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Clinical Experiences for Cardiac Myxomas (심장 점액종의 임상적 고찰)

  • Lee, Geun-Dong;Lee, Jae-Won;Jung, Jae-Seung;Jung, Sung-Ho;Je, Hyoung-Gon;Choo, Suk-Jung;Song, Hyun;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.703-709
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    • 2008
  • Background: Diagnosis and treatment are often successful in the setting of cardiac myxomas. However, cardiac myxomas can lead to catastrophic complications, due to intracardiac obstruction and embolism preoperatively, and can recur postoperatively. Material and Method: We retrospectively reviewed the clinical characteristics, surgical treatment, and recurrence data of 85 patients who underwent cardiac myxoma surgery at Asan Medical Center between November 1994 and June 2007. We analyzed the morphologic characteristics of 58 patients with left atrial myxomas and determined the development of functional mitral valve stenosis and systemic embolism through reviewing the results of preoperative echo-cardiograms to find potential preoperative risk factors. Result: Twenty-seven (31.8%) patients were men, and 58 (68.2%) were women. The mean patient age was $54.5{\pm}14.3$ years. Preoperative symptoms included obstructive symptoms in 41 (48.2%) patients, signs of embolism in 19 (22.4%), constitutional symptoms in 8 (9.4%), and no symptoms in 19 (20.0%). Among the 58 patients with left atrial myxomas, the mean maximal tumor diameter was $4.3{\pm}1.8$ (range $1.1{\sim}8\;cm$)cm. Twenty-six (44.8%) patients had a prolapsing type, defined as a tumor mobile enough to move down. to the mitral. annular plane during diastole, and 32 (55.2%) had villous type, defined as a tumor consisting of multiple fine villous extensions on the surface. Twelve (20.7%) patients had severe functional mitral valve stenosis, and 15 (25.9%) had systemic embolism preoperatively. The incidence of severe functional mitral valve stenosis was significantly higher in patients with the prolapsing type than in those with the non-prolapsing type (p=0.001). The mean maximal tumor diameter in patients with severe functional mitral valve stenosis was $5.1{\pm}1.0\;cm$, significantly larger than that seen in patients without severe functional mitral valve stenosis (p=0.041). The incidence of systemic embolism was significantly higher in patients with the villous type than in those with the smooth type (p=0.006). Postoperative complications were noted in 6 (7.1%) patients, and early mortality was noted in 1 (1.2%). The mean postoperative follow-up duration was $36.2{\pm}37.5$ months, with recurrence reported in 2(2.4%) patients during the follow-up period. The disease free interval were 48, 12 months, respectively. Conclusion: Surgical treatment for cardiac myxomas was performed safely, and long-term prognosis was good. In patients with left atrial myxoma, close attention should be maintained and surgery should be performed promptly in those of prolapsing type, those with large maximal diameter in order to prevent severe functional mitral valve stenosis, and those of villous type in order to prevent systemic embolism. Echocardiography should be followed serially in order to detect recurrence.

Division of the N2 Stage According to the Multiplicity of the Involved Nodal Stations May be Necessary in the N2-NSCLC Patients Who are Treated with Postoperative Radiotherapy (비소세포성 폐암으로 수술 후 방사선치료가 시행된 N2병기 환자들에서 다발 부위 종격동 림프절 전이 여부에 따른 N2병기 구분의 임상적 의미)

  • Yoon, Hong-In;Kim, Yong-Bae;Lee, Chang-Geol;Lee, Ik-Jae;Kim, Song-Yih;Kim, Jun-Won;Kim, Joo-Hang;Cho, Byung-Chul;Lee, Jin-Gu;Chung, Kyung-Young
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.126-132
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    • 2009
  • Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

The Analyses of Treatment Results and Prognostic Factors in Supradiaphragmatic CS I-II Hodgkin's Disease (횡경막상부에 국한된 임상적 병기 1-2기 호지킨병에서 치료 결과와 예후 인자의 분석)

