• Journal of Chest Surgery
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• v.37 no.9
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• pp.755-761
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• 2004

We evaluated the efficacy of Dor procedure in patients with ischemic left ventricular dysfunction. Material and Method: Between April 1998 and December 2002, 45 patients underwent the Dor procedure con-comitant with coronary artery bypass grafting (CABG). Left ventricular ejection fraction (LVEF) and left ventricular end-diastolic/end-systolic volumes (LVEDV/LVESV) were measured by echocardiography, myocardial SPECT, and cardiac catheterization and angiography performed at the sequence of preoperative, early postoperative, and one year postoperative stage. Result: Cardiopulmonary bypass and aortic clamp times were mean 141$\pm$64, 69$\pm$24 minutes, respectively. Intraaortic balloon pump (IABP) therapy was required in 19 patients (42%; 7 preoperatively, 9 intraoperatively, 3 postoperatively). Operative mortality rate was 2.2% (1/45). Postoperative morbidities were low cardiac output syndrome (12), atrial fibrillation (5), acute renal failure (4), and postoperative bleeding (4). Functional class (NYHA) was improved from classes 2.8 to 1.1 (p < 0,01). When we compared between the preoperative and early postoperative values, LVEF was improved from 32$\pm$9% to 52$\pm$11% (p<0.01). The asynergy portion decreased from 57$\pm$12% to 22$\pm$9%, and LVEDV/LVESV indexes improved from 125$\pm$39 mL/$m^2$, 85$\pm$30 mL/$m^2$ to 66$\pm$23 mL/$m^2$, 32$\pm$16 mL/$m^2$ (p<0.01). Although these changes in volumes were relatively preserved at postoperative one year, the left ventricular volumes showed a tendency to increase. Conclusion: After the Dor procedure for ischemic left ventricular dysfunction, LVEF improvement and left ventricular volume reduction were maintained till postoperative one year. The tendency for left ventricular volume to increase at postoperative one year suggested the requirement of strict medical management.

• Journal of Genetic Medicine
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• v.4 no.1
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• pp.72-79
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• 2007

Purpose : Glycogen storage disease type III (GSD-III) is a rare autosomal recessive disorder of glycogen metabolism. The affected enzyme, amylo-1,6-glucosidase, 4-alpha-glucanotransferase (AGL, glycogen debranching enzyme), is responsible for the debranching of the glycogen molecule during catabolism. The disease shows clinical and biochemical heterogeneity, reflecting genotype-phenotype heterogeneity among different patients. In this study, we aim at analyzing mutations of the AGL gene in three unrelated Korean GSD-III patients, and characterizing their clinical and laboratory findings. Methods : We characterized the clinical features of three unrelated Korean GSD-III patients by biochemical, histological and imaging studies. The 35 exons and part of exon-intron boundaries of AGL were analyzed by direct sequencing using genomic DNA extracted from the peripheral leukocytes of patients. Results : Diverse clinical features were observed in these patients including hepatomegaly (all patients), seizures (patient 2), grow th failure (patients 1 and 2), hyperlipidemia (patients 1 and 3), raised transaminase and creatine kinase concentrations (all patients), and mild cardiomyopathy (patient 2). Liver transplantation w as performed in patient 2 due to progressive hepatic fibrosis. A dministration of uncooked corn starch maintained normoglycemia and improved biochemical and growth profiles. DNA sequence analysis revealed mutations in 5 out of 6 alleles. Patient 1 was a compound heterozygote of c.1282 G>A (p.R428K) and c.1306delA (p.S603PfsX6), patient 2 had c.1510_1511insT (p.Y 504L fsX 10), and patient 3 had c.3416 T >C (p.L 1139P) and c.1735+1 G>T (p.Y 538_R578delfsX 4) mutations. A part from the p.R428K mutation, the 4 other substitutions identified w ere nov el. Conclusion : GSD-III patients display variable phenotypic characteristics resembling those of GSD-Ia. Molecular defects in the AGL gene of Korean GSD-III patients are genetically heterogeneous.

• Journal of the Daesoon Academy of Sciences
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• v.50
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• pp.219-257
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• 2024

In this article The Woodcutter and the Fairy (나무꾼과 선녀) and Snake Bridegroom (구렁덩덩 신선비) are compared to explore the principles of conflict and harmony reflected in the 'separation-reunion' structure. These two works center on relationships; couples formed by the union of a divine being and an ordinary being. The woodcutter and his third daughter are the representatives of ordinary beings, while the fair maiden and the fresh rain are the representatives of divine beings, and the narrative emphasizes that the members of each couple are existentially different. This article focuses on the problems that arise due to existential differences in such relationships. Thus, in section 2, the narratives of The Woodcutter and the Fairy and Snake Bridegroom are shown to be based on the same structure. If the narrative of both works is analyzed centered on the relationship problem of couples, the sequence can be summarized as '(appearance and search) - encounter - connection - separation - reunion - test - passage.' And in this structure, the core of the narrative is especially contained in the 'separation-reunion' stage. The structure of a spouse leaving (separation) and a spouse returning (reunion) implies a reflection on the points that cause discord in a couple's relationship and the points that make unity possible. Accordingly, this article explores the narrative differences in the failure and success of reconciliation by examining how the 'leaver' and 'left-behind' spouses respond to this issue. In other words, it examines the factors that drive the process of relationship-change in the narratives of the two works, and attempts to capture the principles of reconciliation by capturing the causes of discord and the forces that bring about reconciliation. Through this, it can be found that The Woodcutter and the Fairy and Snake Bridegroom are works that convey the realization that a couple can continue their relationship by understanding and caring for the wishes of the world or the wishes of the other person. In other words, the two works tell readers that it is difficult to reach harmony through the will to continue the relationship, and that listening to the wishes of the world or one's spouse opens the way to true harmony.