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Early Results of Maze III Operation Without Cryoablation (냉동절제 없이 시행한 Maze III 술식의 조기 결과)

  • 김형수;이원용;오동진;지현근;홍기우;두영철
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.255-261
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    • 1999
  • Background: Atrial fibrillation is one of the most prevalent of all arrhythmias and in up to 79% of the patients with mitral valve disease. This study examined whether the atrial fibrillation that occur in patients with mitral valve operation could be eliminated by a concommitant maze operation without cryoablation. Material and Method: From May 1997 to April 1998, 14 patients with atrial fibrillation associated with mitral valve disease underwent Maze III operation without cryoablation. Preoperatively there were 6 men and 8 women with an average age of 46.2${\pm}$10.7 years. Eleven patients had mitral stenosis, and three had mitral insufficiency. The associated heart diseases were aortic valve disease in 4, tricuspid valve regurgitation in 1 and ASD in 2. Using transthoracic echocardiography, the mean left atrial diameters was 54.7${\pm}$5.3 mm and thrombi were found in the left atrium of 2 patients. Postoperatively the ratio between the peak speed of the early filling wave and that of the atrial contraction wave (A/E ratio) was determined from transmitral flow measurement. Operations were mitral valve replacement in 13 including 4 aortic valve replacements, 1 DeVega annuloplasty and 2 ASD closures. Maze III operation was performed in 1 patient. Result: Five patients (38%) had recurred atrial fibrillation, which was reversed with flecainide or amiodarone at the average time of postoperative 38.8${\pm}$23.5 days. Postoperative complications were postoperative transient junctional rhythm in 6, transient atrial fibrillation in 5, reoperation for bleeding in 3, postpericardiotomy syndrome(1), unilateral vocal cord palsy(1), postoperative psychosis(1), and myocardial infarction(1). Postoperatively A/E ratio was 0.43${\pm}$0.22 and A wave found in 9(64%) patients. 3 to 14 months postoperatively (average follow- up, 8.1 months), all of patients had normal sinus rhythm and 9(64%) patients had left atrial contraction and 11(79%) patients were not on a regimen of antiarrhythmic medication. Conclusion: We conclude that Maze III operation without cryoablation is an effective surgical treatment in atrial fibrillation associated with the mitral valve disease.

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The Determination Factor's Variation of Real Estate Price after Financial Crisis in Korea (2008년 금융위기 이후 부동산가격 결정요인 변화 분석)

  • Kim, Yong-Soon;Kwon, Chi-Hung;Lee, Kyung-Ae;Lee, Hyun-Rim
    • Land and Housing Review
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    • v.2 no.4
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    • pp.367-377
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    • 2011
  • This paper investigates the determination factors' variation of real estate price after sub-prime financial crisis, in korea, using a VAR model. The model includes land price, housing price, housing rent (Jensei) price, which time period is from 2000:1Q to 2011:2Q and uses interest rate, real GDP, consumer price index, KOSPI, the number of housing construction, the amount of land sales and practices to impulse response and variance decomposition analysis. Data cover two sub-periods and divided by 2008:3Q that occurred the sub-prime crisis; one is a period of 2000:1Q to 2008:3Q, the other is based a period of 2000:1Q to 2011:2Q. As a result, Comparing sub-prime crisis before and after, land price come out that the influence of real GDP is expanding, but current interest rate's variation is weaken due to the stagnation of current economic status and housing construction market. Housing price is few influenced to interest rate and real GDP, but it is influenced its own variation or Jensei price's variation. According to the Jensei price's rapidly increasing in nowadays, housing price might be increasing a rising possibility. Jensei price is also weaken the influence of all economic index, housing price, comparing before sub-prime financial crisis and it is influenced its own variation the same housing price. As you know, real estate price is weakened market basic value factors such as, interest rate, real GDP, because it is influenced exogenous economic factors such as population structural changes. Economic participators, economic officials, consumer, construction supplyers need to access an accurate observation about current real estate market and economic status.

The Study on Quantifying and Evaluating for the Functions of Flood Control and Fostering Water Resources in Agriculture (농업의 홍수조절기능과 수자원함양기능 계량화 및 가치평가에 관한 연구)