  • Park Won;Suh Chang Ok;Chung Eun Ji;Cho Jae Ho;Chung Hyun Cheol;Kim Joo Hang;Roh Jae Kyung;Hahn Jee Sook;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.147-157
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    • 1998
  • Purpose : The aim of this retrospective study is to assess the necessity of s1aging laparotomy in the management of supradiaphragmatic CS I-II Hodgkin's disease. Prognostic factors and the usefulness of prognostic factor groups were also analyzed. Materials and Methods : From 1985 to 1995, fifty one Patients who were diagnosed as supradiaphragmatic CS I-II Hodgkin's disease at Yonsei Cancer Center in Seoul, Korea were enrolled in this study Age range was 4 to 67 with median age of 30. The number of patients with each CS IA, II A, and IIB were 16, 25, and 10, respectively. Radiotherapy(RT) was delivered using 4 or 6 MV photon beam to a total dose of 19.5 to 55.6Gy (median dose : 45Gy) with a 1.5 to 1.BGy per fraction. Chemotherapy(CT) was given in 2-12 cycles(median : 6 cycles). Thirty one Patients were treated with RT alone, 4 patients with CT alone and 16 patients with combined chemoradiotherapy. RT volumes varied from involved fields(3), subtotal nodal fields(18) or mantle fields(26). Results : Five-year disease-free survival rate(DFS) was $78.0\%$ and overall survival rate(05) was $87.6\%$. Fifty Patients achieved a complete remission after initial treatment and 8 patients were relapsed. Salvage therapy was given to 7 patients, 1 with RT alone, 4 with CT alone, 2 with RT+CT. Only two patients were successfully salvaged. Feminine gender and large media-stinal adenopathy were significant adverse prognostic factors in the univariate analysis for DFS. The significant adverse prognostic factors of OS were B symptom and clinical stage. When patients were analyzed according to European Organization for Research and Treatment of Cancer(EORTC) prognostic factor groups, the DFS in Patients with very favorable, favorable and unfavorable group was 100, 100 and $55.8\%$(p<0.05), and the 05 in each patients' group was 100, 100 and $75.1\%$(p<0.05), respectively. In very favorable and favorable groups, the DFS and 05 were all $100\%$ by RT alone, but in unfavorable group, RT with CT had a lesser relapse rate than RT alone. The subtotal nodal irradiation had better OFS than mantle RT in patients treated with RT. Conclusion : In present study, the DFS and OS in patients who did not undergo s1aging laparotomy were similar with the results in the literatures of which patients were surgically staged. Therefore, we may suggest that staging laparotomy would not influence the outcome of treatments. In univariate analysis, gender, large mediastinal adenopathy. B symptoms and clinical stage were significant prognostic factors for the survival rate. We confirm the usefulness of EORTC prognostic factor groups which may be a good.

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Evaluation of External Quality of Polished Barley (시판 소포장 보리쌀의 품위 평가)

