which are routinely measured can provide important information on each well in assessment of nitrate contamination. The most relevant buffer radii can be applied to estimation of travel time of contaminants in surface environment to wells.

Postoperative Adjuvant MVP Chemotherapy and Radiotherapy for Non-Small Cell Lung Cancer (비소세포성폐암의 수술후 MVP복합화학요법과 방사선병용치료 결과)

  • Kim, Jong-Hoon;Choi, Eun-Kyung;Chang, Hyesook;Kim, Sang-Wee;Suh, Chul-won;Lee, Kyoo-Hyung;Lee, Jung, Shin;Kim, Sang-Hee;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Park, Seung-Il;Sohn, Kwang-Hyun
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.149-156
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    • 1995
  • Purpose : Since February 1991 a Prospective study for non-small cell lung cancer patients who underwent radical resection and had a risk factor of positive resection margin or regional lymph node metastasis has been conducted to evaluate the effect of MVP chemotherapy and radiotherapy on the pattern of failure, disease free and overall survival. and tolerance of combined treatment. Materials and Methods: Twenty nine patients were registered to this study until Sep. 1993; of these 26 received planned therapy Within 3 weeks after radical resection, two cycles of MVP(Mitomycin C $6mg/m^2,$ Vinblastin $6mg/m^2,$ Cisplatin $60mg/m^2$) chemotherapy was given with 4 weeks intervals. Radiotherapy (5040cGy tumor bed dose and 900cGy boost to high risk area) was started 3 to 4 weeks after chemotherapy. Results: One and two year overall survival rates were $76.5\%\;and\;58.6\%$ respectively. Locoregional failure developed in 6 patients$(23.1\%)$ and distant failure in 9 patients$(34.6\%)$ Number of involved lymph nodes, resection margin positivity showed some correlation with failure pattern but T-stage and N-stage showed no statistical significance. The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70 days showed lower incidence of distant metastasis. Postoperative combined therapy were well tolerated without definite increase of complication rate, and compliance rate in this study was $90\%$. Conclusion: 1) MVP chemotherapy showed no effect on locoregional recurrence, but appeared to decrease the distant metastasis rate and 2) combined treatments were well tolerated in all patients. 3) The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70days showed lower incidence of distant metastasis. 4) Addition of chemotherapy to radiotherapy failed to increase the overall or disease free survival.

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