  • Seo, Myung-Chul;Kang, Ki-Kyung;Hyun, Byung-Geun;Yun, Hong-Bae;Eom, Ki-Cheol
    • Korean Journal of Soil Science and Fertilizer
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    • v.41 no.2
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    • pp.143-152
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    • 2008
  • In order to share the understanding agricultural multifunctionality with people, we carried out quantification and monetary evaluation for controlling flood and fostering water resources function in paddy and upland farming in Korea. The amount of water controlling flood and fostering water resources function in paddy farming was much greater than that in upland. The quantification of flood control function could be estimated by sum of the height of dike and water infiltrated during the flooding periods in paddy farming, and water excepting runoff water from precipitation at flooding time in upland farming. As results of estimation of flood control function, the amounts of water controlling flood have been evaluated as $294mm\;year^{-1}$ in paddy farming and $72.6mm\;year^{-1}$ upland farming, and was calculated 3.71 billion MT on a nation basis in 2006. When it was carried out monetary estimation as the cost of dam construction and the depreciation expense by using replacement cost method, flood control functions in paddy and upland were evaluated as 44,338.9 and 7,221.5 billion won, respectively. Comparing with previous reports, monetary value was analyzed much to increase because of rising price cost recently. Fostering water resource functions were also quantified in paddy and upland farming as the amount of water keeping and infiltrating water during the cultivation. In the basis of estimation model, it was showed that paddy and upland farming had been estimated to have $414.28mm\;year^{-1}$, $18.7mm\;year^{-1}$, respectively. They were also calculated to 4.49 and 0.137 billion MT on a nation basis in 2006, respectively. The economic values of fostering water resources function in paddy and upland farming were also estimated to 1,769.4 and 52.8 billion won, respectively, as replacing the amount of water to the cost of drinking water in 2006. There were differences by much to the amounts of controlling flood function and fostering water resource between paddy and upland farming. It means that paddy farming more play an important role in environment than upland farming in Korea.

Significance of Apoptotic Cell Death after $\gamma-Irradiation$ (방사선 조사에 의한 세포사에 있어서 세포고사의 의미)

  • Wu H.G.;Kim I.H.
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.252-258
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    • 2001
  • Purpose : The objectives of this study are to investigate the significance of apoptotic death compared to total cell death after $\gamma-ray$ irradiation in human H&N cancer cell lines and to find out correlation between apoptosis and radiation sensitivity. Materials and method : Head and neck cancer cell lines (PCI-1, PCI-13, and SNU-1066), leukemia cell line (CCRF-CEM), and fibroblast cell line (LM217) as a normal control were used for this study. Cells were irradiated using Cs-137 animal experiment irradiator. Total cell death was measured by clonogenic assay. Annexin-V staining was used to detect the fraction of apoptotic death. Results : Surviving fraction at 2 Gy (SF2) were 0.741, 0.544, 0.313, 0.302, and 0.100 for PCI-1, PCI-13, SNU-1066, CCRF-CEM, and LM217 cell lines, respectively. Apoptosis was detected in all cell lines. Apoptotic index reached peak value at 72 hours after irradiation in head and neck cancer cell lines, and that was at 24 hours in CCRF-CEM and LM217. Total cell death increased exponentially with increasing radiation dose from 0 Gy to 8 Gy, but the change was minimal in apoptotic index. Apoptotic fractions at 2 Gy were $46\%,\;48\%,\;46\%,\;24\%,\;and\;19\%$ and at 6 Gy were $20\%,\;33\%,\;35\%,\;17\%,\;and\;20\%$ for PCI-1, PCI-13, SNU-1066, CCRF-CEM, and LM217, respectively. The radioresistant cell lines showed more higher apoptotic fraction at 2 Gy, but there was not such correlation at 6 Gy. Conclusion : All cell lines used in this study showed apoptosis after irradiation, but time course of apoptosis was different from that of leukemia cell line and normal fibroblast cell line. Reproductive cell death was more important mode of cell death than apoptotic death in all cell lines used in this study. But there was correlation between apoptotic fraction and radiation sensitivity at 2 Gy.

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Development of a High Heat Load Test Facility KoHLT-1 for a Testing of Nuclear Fusion Reactor Components (핵융합로부품 시험을 위한 고열부하 시험시설 KoHLT-1 구축)

  • Bae, Young-Dug;Kim, Suk-Kwon;Lee, Dong-Won;Shin, Hee-Yun;Hong, Bong-Guen
    • Journal of the Korean Vacuum Society
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    • v.18 no.4
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    • pp.318-330
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    • 2009
  • A high heat flux test facility using a graphite heating panel was constructed and is presently in operation at Korea Atomic Energy Research Institute, which is called KoHLT-1. Its major purpose is to carry out a thermal cycle test to verify the integrity of a HIP (hot isostatic pressing) bonded Be mockups which were fabricated for developing HIP joining technology to bond different metals, i.e., Be-to-CuCrZr and CuCrZr-to-SS316L, for the ITER (International Thermonuclear Experimental Reactor) first wall. The KoHLT-1 consists of a graphite heating panel, a box-type test chamber with water-cooling jackets, an electrical DC power supply, a water-cooling system, an evacuation system, an He gas system, and some diagnostics, which are equipped in an authorized laboratory with a special ventilation system for the Be treatment. The graphite heater is placed between two mockups, and the gap distance between the heater and the mockup is adjusted to $2{\sim}3\;mm$. We designed and fabricated several graphite heating panels to have various heating areas depending on the tested mockups, and to have the electrical resistances of $0.2{\sim}0.5$ ohms during high temperature operation. The heater is connected to an electrical DC power supply of 100 V/400 A. The heat flux is easily controlled by the pre-programmed control system which consists of a personal computer and a multi function module. The heat fluxes on the two mockups are deduced from the flow rate and the coolant inlet/out temperatures by a calorimetric method. We have carried out the thermal cycle tests of various Be mockups, and the reliability of the KoHLT-1 for long time operation at a high heat flux was verified, and its broad applicability is promising.