  • Bae, Sook-Hyun;Kim, Hong-Sig;Jong, Seung-Keun
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.54 no.1
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    • pp.124-133
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    • 2009
  • Demand for the high quality barley with fibroid material and functional substances has been increasing in recent although the amount of barley consumption decreased drastically during the last two decades. But the limited information on quality of barley makes consumers hard when they purchase barley for their own consumption. Therefore, 51 brand barley, .i.e., 28 naked barley and 23 waxy barley from supermarkets and 10 polished barley from local markets were collected, and their external quality were analyzed to provide basic information on brand barley. Among 51 brand barley, 56% were 1kg package and 25% were 800 g package and there was no significant difference ($1{\pm}3.62\;g$) between printed and actual weighs. The weight of 1,000 grains of naked barley and waxy barley ranged $18.6{\sim}26.7\;g$ and $14.6{\sim}24.7\;g$, respectively. Thousand grain weight of 38% of naked barley ranged $20{\sim}22\;g$, while that of 43% of waxy barley ranged $18{\sim}20\;g$. The ratio of normal grains was 88% and 94% for naked barley and waxy barley, respectively, when separated with 1.7 mm sieve. Although 82% of brand barley products were free from foreign substances, in 18% of brand barley products, sands, pieces of cloth and wood, other kinds of grain and insect larvae were found, Average test weight of brand barleys was $843g{\cdot}L^{-1}$ with range of $805{\sim}917g{\cdot}L^{-1}$. Water content was less than 14% in 7.8% of barley products, while it was $14{\sim}15%$ in 62.7% of them. Average whiteness of brand barley was 31.06, while waxy barley had higher whiteness with 27.28 than naked barley with 34.16. Heated water uptake rate of milled naked barley and milled waxy barley were 215.4% and 231.7%, respectively, while expansion rate of milled naked barley and milled waxy barley were 379.7% and 401.6%, respectively. Barley from local markets were as good as brand barley products in 1,000 grain weight, ratio of normal grains, inclusion of foreign substances, test weight, water content, whiteness, water uptake rate, and expansion rate, but they showed higher ratio of foreign substances included.

If This Brand Were a Person, or Anthropomorphism of Brands Through Packaging Stories (가설품패시인(假设品牌是人), 혹통과고사포장장품패의인화(或通过故事包装将品牌拟人化))

  • Kniazeva, Maria;Belk, Russell W.
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.3
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    • pp.231-238
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    • 2010
  • The anthropomorphism of brands, defined as seeing human beings in brands (Puzakova, Kwak, and Rosereto, 2008) is the focus of this study. Specifically, the research objective is to understand the ways in which brands are rendered humanlike. By analyzing consumer readings of stories found on food product packages we intend to show how marketers and consumers humanize a spectrum of brands and create meanings. Our research question considers the possibility that a single brand may host multiple or single meanings, associations, and personalities for different consumers. We start by highlighting the theoretical and practical significance of our research, explain why we turn our attention to packages as vehicles of brand meaning transfer, then describe our qualitative methodology, discuss findings, and conclude with a discussion of managerial implications and directions for future studies. The study was designed to directly expose consumers to potential vehicles of brand meaning transfer and then engage these consumers in free verbal reflections on their perceived meanings. Specifically, we asked participants to read non-nutritional stories on selected branded food packages, in order to elicit data about received meanings. Packaging has yet to receive due attention in consumer research (Hine, 1995). Until now, attention has focused solely on its utilitarian function and has generated a body of research that has explored the impact of nutritional information and claims on consumer perceptions of products (e.g., Loureiro, McCluskey and Mittelhammer, 2002; Mazis and Raymond, 1997; Nayga, Lipinski and Savur, 1998; Wansik, 2003). An exception is a recent study that turns its attention to non-nutritional packaging narratives and treats them as cultural productions and vehicles for mythologizing the brand (Kniazeva and Belk, 2007). The next step in this stream of research is to explore how such mythologizing activity affects brand personality perception and how these perceptions relate to consumers. These are the questions that our study aimed to address. We used in-depth interviews to help overcome the limitations of quantitative studies. Our convenience sample was formed with the objective of providing demographic and psychographic diversity in order to elicit variations in consumer reflections to food packaging stories. Our informants represent middle-class residents of the US and do not exhibit extreme alternative lifestyles described by Thompson as "cultural creatives" (2004). Nine people were individually interviewed on their food consumption preferences and behavior. Participants were asked to have a look at the twelve displayed food product packages and read all the textual information on the package, after which we continued with questions that focused on the consumer interpretations of the reading material (Scott and Batra, 2003). On average, each participant reflected on 4-5 packages. Our in-depth interviews lasted one to one and a half hours each. The interviews were tape recorded and transcribed, providing 140 pages of text. The products came from local grocery stores on the West Coast of the US and represented a basic range of food product categories, including snacks, canned foods, cereals, baby foods, and tea. The data were analyzed using procedures for developing grounded theory delineated by Strauss and Corbin (1998). As a result, our study does not support the notion of one brand/one personality as assumed by prior work. Thus, we reveal multiple brand personalities peacefully cohabiting in the same brand as seen by different consumers, despite marketer attempts to create more singular brand personalities. We extend Fournier's (1998) proposition, that one's life projects shape the intensity and nature of brand relationships. We find that these life projects also affect perceived brand personifications and meanings. While Fournier provides a conceptual framework that links together consumers’ life themes (Mick and Buhl, 1992) and relational roles assigned to anthropomorphized brands, we find that consumer life projects mold both the ways in which brands are rendered humanlike and the ways in which brands connect to consumers' existential concerns. We find two modes through which brands are anthropomorphized by our participants. First, brand personalities are created by seeing them through perceived demographic, psychographic, and social characteristics that are to some degree shared by consumers. Second, brands in our study further relate to consumers' existential concerns by either being blended with consumer personalities in order to connect to them (the brand as a friend, a family member, a next door neighbor) or by distancing themselves from the brand personalities and estranging them (the brand as a used car salesman, a "bunch of executives.") By focusing on food product packages, we illuminate a very specific, widely-used, but little-researched vehicle of marketing communication: brand storytelling. Recent work that has approached packages as mythmakers, finds it increasingly challenging for marketers to produce textual stories that link the personalities of products to the personalities of those consuming them, and suggests that "a multiplicity of building material for creating desired consumer myths is what a postmodern consumer arguably needs" (Kniazeva and Belk, 2007). Used as vehicles for storytelling, food packages can exploit both rational and emotional approaches, offering consumers either a "lecture" or "drama" (Randazzo, 2006), myths (Kniazeva and Belk, 2007; Holt, 2004; Thompson, 2004), or meanings (McCracken, 2005) as necessary building blocks for anthropomorphizing their brands. The craft of giving birth to brand personalities is in the hands of writers/marketers and in the minds of readers/consumers who individually and sometimes idiosyncratically put a meaningful human face on a brand.

