• Journal of Chest Surgery
• /
• v.31 no.4
• /
• pp.393-397
• /
• 1998

A 25-year-old man with viral cardiomyopathy and chronic active hepatitis successfully underwent dynamic cardiomyoplasty for the first time in Korea on July 30, 1996. The patient had been intermittently dyspneic for 5 years and was admitted to our center twice because of heart failure. For the past 2 years, he was NYHA functional class III status with a left ventricular ejection fraction(LVEF) of around 30%. The patient was born with scoliosis and showed a short stature. The liver function showed elevated liver enzymes, and hepatitis B antigen was positive. The liver biopsy revealed chronic active hepatitis. The preoperative echocardiogram showed decreased left ventricular function with grade II mitral and grade II tricuspid regurgitation with dilated left and right atrium. Recently his symptoms worsened and we decided to perform a dynamic cardiomyoplasty. The left latissmus dorsi muscle(LDM) was mobilized and tested with lead placement on his right lateral decubitus position. The patient was positioned into supine and, after median sternotomy, the heart was wrapped with the mobilized muscle. The Russian made cardiomyostimulator(EKS-445) and leads (Myocardial PEMB for heart and PEMP-1 for LDM) were used. The total operation time was 8 hours and there were no perioperative episodes. Postoperatively the LDM had been trained for a 10 week period and currently the stimulation ratio is maintained at 1:4. The postoperative LVEF did not increase with the value of 30-35%. However, the patient feels better postoperatively with slightly increased activity.

• Korean Journal of Cognitive Science
• /
• v.29 no.4
• /
• pp.265-281
• /
• 2018

This study examines the effect of present and future situation on the temporal distance estimation to the future. The effect of present and future situation on time expression was verified. In Experiment 1, an experiment was conducted to investigated the effects of positivity/negativity situation of the present and the future on the judgment of subjective the distance to a certain future time. The results are as follows. When the present is positive and the future is negative, the future looks closer than the objective temporal distance and comes faster, When the present is negative and the future is positive, the future looks farther and comes slower. On the other hand, when the present and the future are both negative, the future looks coming slower. And when the present and the future are both positive, the future is expected to come faster. In Experiment 2, the cognitive and emotional aspects of subjective time through time expressions. It can be said to be 'the time of perseverance' in the sense of time for effort. On the other hand, when the present is positive compared to the future, the time seems go fast and we generally prefer to use cognitive expressions such as 'fast' and emotional expressions such as 'near' and 'pleasant' and 'flutter'. It is 'the time of availability', which means the time to enjoy and utilize.

• KSCE Journal of Civil and Environmental Engineering Research
• /
• v.26 no.6A
• /
• pp.1013-1022
• /
• 2006

Although the cable-stayed bridges with two I-type girders inherently do not have good aerodynamic characteristics, a lot of the bridges with this type girders are constructed in Korea recently because of an economical merit. This paper investigated the aerodynamic characteristics of the cable-stayed bridges with two I-type girders. Section model tests were conducted in order to investigate the aerodynamic behaviors of this section with varying of the angles of attack, turbulence intensity and damping ratios. Two deck section configurations with different torsional stiffness were studied under construction and after completion respectively. Three types of the fairings were investigated to improve the aerodynamic characteristics of the bridges. The result of this study showed that the traditional section model test in uniform flow estimates the aerodynamic behavior rather pessimistically. The wind induced responses of the bridges were severely varied in accordance with the turbulence intensity and the structural damping ratio. The proposed fairing reduced the magnitude of the vortex-shedding vibrations and buffeting responses. It also increased the wind speed at which flutter occurs. It is expected that these investigations would provide a lot of information for the design of the cable stayed bridges with two I-type girders regarding wind resistance.