Immunohistochemical Study to Evaluate the Prognostic Significance of Four Biomolecular Markers in Radiotherapy of Nasopharyngeal Carcinoma (방사선 치료를 받은 코인두암의 생체분자적 예후 인자를 찾기 위한 면역조직화학염색 연구)

  • Kim, Yeon-Joo;Lee, Seung-Hee;Wu, Hong-Gyun;Go, Heoun-Jeong;Jeon, Yoon-Kyung
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.57-63
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    • 2010
  • Purpose: We performed an immunohistochemical study with pre-treatment biopsy specimens to evaluate the prognostic significance of four biomolecular markers which can be used as a predictive assay for radiotherapy (RT) treatment of nasopharyngeal carcinoma (NPC). Materials and Methods: From January 1998 through December 2006, 68 patients were histologically diagnosed as non-metastatic NPC and treated by RT. Only 38 patients had the paraffin block for the immunohistochemical study. Thirty-one patients had undifferentiated carcinoma and 7 patients had squamous cell carcinoma. Thirtytwo patients (84%) had advanced stage NPC (2002 AJCC Stage III~IV). Immunohistochemical staining was performed for Met, COX-2, nm23-H1, and epidermal growth factor receptor (EGFR) expression using routine methods. Results: The median follow-up time was 30 months (range, 11 to 83 months) for all patients, and 39 months (range, 19 to 83 months) for surviving patients. The 5-year overall survival (OS) rate of the patients with high Met extent (${\geq}50%$) was significantly lower than that of the patients with low Met extent (48% vs. 84%, p=0.02). In addition, Met extent was also a significant prognostic factor in multivariate analysis (p=0.01). No correlation was observed between Met extent and T stage, N stage, stage group, gender, age, and the response to chemotherapy or RT. Met extent showed moderate correlation with COX-2 expression (Pearson coefficient 0.496, p<0.01), but COX-2 expression did not affect OS. Neither nm23-H1 or EGFR expression was a prognostic factor for OS in this study. Conclusion: High Met extent (${\geq}50%$) might be an independent prognostic factor that predicts poor OS in NPC treated with RT.

Conservation and Reproduction of Cheongpung Buwongun Kim Wumyeong's Funeral Bier (청풍부원군 김우명 상여의 보존 및 복제)

  • Jeong, Jaeung;Huh, Ilkwon;Park, Seungwon;Yi, Yonghee
    • Conservation Science in Museum
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    • v.14
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    • pp.91-113
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    • 2013
  • Cheongpung Buwongun Kim Wu-myeong's Funeral Bier, an important folklore cultural property No.120, possessed by Chuncheon National Museum was donated in 2002 (by Kim Seonggu). It consists of a bier, yoyeo(腰輿), myeongjeongdae(銘旌臺), and manjangdae(輓章臺). It has a high value as the oldest royal bier. The bier which had a resting time in the storage for special exhibition of "The great cultural treasure of Gangwon province" was inspected in September 2012 and colored pigment layer of the wooden part had the risk of peeling off and surface damage of the textile was serious. Therefore, conservation treatment was conducted. In addition, knots and susiks(垂飾) were severely damaged and their exhibition was impossible. Therefore, a reproduction to replace them through a close investigation was made. All parts of the funeral bier were in separation except for the basic furniture. Conservation was made by dividing the parts into wooden parts and textile parts. Yoyeo was reinforced after disassembling bujae from it and then was reassembled. Paraloid B-72 2 wt% (in ethyle acetate), acrylic resin, was applied to the wooden part of the bier in order to reinforce the colored pigment layer with the addition of sodium alginate 2 wt%(in stilled water) and glue 4 wt%(in stilled water). The pollutants on the surface of the textile part were removed (vacuuming) and its creases were smoothed out (steaming). Fat-soluble pollutants were removed using an nonionic surfactant(Saponin, concentration at 0.25 to 0.5 g/𝑙, in de-ionized water). After the disassembly of the yoyeo from the broken wooden, it was bonded with glue (3 wt% for the first gluing, 35 wt% for gluing), and pine wood was used to restore missing parts. In the process of connecting Wongak(雲角), the original metal hinge and nails were reused to complete the assembly.