Sesquiterpenoids Bioconversion Analysis by Wood Rot Fungi

  • Lee, Su-Yeon;Ryu, Sun-Hwa;Choi, In-Gyu;Kim, Myungkil
    • 한국균학회소식:학술대회논문집
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    • 2016.05a
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    • pp.19-20
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    • 2016
  • Sesquiterpenoids are defined as $C_{15}$ compounds derived from farnesyl pyrophosphate (FPP), and their complex structures are found in the tissue of many diverse plants (Degenhardt et al. 2009). FPP's long chain length and additional double bond enables its conversion to a huge range of mono-, di-, and tri-cyclic structures. A number of cyclic sesquiterpenes with alcohol, aldehyde, and ketone derivatives have key biological and medicinal properties (Fraga 1999). Fungi, such as the wood-rotting Polyporus brumalis, are excellent sources of pharmaceutically interesting natural products such as sesquiterpenoids. In this study, we investigated the biosynthesis of P. brumalis sesquiterpenoids on modified medium. Fungal suspensions of 11 white rot species were inoculated in modified medium containing $C_6H_{12}O_6$, $C_4H_{12}N_2O_6$, $KH_2PO_4$, $MgSO_4$, and $CaCl_2$ for 20 days. Cultivation was stopped by solvent extraction via separation of the mycelium. The metabolites were identified as follows: propionic acid (1), mevalonic acid lactone (2), ${\beta}$-eudesmane (3), and ${\beta}$-eudesmol (4), respectively (Figure 1). The main peaks of ${\beta}$-eudesmane and ${\beta}$-eudesmol, which were indicative of sesquiterpene structures, were consistently detected for 5, 7, 12, and 15 days These results demonstrated the existence of terpene metabolism in the mycelium of P. brumalis. Polyporus spp. are known to generate flavor components such as methyl 2,4-dihydroxy-3,6-dimethyl benzoate; 2-hydroxy-4-methoxy-6-methyl benzoic acid; 3-hydroxy-5-methyl phenol; and 3-methoxy-2,5-dimethyl phenol in submerged cultures (Hoffmann and Esser 1978). Drimanes of sesquiterpenes were reported as metabolites from P. arcularius and shown to exhibit antimicrobial activity against Gram-positive bacteria such as Staphylococcus aureus (Fleck et al. 1996). The main metabolites of P. brumalis, ${\beta}$-Eudesmol and ${\beta}$-eudesmane, were categorized as eudesmane-type sesquiterpene structures. The eudesmane skeleton could be biosynthesized from FPP-derived IPP, and approximately 1,000 structures have been identified in plants as essential oils. The biosynthesis of eudesmol from P. brumalis may thus be an important tool for the production of useful natural compounds as presumed from its identified potent bioactivity in plants. Essential oils comprising eudesmane-type sesquiterpenoids have been previously and extensively researched (Wu et al. 2006). ${\beta}$-Eudesmol is a well-known and important eudesmane alcohol with an anticholinergic effect in the vascular endothelium (Tsuneki et al. 2005). Additionally, recent studies demonstrated that ${\beta}$-eudesmol acts as a channel blocker for nicotinic acetylcholine receptors at the neuromuscular junction, and it can inhibit angiogenesis in vitro and in vivo by blocking the mitogen-activated protein kinase (MAPK) signaling pathway (Seo et al. 2011). Variation of nutrients was conducted to determine an optimum condition for the biosynthesis of sesquiterpenes by P. brumalis. Genes encoding terpene synthases, which are crucial to the terpene synthesis pathway, generally respond to environmental factors such as pH, temperature, and available nutrients (Hoffmeister and Keller 2007, Yu and Keller 2005). Calvo et al. described the effect of major nutrients, carbon