• Journal of Chest Surgery
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• v.34 no.6
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• pp.477-484
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• 2001

Background: Initial symptoms for esophageal perforation have not been clarified, but when there is no early diagnosis and proper treatment to follow immediately after the diagnosis, it is fatal for the patients. Therefore, this study attempted to discover the factors that influence the prognosis of esophageal perforation to contribute to the improvement of the treatment result. Material and Method: The subjects of this study are 32 patients who came to the hospital with esophageal perforation from October, 1984 to June, 2000. This study examined the items for clinical observation such as patients' sex, age, cause of the perforation, perforation site, the time spent until the beginning of the treatment, symptoms caused by the perforation and its complication, and treatment methods. This study tried to find out the relationship between the survival of patients and each item. Result: There were 24 male and 8 female patients and their mean age was 49.7+16.4. For the causes of perforation, there were 14 cases(43%) of iatrogenic perforation, which ranked first, caused by the medical instrument operation and surgical damage. As for the perforation sites, thoracic esophagus was the most common site(26 cases of 81.2%) and chest pain was the most frequent symptom. The complication caused by esophageal perforation showed the highest cases in the order of mediastinitis, empyema, sepsis and peritonitis. After the treatment, there were 23 cases of survival and 9 cases of mortality. The total mortality rate was 28.1% and the main causes of mortality were sepsis and acute respiratory distress syndrome(ARDS). As for the treatment, 8 cases(25.0%) treated the perforation successfully using conservative treatment only. As for the surgical treatment, there were 5 cases(15.6%) of cervical drainage, 7 cases (21.8%) of primary repair and 12 cases(37.5%) of esophageal reconstruction after performing an exclusion-diversion. There were 18 cases(56.2%) of complete treatment of esophageal perforation at its initial treatment and in 14 cases(43.8%) of treatment failure at its initial treatment, patients were completely cured in the next treatment stage or died during the treatment. The cases of perforation in thoracic esophagus, complication into severe mediastinitis or sepsis and the cases of failure at initial treatment showed a statistically significant mortality rate (p<0.05).

• Journal of Chest Surgery
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• v.32 no.9
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• pp.806-812
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• 1999

Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1323-1328
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• 1996

The obstructive diseases involving the left main coronary artery(LMCA) are serious. Surgical treatment is generally regarded as much more effective than medical therapy in terms of long-term survival and relief of symptoms. This study represents an attempt to present an analysis of early surgical results in 21 cases conducted at Chonnam University Hospital between October 1992 And August 1995. The subject. 12 males and 9 female, ranged in age from 25 to 67 years with a mean age of 49.3${\pm}$12.5 years. As for indications for operation, unstable angina was reported on 66.7% of the subjects, while stable angina and acute myocardial infarction in 4 and 3 cases, respectively. There were also 2 cases of Takayasu's aortitis and 1 case of failed percutaneous translumlnal coronary angioplasty(PTCA). Eleven subjects had isolated LMCA diseases compared to 10 subjects with associated LMCA diseases. Of the patients with ass;3ciated LMCA diseases, 4 subjects had single coronary artery disease, 3 had double coronary artery disease, remaining 3 suffered from triple coronary artery disease. As for the group with isolated LMCA disease, ostidl angioplasty llsing autopericardium was conducted with 5 subjects. The remaining subjects with the isolated diseases and all of the patients with associated LMCA disease underwent aortocoronary bypass grafts. The left internal mammary artery was used in all patients and the average number of anastomoses was 3.13 ${\pm}$0.93. One subject died of low cardiac output syndrome at the second postoperative day. There were 5 instances of postoperative complication including reoperation for bleeding in two patients, wound infection in two, and arrhythmia in one. Follow-up coronary angiogram were conducted with eights patients, including five patients who underwent ostial angioplasty. In these cases, the patients showed surf. ficient enlargement of the left coronary ostium and the grafted vessels kept their patency. In our experience, surgical treatment of the LMCA diseases has not shown a higher rAte of operative mortAlity or morbidity than other obstructive coronary artery diseases. To patients with ostial stenosis, which is frequently observed among young female, angioplasly utilizing autopericardium seems to be a desirable choice considering the cosmetic effect, chances of reoperation and hemodynamic characteristics.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.790-798
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• 1999

Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.