• Clinical and Experimental Pediatrics
• /
• v.50 no.1
• /
• pp.40-46
• /
• 2007

Purpose : This study assessed the long term survival rate and long term complications of patients who had a modified Fontan operation for functionally univentricular cardiac anomaly. Methods : Between June 1986 and December 2000, 302 patients with a functional single ventricle underwent surgical interventions and were followed up until February 2006. The mean follow-up period was $8.3{\pm}5.3years$ (range 3.5-18 years). Their median age was 2.4 years at the Fontan operation. The survival rate, the incidence and the risk factor of late complications were evaluated retrospectively. Results : The verall survival rate was 91 percent at 5 years and 87 percent at 10 years. In multivariate analysis, early calendar year of operation and significant regurgitation were risk factors of death. The surviving patients showed NYHA functional class I in 82 percent, class II in 15 percent, and class III in 3 percent. Redo Fontan operations were necessary in 8.8 percent of patients at average $12.8{\pm}3.6years$ after initial Fontan operation. The most common cause of Fontan conversion was atrial arrhythmia. The incidence of thromboembolic events was 9.3% and these complications were associated with the occurrence of atrial tachyarrhythmia. Supraventricular tachycardia including atrial flutter or fibrillation were reported on the follow-up examination by 11.2 percent of survivors after $8.4{\pm}5.6years$. Atriopulmonary connection showed higher rates of late tachycardia than lateral tunnel operation. Conclusions : This study revealed that the recent survival rate of Fontan type operation was satisfactory, but the occurrence of late complications after a Fontan type operation increased with the longer survival. There is a need for strict follow up and early treatment of late complications in patients who had a Fontan operation.

• Clinical and Experimental Pediatrics
• /
• v.50 no.11
• /
• pp.1085-1090
• /
• 2007

Purpose : Radiofrequency catheter ablation (RFCA) has become an effective therapeutic modality for treating pediatric tachyarrhythmias. Using conventional RFCA catheters, ablation of parahisian accessory pathways may be difficult and have high risk for heart block. We reviewed the efficacy and complications of the RFCA in children and adolescent with arrhythmias including parahisian accessory pathways. Methods : We studied 48 patients (aged 2 years to 20 years) who had undergone RFCA from August 2003 to March 2007. We reviewed clinical findings, electrophysiologic studies, RFCA data, complications, and follow-up results of the patients. Results : Mean age of the patients was 13.1 years. Numbers and types of arrhythmias (age, acute success rate) were as follows: 19 WPW syndrome including 5 parahisian accessory pathways ($13.7{\pm}4.6yr$, 18/19), 11 atrioventricular reentrant tachycardia with concealed bypass tract ($12.3{\pm}5.0yr$, 10/11), 13 atrioventricular nodal reentrant tachycardia ($12.6{\pm}4.4yr$, 13/13), 4 atrial flutter ($13.0{\pm}7.4yr$, 3/4), and 1 ventricular tachycardia (20 yr, 1/1). Associated cardiac structural lesion was not detected in 48 patients. The recurrence rate was 6.5%, and the final success rate was 93.8%. Conclusion : These results suggest that RFCA is a highly effective treatment method in children and adolescent with tachyarrhythmia.

• Journal of Life Science
• /
• v.31 no.10
• /
• pp.913-921
• /
• 2021

Limb-girdle muscular dystrophy (LGMD) which is characterized by progressive muscle weakening of the hip and shoulder shows both dominant and recessive inheritances with many pathogenic genes including TTN. This study performed to identify genetic causes of a male patient with late onset (45 years old) autosomal recessive LGMD and atrial flutter. By application of the whole exome sequencing, we identified bi-allelic variants of TTN gene in the patient. One allele had a single missense variant of [c.24124G>T (p.V8042F)], while the other allele consisted of three missense variants of [c.29222G>C (p.R9741P) + c.67490A>G (p.H22497R) + c.75376C>T (p.R25126C)]. The p.V8042F allele was transmitted from his mother, while the other haplotype allele was putatively transmitted from his father. His two unaffected sons had only the p.R9741P. These variants have been not reported or rarely reported in the public human genome databases (1,000 Genome, gnomAD, and KRGDB). Most variants were located in the highly conserved immunoglobulin or fibronectin domains and were predicted to be pathogenic by the in silico analyses. The TTN giant protein plays a key role in muscle assembly, force transmission at the Z-line, and maintenance of resting tension in the I-band. In conclusion, we think that these bi-allelic compound heterozygous mutations may play a role as the genetic causes of the LGMD phenotype.