and nitrogen, on the synthesis of secondary metabolites (Calvo et al. 2002). P. brumalis did not prefer to synthesize sesquiterpenes under all growth conditions. Results of differences in metabolites observed in P. brumalis grown in PDB and modified medium highlighted the potential effect inorganic sources such as $C_4H_{12}N_2O_6$, $KH_2PO_4$, $MgSO_4$, and $CaCl_2$ on sesquiterpene synthesis. ${\beta}$-eudesmol was apparent during cultivation except for when P. brumalis was grown on $MgSO_4$-free medium. These results demonstrated that $MgSO_4$ can specifically control the biosynthesis of ${\beta}$-eudesmol. Magnesium has been reported as a cofactor that binds to sesquiterpene synthase (Agger et al. 2008). Specifically, the $Mg^{2+}$ ions bind to two conserved metal-binding motifs. These metal ions complex to the substrate pyrophosphate, thereby promoting the ionization of the leaving groups of FPP and resulting in the generation of a highly reactive allylic cation. Effect of magnesium source on the sesquiterpene biosynthesis was also identified via analysis of the concentration of total carbohydrates. Our current study offered further insight that fungal sesquiterpene biosynthesis can be controlled by nutrients. To profile the metabolites of P. brumalis, the cultures were extracted based on the growth curve. Despite metabolites produced during mycelia growth, there was difficulty in detecting significant changes in metabolite production, especially those at low concentrations. These compounds may be of interest in understanding their synthetic mechanisms in P. brumalis. The synthesis of terpene compounds began during the growth phase at day 9. Sesquiterpene synthesis occurred after growth was complete. At day 9, drimenol, farnesol, and mevalonic lactone (or mevalonic acid lactone) were identified. Mevalonic acid lactone is the precursor of the mevalonic pathway, and particularly, it is a precursor for a number of biologically important lipids, including cholesterol hormones (Buckley et al. 2002). Farnesol is the precursor of sesquiterpenoids. Drimenol compounds, bi-cyclic-sesquiterpene alcohols, can be synthesized from trans-trans farnesol via cyclization and rearrangement (Polovinka et al. 1994). They have also been identified in the basidiomycota Lentinus lepideus as secondary metabolites. After 12 days in the growth phase, ${\beta}$-elemene caryophyllene, ${\delta}$-cadiene, and eudesmane were detected with ${\beta}$-eudesmol. The data showed the synthesis of sesquiterpene hydrocarbons with bi-cyclic structures. These compounds can be synthesized from FPP by cyclization. Cyclic terpenoids are synthesized through the formation of a carbon skeleton from linear precursors by terpene cyclase, which is followed by chemical modification by oxidation, reduction, methylation, etc. Sesquiterpene cyclase is a key branch-point enzyme that catalyzes the complex intermolecular cyclization of the linear prenyl diphosphate into cyclic hydrocarbons (Toyomasu et al. 2007). After 20 days in stationary phase, the oxygenated structures eudesmol, elemol, and caryophyllene oxide were detected. Thus, after growth, sesquiterpenes were identified. Per these results, we showed that terpene metabolism in wood-rotting fungi occurs in the stationary phase. We also showed that such metabolism can be controlled by magnesium supplementation in the growth medium. In conclusion, we identified P. brumalis as a wood-rotting fungus that can produce sesquiterpenes. To mechanistically understand eudesmane-type sesquiterpene biosynthesis in P. brumalis, further research into the genes regulating the dynamics of such biosynthesis is warranted.