• Journal of Chest Surgery
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• v.40 no.6 s.275
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• pp.420-427
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• 2007

Background: Postpneumonectomy empyema (PPE) due to bronchopleural fistula (BPF) can be a surgical challenge for surgeons. We analyzed the follow-up outcomes after performing omentopexy and thoracoplasty for the treatment of PPE with BPF after pneumonectomy. Material and Mehod: Between December 1991 and January 2006, 9 patients underwent BPF closure using an omental pedicled flap for the treatment of PPE with BPF after pneumonectomy. There were 7 males and 2 females (mean age: $45.9{\pm}9$ years). The patients were followed up for a mean of 58 months (median: 28 months, range: $6{\sim}169$). When we performed omentopexy, the surgical procedures for empyema were thoracoplasy for 8 patients and the Clagett procedure for 1 patient. Thoracoplasty was performed for the latter patient due to recurrence of empyema, Result: For the 8 patients who were treated by omentopexy and thoracoplasty, there was 1 operation-related death due to sepsis. During follow up, 1 patient, who was treated by omentopexy and a Clagett procedure, died of acute hepatitis 40 months postoperatively. The early mortality was 11.1% (8/9). Of the 8 patients, including the 1 late death patient, successful closure of the BPF were achieved in all patients (8/9) and the empyema was cured in 7 patients (7/8). Conclusion: The BPF closure using an omental pedicled flap was an effective method for treating PPE with BPF due to 75-destroyed lung, and thoracoplasty with simultaneous omentopexy was effective and safe for removing dead space if the patient was young and in a good general condition.

• Fire Science and Engineering
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• v.31 no.5
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• pp.53-62
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• 2017

Electric power which is the energy source of economy and industries requires long distance transportation due to regional difference between its production and consumption, and it is supplied through the multi-loop transmission and distribution system. Prior to its actual use, electric power flows through several transformations by voltage transformers in substations depending on the characteristics of each usage, and a transformer has the structure consisting of the main body, winding wire, insulating oil and bushings. A transformer fire that breaks out in substations entails the primary damage that interrupts the power supply to houses and commercial facilities and causes various safety accidents as well as the secondary economic losses. It is considered that causes of such fire include the leak of insulating oil resulting from the destruction of bottom part of bushings, and the chain reaction of fire due to insulating oil that reaches its ignition point within 1 second. The smoke detector and automatic fire extinguishing system are established in order to minimize fire damage, but a difficulty in securing golden time for extinguishing fire due to delay in the operation of detector and release of gas from the extinguishing system has become a problem. Accordingly, this study was carried out according to needs of active mechanism to prevent the spread of fire and block the leak of insulating oil, in accordance with the importance of securing golden time in extinguishing a fire in its early stage. A bushings fireproof structure was developed by applying the high temperature shape retention materials, which are expanded by flame, and mechanical flame cutoff devices. The bushings fireproof structure was installed on the transformer model produced by applying the actual standards of bushings and flange, and the full scale fire test was carried out. It was confirmed that the bushings fireproof structure operated at accurate position and height within 3 seconds from the flame initiation. It is considered that it could block the spread of flame effectively in the event of actual transformer fire.

• (The) Research of the performance art and culture
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• no.36
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• pp.137-167
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• 2018

