• Journal of Chest Surgery
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• v.31 no.5
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• pp.472-480
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• 1998

We reviewed the surgical results of intracardiac lateral tunnel Fontan procedure for the repair of functional single ventricles. Between 1990 and 1996, 104 patients underwent total cavopulmonary anastomosis. Patients' age and body weight averaged 35.9(range 10 to 173) months and 12.8(range 6.5 to 37.8) kg. Preoperative diagnoses included 18 tricuspid atresias and 53 double inlet ventricles with univentricular atrioventricular connection and 33 other complex lesions. Previous palliative operations were performed in 50 of these patients, including 37 systemic to pulmonary artery shunts, 13 pulmonary artery bandings, 15 surgical atrial septectomies, 2 arterial switch procedures, 2 resections of subaortic conus, 2 repairs of total anomalous pulmonary venous connection and 1 Damus-Stansel-Kaye procedure. In 19 patients bidirectional cavopulmonary shunt operation was performed before the Fontan procedure and in 1 patient a Kawashima procedure was required. Preoperative hemodynamics revealed a mean pulmonary artery pressure of 14.6(range 5 to 28) mmHg, a mean pulmonary vascular resistance of 2.2(range 0.4 to 6.9) wood-unit, a mean pulmonary to systemic flow ratio of 0.9(range 0.3 to 3.0), a mean ventricular end-diastolic pressure of 9.0 (range 3.0 to 21.0) mmHg, and a mean arterial oxygen saturation of 76.0(range 45.6 to 88.0)%. The operative procedure consisted of a longitudinal right atriotomy 2cm lateral to the terminal crest up to the right atrial auricle, followed by the creation of a lateral tunnel connecting the orifices of either the superior caval vein or the right atrial auricle to the inferior caval vein, using a Gore-Tex vascular graft with or without a fenestration. Concomitant procedures at the time of Fontan procedure included 22 pulmonary artery angioplasties, 21 atrial septectomies, 4 atrioventricular valve replacements or repairs, 4 corrections of anomalous pulmonary venous connection, and 3 permanent pacemaker implantations. In 31, a fenestration was created, and in 1 an adjustable communication was made in the lateral tunnel pathway. One lateral tunnel conversion was performed in a patient with recurrent intractable tachyarrhythmia 4 years after the initial atriopulmonary connection. Post-extubation hemodynamic data revealed a mean pulmonary artery pressure of 12.7(range 8 to 21) mmHg, a mean ventricular end-diastolic pressure of 7.6(range 4 to 12) mmHg, and a mean room-air arterial oxygen saturation of 89.9(range 68 to 100) %. The follow-up duration was, on average, 27(range 1 to 85) months. Post-Fontan complications included 11 prolonged pleural effusions, 8 arrhythmias, 9 chylothoraces, 5 of damage to the central nervous system, 5 infectious complications, and 4 of acute renal failure. Seven early(6.7%) and 5 late(4.8%) deaths occured. These results proved that the lateral tunnel Fontan procedure provided excellent hemodynamic improvements with acceptable mortality and morbidity for hearts with various types of functional single ventricle.

• Clinical and Experimental Pediatrics
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• v.52 no.12
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• pp.1364-1369
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• 2009

Purpose : To analyze abnormal ventricular activation in childhood congenital heart disease induced by postoperative changes in ventricular volume and pressure and ventricular scar formation using signal-averaged electrocardiography (SAECG). Methods : Fifty-two patients who had undergone open heart surgery (OHS) were enrolled. Patients were divided into the following 3 groups: right ventricular volume overload (atrial septal defect, group1), left ventricular volume overload (ventricular septal defect, group2), and right ventricular pressure overload (tetralogy of Fallot, group 3). The patients were monitored by standard 12-lead ECG and SAECG before and 2 months after the operation. QRS duration, QT and QTc intervals, filtered QRS (f-QRS), high frequency low amplitude potential (HFLA), and root mean square (RMS) voltage in the terminal 40 ms of SAECG were determined. Results : In the preoperative period, group1 showed significant increase in QRS (P=0.011) compared to those of the other 2 groups. In the postoperative period, group3 showed significant increase in the QTc interval (P=0.004) compared to those in the other 2 groups. SAECG parameters showed no significant differences among the groups in the pre- or postoperative period. Of the 52 patients, 12 (23%) in the preoperative period and 21 (40%) in the postoperative period had at least 1 SAECG abnormality. The prevalence of SAECG abnormalities was significantly higher in the postoperative group 2 and group 3 (preoperative: 20% versus postoperative: 28%, P<0.001, preoperative: 14% versus postoperative: 64%, P<0.001, respectively). Conclusion : Abnormal SAECG patterns may be attributed to postoperative scars, OHS itself, and/or ventricular overload.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.29 no.11B
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• pp.980-990
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• 2004