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Geochemical Equilibria and Kinetics of the Formation of Brown-Colored Suspended/Precipitated Matter in Groundwater: Suggestion to Proper Pumping and Turbidity Treatment Methods (지하수내 갈색 부유/침전 물질의 생성 반응에 관한 평형 및 반응속도론적 연구: 적정 양수 기법 및 탁도 제거 방안에 대한 제안)

  • 채기탁;윤성택;염승준;김남진;민중혁
    • Journal of the Korean Society of Groundwater Environment
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    • v.7 no.3
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    • pp.103-115
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    • 2000
  • The formation of brown-colored precipitates is one of the serious problems frequently encountered in the development and supply of groundwater in Korea, because by it the water exceeds the drinking water standard in terms of color. taste. turbidity and dissolved iron concentration and of often results in scaling problem within the water supplying system. In groundwaters from the Pajoo area, brown precipitates are typically formed in a few hours after pumping-out. In this paper we examine the process of the brown precipitates' formation using the equilibrium thermodynamic and kinetic approaches, in order to understand the origin and geochemical pathway of the generation of turbidity in groundwater. The results of this study are used to suggest not only the proper pumping technique to minimize the formation of precipitates but also the optimal design of water treatment methods to improve the water quality. The bed-rock groundwater in the Pajoo area belongs to the Ca-$HCO_3$type that was evolved through water/rock (gneiss) interaction. Based on SEM-EDS and XRD analyses, the precipitates are identified as an amorphous, Fe-bearing oxides or hydroxides. By the use of multi-step filtration with pore sizes of 6, 4, 1, 0.45 and 0.2 $\mu\textrm{m}$, the precipitates mostly fall in the colloidal size (1 to 0.45 $\mu\textrm{m}$) but are concentrated (about 81%) in the range of 1 to 6 $\mu\textrm{m}$in teams of mass (weight) distribution. Large amounts of dissolved iron were possibly originated from dissolution of clinochlore in cataclasite which contains high amounts of Fe (up to 3 wt.%). The calculation of saturation index (using a computer code PHREEQC), as well as the examination of pH-Eh stability relations, also indicate that the final precipitates are Fe-oxy-hydroxide that is formed by the change of water chemistry (mainly, oxidation) due to the exposure to oxygen during the pumping-out of Fe(II)-bearing, reduced groundwater. After pumping-out, the groundwater shows the progressive decreases of pH, DO and alkalinity with elapsed time. However, turbidity increases and then decreases with time. The decrease of dissolved Fe concentration as a function of elapsed time after pumping-out is expressed as a regression equation Fe(II)=10.l exp(-0.0009t). The oxidation reaction due to the influx of free oxygen during the pumping and storage of groundwater results in the formation of brown precipitates, which is dependent on time, $Po_2$and pH. In order to obtain drinkable water quality, therefore, the precipitates should be removed by filtering after the stepwise storage and aeration in tanks with sufficient volume for sufficient time. Particle size distribution data also suggest that step-wise filtration would be cost-effective. To minimize the scaling within wells, the continued (if possible) pumping within the optimum pumping rate is recommended because this technique will be most effective for minimizing the mixing between deep Fe(II)-rich water and shallow $O_2$-rich water. The simultaneous pumping of shallow $O_2$-rich water in different wells is also recommended.