As Gwangju Gwonbeon(meaning of a gisaeng call-office) was representative Gwonbeon in Honam area, it educated gugak(Korean traditional music) from the period of Japanese occupation to 1951, the year of foundation of Gwangju gugak center. As Gwangju Gwonbeon's later self, Gwangju gugak center was also an institution that local influentials interested in the education of gugak of Gwangju region cooperated and built. Therefore, Gwangju Gwonbeon should be considered when premodern and modern history of gugak in Gwangju is mentioned. However, the studies of Gwangju Gwonbeon as well as related studies are still thin. Previous researches related to Gwangju Gwonbeon are mostly focused on the operation and dance of Gwonbeon. However, Gwangju was a region where Pansori was invigorated. According to "Joseonmiinbogam", a record of gisaeng(Korean geisha) in 1918, gisaengs of Gwangju Gwonbeon were specialized in Pansori as compared with those of other regions. In addition, today, there are many master singers of Pansori heard by people, among persons who were educated and a lecturer in Gwangju Gwonbeon; therefore, their oral statement is important materials for understanding transmission of Pansori in Gwangju. Nevertheless, the relationship between Gwangju Gwonbeon and Pansori was not studied yet. Especially, oral statement of master singers of Pansori related to Gwangju Gwonbeon was collected partly, as a result, it is not recognized as valuable research materials. Foundation of Gwangju Gwonbeon and Gwangju gugak center became an important basis for education of Pansori as early private institute educating Korean classical musicians in Gwangju. And it is also meaningful as the trigger that gugak in Gwangju was begun in earnest. Therefore, the purpose of this study is reconstruct activities of master singers who worked in Gwangju Gwonbeon and Gwangju gugak center and is to examine transmission and value of Pansori in Gwangju from the period of Japanese occupation to 1973, collecting oral statement of master singers related to Gwangju Gwonbeon. Finally, this study might be helpful for expanding the interest in Pansori and activating related studies.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.505-512
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• 2018

Purpose: Many reconstruction methods have been attempted after an en-bloc resection of the proximal humerus. In particular, the introduction of reverse shoulder arthroplasty (RSA) has made a breakthrough in the functional recovery of the shoulder. Nevertheless, RSA has limitations when the humeral bone stock loss is significant. In addition, it is unclear if RSA is effective in patients showing failure with non-operative treatment of a proximal humeral tumor. Materials and Methods: A reconstruction was performed using an overlapping allograft-RSA composite for 11 patients with a failed proximal humeral construct. Delayed RSA was performed on 6 patients with failed non-operative treatment. The pre- and postoperative Musculoskeletal Tumor Society (MSTS) score and the complications were addressed. Results: Overlapping allograft-RSA composite afforded a stable construct in 11 failed proximal humeral reconstructions and the patient's chief complaints were resolved. The mean time to the union of overlapped allograft-host junction was 5.5 months. Average preoperative MSTS score of 20.3 point increased to 25.7 point, postoperatively. Four of the six patients who had RSA within 4 years from the index operation showed arm elevation of more than $90^{\circ}$ whereas the remaining 5 patients showed some disability. The complications include one case each of dislocation and aseptic infection, which were resolved by changing the polyethylene liner and scar revision, respectively. None of the 6 patients who underwent delayed RSA after the failure of non-operative treatment showed arm elevation more than $90^{\circ}$. Conclusion: An overlapping allograft-RSA composite is a simple and reliable reconstructive modality in patients with massive bone loss. In patients with metastatic cancer necessitating a surgical resection at presentation, early conversion to RSA is recommended to secure functional recovery.

• Journal of agricultural medicine and community health
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• v.44 no.1
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• pp.11-27
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• 2019

Dementia is major epidemic disease of the 21st century in the world. Dementia is one of the major issues in public health globally. Also in Korea, the estimated prevalence of dementia was 8.7%(0.47 million) in 2010, the number will reach the 1 million mark in 2024, it will become a 15.1%(2.71 million) by 2050. Among Koreans aged 65 or older, 725,000 are estimated to be suffering from dementia in 2017. Against dementia, Korea developed three National Dementia Plans in 2008, 2012, and 2016. The 1st plan was came into effect in 2008 and focused on prevention, early diagnostic, development and coordination of infrastructures and management, and improving awareness. The 2nd plan was launched in 2012, addressed the same priorities but had a stronger focus on supporting family members. In 2012 the Dementia Management Act established a statutory basis for organization of the National Dementia Plans. Under the Dementia Management Act, the government is required to produce a comprehensive plan for dementia every 5 years. The Act also orders that the government should register the dementia patients and collect statistics on epidemiology and the management of the dementia conditions. The Dementia Management Act of Korea required the operation of the National Institute of Dementia and Metropolitan/Provincial Dementia Centers to make and carry out dementia management plans throughout the nation. The Act also mandate to establish Dementia Counselling Centers in every public health center and the National Dementia Helpline. The 3rd National Dementia Plan of 2016 aims to build a dementia friendly community to ensure people with dementia and their carer live well. This plan focus on community-based prevention and management of dementia, convenient and safe diagnosis, treatment, and care for people with dementia, the reduction of the care burden for family care-givers of people with dementia, and support for dementia research through research, statistics and technology. In 2017, Moon's government will introduce the "National Dementia Responsibility System," which guarantees most of the burden caused by dementia. This plan include that the introduction of a ceiling on self-pay for dementia diseases, expansion of the application of dementia care standards through alleviating the support criteria for long-term care insurance for mild dementia, expansion of dementia support centers, expansion of national and public dementia care facilities. In the meantime, Korea has accomplished many accomplishments by establishing many measures related to dementia and promoting related projects in a short time, but there are still many challenges.