In this paper, we propose the dynamic bandwidth allocation algorithm for the IEEE802.3ah Ethernet Passive Optical Network(EPON) system to provide the fairness among terminals, and evaluate the delay-throughput performance by simulation. For the conventional EPON systems, an Optical Line Termination (OLT) schedules the upstream bandwidth for each Optical Network Unit (ONU), based on its buffer state. This scheme can provide a fair bandwidth allocation for each ONU. However, it has a critical problem that it does not guarantee the fair bandwidth among terminals which are connected to ONUs. For an example, we assume that the traffic from a greedy terminal increases at a time. Then, the buffer state of its ONU is instantly reported to the OLT, and finally the OW can get more bandwidth. As a result, the less bandwidth is allocated to the other ONUs, and thus the transfer delay of terminals connected to the ONUs gets inevitably increased. Noting that this unfairness problem exists in the conventional EPON systems, we propose a fair bandwidth allocation scheme by OLT with considering the buffer state of ONU as welt as the number of terminals connected it. For the performance evaluation, we develop the EPON simulation model with SIMULA simulation language. From the result of the throughput-delay performance and the dynamics of buffer state along time for each terminal and ONU, respectively, one can see that the proposed scheme can provide the fairness among not ONUs but terminals. Finally, it is worthwhile to note that the proposed scheme for the public EPON systems might be an attractive solution for providing the fairness among subscriber terminals.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.118-124
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• 1984

Congenital Cystic Adenomatiod Malformation (C.C.A.M.) is rare, but one of the most common congenital pulmonary anomalies that cause acute respiratory distress in the newborn infants. It is characterized and differentiated from the diffuse pulmonary cystic disease pathologically, i.e. adenomatoid appearance due to marked proliferation of the terminal respiratory components. An 2/12 year old male patient was suffered from respiratory distress and cyanosis on crying since birth, but no specific therapy was given. With progression of symptoms, he came to Korea University Hospital for further evaluation and then transfered to Dept. of Chest Surgery for operative correction under the impression of Congenital Obstructive Emphysema suggested by a pediatrician. On gestational and family history, there was nothing to be concerned such as congenital anomaly. Physical examinations showed; moderate nourishment and development (Wt. 5.5kg), cyanosis on crying, both intercostal and lower sternal retraction on inspiration, Lt. chest building with tympany, Rt. shifting of cardiac dullness, decreased breathing sound with expiratory wheezing on entire Lt. lung field, decreased breathing sound on Rt. upper lung filed, and tachycardia. The remainders were nonspecific. Laboratory findings were normal except WBC $14000/mm^3$ (lymphocyte 70%), Hgb 9.8m%, Hct 28%, negative Mantaux test, and sinus tachycardia and counter-clockwise rotation on EKG. Preoperative simple Chest PA revealed marked hyperlucent entire Lt. lung, herniation of Lt. upper lobe to Rt., collapsed Rt. upper lobe, tracheal deviation and mediastinal shifting to Rt., and no pleural reaction. At operation, after Lt. posterolateral thoracotomy, 4th rib was resected. Operative findings were severe emphysematous changes limited to both lingular segmentectomy was done. The resected specimen showed slight solidity, measuring $8{\times}4.5{\times}2cm$ in size, and small multiple cystic spaces filled with air. Microscopically, entire tissue structures were glandular in appearance, cyst were lined by ciliated columnar epithelium, and occasional cartilages were noted around the cystic spaces. Bronchial elements were dilated but normal pattern on histologically. The patient had a good postoperative courses clinically and radiologically, and discharged on POD 10th without event. The authors report a case of Cogenital Cystic Adenomatoid Malformation (C.C.A.M.)