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Surgical Treatment for Isolated Aortic Endocarditis: a Comparison with Isolated Mitral Endocarditis (대동맥 판막만을 침범한 감염성 심내막염의 수술적 치료: 승모판막만을 침범한 경우와 비교 연구)

  • Hong, Seong-Beom;Park, Jeong-Min;Lee, Kyo-Seon;Ryu, Sang-Woo;Yun, Ju-Sik;CheKar, Jay-Key;Yun, Chi-Hyeong;Kim, Sang-Hyung;Ahn, Byoung-Hee
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.600-606
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    • 2007
  • Background: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. Material and Method: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male female=18 : 7, mean age $43.2{\pm}18.6$ years) and 23 patients with isolated mitral endocarditis (Group II, male female=10 : 13, mean age $43.2{\pm}17.1$ years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patients developed mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II, The pre-operative left ventricular ejection fraction for each group was $60.8{\pm}8.7%$ and $62.1{\pm}8.1%$ (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was $37.2{\pm}23.5$ (range $9{\sim}123$) months. Result: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and foo%, 84.9%, and 84.9% for Group II patients, respectively. Conclusion: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.

Creativity of the Unconscious and Religion : Focusing on Christianity (무의식의 창조성과 종교 : 그리스도교를 중심으로)

  • Jung-Taek Kim
    • Sim-seong Yeon-gu
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    • v.26 no.1
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    • pp.36-66
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    • 2011
  • The goal of this article is to examine the connection between creativity of unconscious and religion. Jung criticized how Freud's approach in studying the unconscious as a scientific inquiry focuses on the unconscious as reflecting only those which is repressed by the ego. Jung conceived of the unconscious as encompassing not only the repressed but also the variety of other psychic materials that have not reached the threshold of the consciousness in its range. Moreover, since human psyche is as individualistic as is a collective phenomenon, the collective psyche is thought to be pervasive at the bottom of the psychic functioning and the conscious and the personal unconscious comprising the upper level of the psychic functioning. Through clinical and personal experience, Jung had come to a realization that the unconscious has the self-regulatory function. The unconscious can make "demands" and also can retract its demands. Jung saw this as the autonomous function of the unconscious. And this autonomous unconscious creates, through dreams and fantasies, images that include an abundance of ideas and feelings. These creative images the unconscious produces assist and lead the "individuation process" which leads to the discovery of the Self. Because this unconscious process compensates the conscious ego, it has the necessary ingredients for self-regulation and can function in a creative and autonomous fashion. Jung saw religion as a special attitude of human psyche, which can be explained by careful and diligent observation about a dynamic being or action, which Rudolph Otto called the Numinosum. This kind of being or action does not get elicited by artificial or willful action. On the contrary, it takes a hold and dominates the human subject. Jung distinguished between religion and religious sector or denomination. He explained religious sector as reflecting the contents of sanctified and indoctrinated religious experiences. It is fixated in the complex organization of ritualized thoughts. And this ritualization gives rise to a system that is fixated. There is a clear goal in the religious sector to replace intellectual experiences with firmly established dogma and rituals. Religion as Jung experienced is the attitude of contemplation about Numinosum, which is formed by the images of the collective unconscious that is propelled by the creativity and autonomy of the unconscious. Religious sector is a religious community that is formed by these images that are ritualized. Jung saw religion as the relationship with the best or the uttermost value. And this relationship has a duality of being involuntary and reflecting free will. Therefore people can be influenced by one value, overcome with the unconscious being charged with psychic energy, or could accept it on a conscious level. Jung saw God as the dominating psychic element among humans or that psychic reality itself. Although Jung grew up in the atmosphere of the traditional Swiss reformed church, it does not seem that he considered himself to be a devoted Christian. To Jung, Christianity is a habitual, ritualized institution, which lacked vitality because it did not have the intellectual honesty or spiritual energy. However, Jung's encounter with the dramatic religious experience at age 12 through hallucination led him to perceive the existence of living god in his unconscious. This is why the theological questions and religious problems in everyday life became Jung's life-long interest. To this author, the reason why Jung delved into problems with religion has to do with his personal interest and love for the revival of the Christian church which had lost its spiritual vitality and depth and had become heavily ritualized.