• Korean Journal of Heritage: History & Science
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• v.36
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• pp.347-377
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• 2003

China is a country with large agricultural areas and subject to frequent calamities. Drought is the top of them. It has been a key problem for development of agriculture in the country. In the long struggle against drought, Chinese have accumulated many rational and irrational experiences. The Dragon Kings Belief, which is popular in North China and discussed in a thesis, is one of their irrational experiences. The belief was passed together with Buddhism from India to China in the Tang Dynasty. After it settled down, it was incorporated with the local five dragons belief and a set of beliefs in dragon kings came into existence. The emergence of the dragon kings belief ended the history that the title of rain got was not clear in China and Dragon kings finally got the status. Irrigation is the lifeblood of agriculture in China. In a Chinese mind, Dragon kings are the most important gods who take charge of rain and thus offer the lifeblood. In understanding the nature and characteristics of Chinese traditional culture, it is important for us to make clear the origin and evolution of the belief, find out its nature, function and operation. In the every year beginning of February of the Fanzhuang calendar in the people of Hebeisheng Zhaoxian, would all hold a festival to offer sacrifices to the $^{{\circ}TM}^{\prime}longpai$. Longpai was regarded as the core of the temple fair, thus the native sons came to call this festival; "longpaihui". In this region the'Fanzhuang longpaihui'developed into a well knownand grand temple fair. It was able to attract numerous pilgrims with its special magic power, occupying a place in $China^{{\circ}TM}$ 'eryueer'festival with festive dragon activities. The dragon is a common totem among Chinese nationals. The belief worship of the dragon dates from the start time of primitive societies. Dragon oneself the ancients worship's thunder lightning. In the worship of the great universe, at first afterwards this belief with the tribe's totem worships to combine to become the animal spirit. In ancient myths legends, along with folk religion and beliefs all hold a very important position. The longpaihui is a temple fair without a temple; this characteristic is a distinction between longpaihui and other temple fairs. As for longpaihui must of the early historical records are unclear. The originator of a huitou system has a kind of organized form of the special features rather, originator of a huitou not fix constant, everything follows voluntarily principle, can become member with the freedom, also can back at any time the meeting. There is a longpaihui for 'dangjiaren', is total representative director in the originator of a huitou will. 'banghui' scope particularly for extensive, come apparently every kind of buildup that help can return into the banghui, where is the person of this village or outside village of, the general cent in banghui work is clear and definite, for longpaihui would various businesses open smoothly the exhibition provides to guarantees powerfully. Fanzhuang longpaihui from the beginning of February to beginning six proceed six days totally. The longpai is used as the ancestry absolute being to exsits with the community absolute being at the same time in fanzhuang first took civil faith, in reality is a kind of method to support social machine in native folks realize together that local community that important function, it provided a space, a kind of a view to take with a relation, rising contact, communication, solidify the community contents small village, formation with fanzhuang. The fanzhuang is used as supplies for gathering town, by luck too is this local community trade exchanges center at the same time therefore can say the faith of the longpai, in addition to its people's custom, religious meaning, still have got the important and social function. Moreover matter worthy of mentioning, Longpai would in organize process, from prepare and plan the producing of meeting every kind of meeting a longpeng of the matter do, all letting person feeling is to adjust the popular support of, get the mass approbation with positive participate. Apart from the originator of a huitou excluding, those although not originator of a huitou, however enthusiasm participate the banghui of its business, also is too much for the number.