• Journal of Chest Surgery
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• v.12 no.4
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• pp.324-335
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• 1979

During the period of 4 years from August 1975 to August 1979 one hundred and forty seven cases of lung cancer were seen at Paik Foundation Hospital in Seoul, Korea. Among these 147 cases, 104 patients had primary carcinoma of the lung and the remainder was metastatic carcinoma to the lung. Among these 104 primary carcinoma patients, 73 cases were proven histologically as primary carcinoma of the lung. There were three cases of alveolar cell carcinoma [Table 1 ]. This clinical observation is based on those 73 cases including three case reports of the alveolar cell carcinoma. 1. Peak incidence was observed in the 5th decade of life. Male to female ratio was 2 to 1 [Fig. 1]. 2. Pathological classifications were as follows: epidermoid carcinoma, 24 cases [32.9%]; undifferentiated carcinoma, 20 cases [27.4%]; adenocarcinoma, 15 cases [20.5%]; bronchioloalveolar carcinoma [5.5%] and positive cytology, 10 cases [13.7%] [Fig. 2]. 3. Evidence of inoperability was observed in 55 patients [75% of the 73 cases] [Table 3]. 4. Among those 73 cases, operability was evaluated in 18 patients or 25%. One patient refused operation and 17 patients [23.6%] were explored. In 11 [15%] out of 17 patients, thoracotomies were performed. Six cases were pneumonectomies and 5 cases were lobectomies or bilobectomies [Fig. 3]. 5. First case of alveolar cell carcinoma was a 46 year-old housewife complaining of cough and hemoptysis for one year. The plain chest X-ray and bronchogram showed characteristic pictures as Figures 4 and 5. A pneumonectomy was carried out. Histologically, a beautiful alveolar carcinoma consisted of the characteristic tall columnar epithelial cells, which were lining the alveolar spaces as seen in Figures 6, 7, 8, and 20. 6. In the second case of 41 year old male, predominant clinical feature was single, well defined mass in the right lower lobe [Fig. 10 and 11] on chest X-ray. Bilobectomized specimen showed fragile, soft and hard tissue containing mucoid secretions and focal yellowish necrosis with pigmentation on cut surface [Fig. 12]. Slides showed tumor cells lined up along the alveolar septa with papillary projections [Fig. 13 and 14]. 7. Third case of alveolar cell carcinoma was a 50-year-old housewife with hemoptysis. An outstanding clinical picture was a round to lobulated mass in the right upper lobe [Fig. 16]. She is living now, 2 years and 1 month post-operatively, but has arrived at terminal stage with military nodular disseminations to the contralateral lung [Fig. 19].

• International Journal of Contents
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• v.11 no.1
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• pp.41-51
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• 2015

Management systems for electronic library have been developed on the basis of Client/Server or ASP framework in domestic market for a long time. Therefore, both service provider and user suffer from their high cost and effort in management, maintenance, and repairing of software as well as hardware. Recently in addition, mobile devices like smartphone and tablet PC are frequently used as terminal devices to access computers through the Internet or other networks, sophisticatedly customized or personalized interface for n-screen service became more important issue these days. In this paper, we propose a new scheme of integrated management system for electronic library based on SaaS and Web Standard. We design and implement the proposed scheme applying Electronic Cabinet Guidelines for Web Standard and Universal Code System. Hosted application management style and software on demand style service models based on SaaS are basically applied to develop the management system. Moreover, a newly improved concept of duplication check algorithm in a hierarchical evaluation process is presented and a personalized interface based on web standard is applied to implement the system. Algorithms of duplication check for journal, volume/number, and paper are hierarchically presented with their logic flows. Total framework of our development obeys the standard feature of Electronic Cabinet Guidelines offered by Korea government so that we can accomplish standard of application software, quality improvement of total software, and reusability extension. Scope of our development includes core services of library automation system such as acquisition, list-up, loan-and-return, and their related services. We focus on interoperation compatibility between elementary sub-systems throughout complex network and structural features. Reanalyzing and standardizing each part of the system under the concept on the cloud of service, we construct an integrated development environment for generating, test, operation, and maintenance. Finally, performance analyses are performed about resource usability of server, memory amount used, and response time of server etc. As a result of measurements fulfilled over 5 times at different test points and using different data, the average response time is about 62.9 seconds for 100 clients, which takes about 0.629 seconds per client on the average. We can expect this result makes it possible to operate the system in real-time level proof. Resource usability and memory occupation are also good and moderate comparing to the conventional systems. As total verification tests, we present a simple proof to obey Electronic Cabinet Guidelines and a record of TTA authentication test for topics about SaaS maturity, performance, and application program features.