Studies on the Occurrence of Upland Weeds and the Competition with Soybeans (전지(田地)와 콩밭에 있어서 잡초(雜草)의 발생(發生) 및 경합(競合)에 관한 조사(調査) 연구(硏究))

  • Lee, Key-Hong;Lee, Eun-Woong
    • Korean Journal of Weed Science
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    • v.2 no.2
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    • pp.75-113
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    • 1982
  • Studies were carried out 1) to define the shape and size of sampling quadrat and its number of observations for weed experiments, 2) to characterize the growth and community of major summer weeds under upland condition and 3) to investigate the factors influencing competition between weeds and soybeans under weed-free and weedy conditions in early and late season cultures. No significant difference was noted among different shapes of quadrat (regular, rectangular, band, and circular) in the sampling efficiency of weeds. The results also suggested that the minimum size of quadrat was 0.25$m^2$ and the minimum number of replication was 2 times per plot. The major dominant weeds were about 10 species in the experimental field and the total number of weeds was in the range of 70 - 1,600 plants per $m^2$. Among the weeds Digitaria sanguinalis and Portulaca oleracea were the most dominant species. Growth amount and reproduction capability were also measured by weed species. Five different weed communities were identified in the field. The degree of dispersion by weed species and association among weeds were investigated. Intra-(within soybeans) and inter-specific (between soybeans and weeds) competition were studied in early and late season cultures of soybeans. The average yield of soybeans per plant was significantly decreased in both season cultures due to intra-specific competition as the planting density of soybeans increased, On the other hand, the average yield of soybeans per l0a was proportionally increased to the increase of planting density and the rate of its increase was more significant under weedy than weed-free condition. Most of the agronomic characteristics of soybeans were affected by weeds and its degree was greater in sparse planting than in dense planting and in early season than in late-season culture. Digitaria sanguinalis was the most competitive to soybeans in early season and both of Digitaria sanguinalis and Portulaca oleracea affected primarily the growth of soybeans in late season with about the same competitiveness. The occurrence of weeds was significantly decreased in early season and slightly decreased in late-season by dense planting of soybeans. The total growth amount of weeds was also considerably decreased by increase of soybean planting density both in early- and late-season cultures. The occurrence of Digitaria sanguinalis which was the most dominant in both seasons, and its growth amount was significantly decreased as the planting density of soybean was increased. On the other hand, the occurrence of Portulaca oleracea which was only dominant in late-season culture did not show significant response to the planting density of soybeans.

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