An Outbreak of Epidemic Keratoconjunctivitis by Adenovirus Type 8 in a Neonatal Intensive Care Unit (신생아 중환자실에서의 아데노바이러스 8형에 의한 유행성 각결막염의 발생)

  • Park, Na-Ri-Mi;Na, Ji-Youn;Joung, Kyoung-Eun;Lee, Ji-Na;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Seong-Joon;Song, Jung-Suk;Oh, Hyang-Soon;Lee, Hoan-Jong;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.44-53
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    • 2008
  • Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.

The Assessment on Health Status of Workers by using HPLP and Sa-sang Constitutional Questionnaire (HPLP와 사상체질설문(四象體質說問)을 이용(利用)한 근로자(勤勞者)들의 건강상태(健康狀態) 평가(評價))

  • Choi Mun-Il;Lee Eun-Kyoung;Kwon So-Hee;Ko Kwang-Jae;Seo Byeong-Yun;Jeoung Jae-Yeal;Jahng Doo-Sub;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.5 no.1
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    • pp.41-56
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    • 2001
  • Overview: The purpose of this study was to evaluate the determinants on the correlation between constitution and health promoting lifestyle profile on the workers. Also, the questionnaire on the HPLP (health promoting lifestyle profile) of Walker(1987) and Sa-sang constitution of Lee(l894) were utilized Methods: Data from a representative sample of 652 workers were analyzed Pearson's chi-square test analysis was utilized to test the explanatory causal model and to determine the direct and indirect effects of independent variables on quality of life. Results: Constitutional distribution among exposed group, were Tae-eum In(43.7%), So-eum In(33.6%), and So-yang In(22.7%). The degree of the subjects practicing health promoting lifestyle, on a scale of 1 to 4, is an average of 2.62, personal relations 2.94, self-realization 2.86, stress management 2.71, nutrition 2.68, responsibility for health 2.37, and exercise 2.21, with personal relations earning the highest points and exercise the lowest As for factors influencing health promoting lifestyle, there is significant difference between sex and age. That is female and higher age. On the difference between constitution and health promoting lifestyle, Tae-eum In is the highest all area except personal relations. So-eum In is the lowest all area except responsibility for health. Conclusions: Tae-eum In totally do health promoting lifestyle well but So-eum In relatively not. On the Study we used the HPLP(health promoting lifestyle profile) on the premise that each person's daily life, the attitude and the practice level to the health have an influence on the health. So in the constitution there is a little differences in the consideration and the practice level and health condition will be different. On this study we finish up by knowing about the health promoting lifestyle. But on next time we will have to go on studying about the sign and the comparison with the result of western and oriental medical health examination to the each constitution on carrying out continuously oriental medical health examination.

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A Study on Accuracy and Usefulness of In-vivo Dosimetry in Proton Therapy (양성자 치료에서 생체 내 선량측정 검출기(In-vivo dosimety)의 정확성과 유용성에 관한 연구)

  • Kim, Sunyoung;Choi, Jaehyock;Won, Huisu;Hong, Joowan;Cho, Jaehwan;Lee, Sunyeob;Park, Cheolsoo
    • Journal of the Korean Society of Radiology
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    • v.8 no.4
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    • pp.171-180
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    • 2014
  • In this study, the authors attempted to measure the skin dose by irradiating the actual dose on to the TLD(Thermo-Luminescence Dosimeter) and EBT3 Film used as the In-vivo dosimetry after planning the same treatment as the actual patient on a Phantom, because the erythema or dermatitis is frequently occurred on the patients' skin at the time of the proton therapy of medulloblastoma patient receiving the proton therapy. They intended to know whether there is the usefulness for the dosimetry of skin by the comparative analysis of the measured dose values with the treatment planned skin dose. The CT scan from the Brain to the Pelvis was done by placing a phantom on the CSI(Cranio-spinal irradiation) Set-up position of Medulloblastoma, and the treatment Isocenter point was aligned by using DIPS(Digital Image Positioning System) in the treatment room after planning a proton therapy. The treatment Isocenter point of 5 areas that the proton beam was entered into them, and Markers of 2 areas shown in the Phantom during CT scans, that is, in all 7 points, TLD and EBT3 Film pre-calibrated are alternatively attached, and the proton beam that the treatment was planned, was irradiated by 10 times, respectively. As a result of the comparative analysis of the average value calculated from the result values obtained by the repeated measurement of 10 times with the Skin Dose measured in the treatment planning system, the measured dose values of 6 points, except for one point that the accurate measurement was lacked due to the measurement position with a difficulty showed the distribution of the absolute dose value ${\pm}2%$ in both TLD and EBT Film. In conclusion, in this study, the clinical usefulness of the TLD and EBT3 Film for the Enterance skin dose measurement in the first proton therapy in Korea was confirmed.