• Nutrition Research and Practice
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• v.12 no.4
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• pp.275-282
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• 2018

BACKGROUND/OBJECTIVE: There is intense interest in soy isoflavone as a hormone replacement therapy for the prevention of postmenopausal osteoporosis. A new kind of isoflavone-enriched whole soy milk powder (I-WSM) containing more isoflavones than conventional whole soy milk powder was recently developed. The aim of this study was to investigate the effects of I-WSM on bone metabolism in ovariectomized mice. MATERIALS/METHODS: Sixty female ICR mice individually underwent ovariectomy (OVX) or a sham operation, and were randomized into six groups of 10 animals each as follows: Sham, OVX, OVX with 2% I-WSM diet, OVX with 10% I-WSM diet, OVX with 20% I-WSM diet, and OVX with 20% WSM diet. After an 8-week treatment period, bone mineral density (BMD), calcium, alkaline phosphatase (ALP), tartrate-resistant acid phosphatase (TRAP) 5b, osteocalcin (OC), procollagen 1 N-terminal propeptide (P1NP), and osteoprotegenin (OPG) were analyzed. RESULTS: BMD was significantly lower in the OVX group compared to the Sham group but was significantly higher in OVX + 10% I-WSM and OVX + 20% I-WSM groups compared to the OVX group (P < 0.05). Serum calcium concentration significantly increased in the OVX + 10% and 20% I-WSM groups. Serum ALP levels were significantly lower in the OVX + 10% and 20% I-WSM groups compared to the other experimental groups (P < 0.05). OC was significantly reduced in the OVX group compared to the Sham group (P < 0.05), but a dose-dependent increase was observed in the OVX groups supplemented with I-WSM. P1NP and OPG levels were significantly reduced, while TRAP 5b level was significantly elevated in the OVX group compared with the Sham group, which was not affected by I-WSM (P < 0.05). CONCLUSIONS: This study suggests that I-WSM supplementation in OVX mice has the effect of preventing BMD reduction and promoting bone formation. Therefore, I-WSM can be used as an effective alternative to postmenopausal osteoporosis prevention.

• Journal of Navigation and Port Research
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• v.41 no.3
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• pp.137-148
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• 2017

Port service level is a metric of competitiveness among ports for the operating/managing bodies such as the terminal operation company (TOC), Port Authority, or the government, and is used as an important indicator for shipping companies and freight haulers when selecting a port. Considering the importance of metrics, we developed software to objectively define and manage six important service indicators exclusive to container and bulk terminals including: berth occupancy rate, ship's waiting ratio, berth throughput, number of berths, average number of vessels waiting, and average waiting time. We computed the six service indicators utilizing berth 1 through berth 5 in the container terminals and berth 1 through berth 4 in the bulk terminals. The software model allows easy computation of expected ship's waiting ratio over berth occupancy rate, berth throughput, counts of berth, average number of vessels waiting and average waiting time. Further, the software allows prediction of yearly throughput by utilizing a ship's waiting ratio and other productivity indicators and making calculations based on arrival patterns of ship traffic. As a result, a TOC is able to make strategic decisions on the trade-offs in the optimal operating level of the facility with better predictors of the service factors (ship's waiting ratio) and productivity factors (yearly throughput). Successful implementation of the software would attract more shipping companies and shippers and maximize TOC profits.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.18 no.6
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• pp.211-221
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• 2019

The death toll for every 10,000 cars registered in Korea is 1.4, which is still the lowest among OECD members, and the need for rescue and response systems is emerging. In response, the company is developing a vehicle ICT-based emergency rescue system (e-Call) that can handle accidents such as rapid and accurate life saving by automatically sending accident detection and related information to the central center in the event of a traffic accident. However, ordinary citizens are negative about the installation and cost of e-Call services. To solve these problems, various introduction and operation methods of e-Call were proposed for activation of terminal distribution. In addition, the effect of introducing e-Call was analyzed by predicting the penetration rate of e-Call terminals. Analysis shows that 463 to 926 deaths and 3,335 to 6,66.9 billion won will be saved in 10 years after the introduction of e-Call terminals.

• The Journal of Korean Institute of Electromagnetic Engineering and Science
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• v.19 no.1
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• pp.15-22
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• 2008

In this paper, we propose a numerical analysis on reversed current of distributed amplifier based on transmission line theory and proposed a theory to obtain optimum transmission line length to minimize the reversed currents by cancelling those components. The reversed current is analyzed as being simply absorbed into the terminal resistance in the conventional analysis. In the proposed analysis, however, they are designed to be cancelled by each other with opposite phase by the optimal length of the transmission lint Circuit simulation and implementation using pHEMT transistor were performed to validate the proposed theory with the cutoff frequency of 3.6 GHz. From the measurement, maximum gain of 14.5dB and minimum gain of 12.3dB were achieved In the operation band. Moreover, measured efficiency of the proposed distributed amplifier is 25.6% at 3 GHz, which is 7.6%, higher than the conventional distributed amplifier. Measured output power Is about 10.9dBm, achieving 1.7dB higher output power than the conventional one. Those improvement is thought to be based on the cancellation of refersed current.