Background: The aortic arch replacement in an acute aortic dissection is technically demanding procedure that has a lot of postoperative morbidity and high mortality The authors have applied several techniques of aortic arch replacement to overcome the risks of the procedure. Therefore we analysed the results of these techniques. Material and Method: From March of 1996 to July of 2002, we performed 31 cases of the aortic arch replacement in the Stanford type A acute aortic dissection. There were 12 male and 19 female patient's with 59.6$\pm$9.4 years of mean age. Among them 18 cases were treated with the hemiarch replacement and 13 cases with the total arch replacement. We approached the aortic arch through median sternotomy in all but 3 cases of Clamshell incision and applied the deep hypothermic circulatory arrest with retrograde cerebral perfusion. The associated procedures were 2 Bentall's procedures, an axillobifemoral bypass, a femorofemoral bypass and a carotid artery bypass. Result: The postoperative morbidities were 8 acute renal failures, 3 CNS complications, 2 low cardiac output syndromes, 2 malpefusion syndromes, and 2 deep wound infections. There were 4 cases of early hospital mortality which were from an acute renal failure a postoperative bleeding, a low cardiac output syndrome, and a reperfusion syndrome. There were 3 cases of late hospital mortality which were from an acute renal failure, and 2 multiorgan failures. So the total mortality rate was 22.5%. There were 4 cases of late mortality after the discharge, which were form 2 cases of distal anastomotic rupture and 2 cases of intracranial hemorrhage. Conclusion: The hemiarch replacement has relatively shorter operative time and lower hospital mortality but higher late mortality than the total arch replacement. The total arch replacement needs more technically demanding procedure.
Purpose: The aim of this study was to determine the incidence and malignant rate of incidental asymmetric palatine tonsillar uptake (ATU) on $^{18}F$-FDG PET/CT in various clinical indications and to evaluate the clinical and PET/CT findings suggesting malignancy. Materials and Methods: We retrospectively reviewed a total of 2,901 patients ($58.4{\pm}12.3$ yrs, range 20~88 yrs, M:F = 1,841:1,060) who underwent $^{18}F$-FDG PET/CT during an 1-year period with various indications except primary tonsillar cancer and lymphoma evaluation. On $^{18}F$-FDG PET/CT, metabolic abnormality of the palatine tonsil and cervical lymph node were visually assessed. ATU was defined as increased palatine tonsillar uptake with diffuse, focal, or irregular pattern compared to contralateral side. The incidence and malignant ratio of ATU were evaluated according to clinical and PET/CT findings. Results: Of 2,901 cases, 290(10,0%) showed ATU. The incidence of ATU showed seasonal variation and was high in the winter (12.1%). Of 209 cases with ATU confirmed pathologically and/or clinically, five (2.4%) were malignant lesions. ATU with irregular uptake pattern (2/2) and in cases referred for cervical lymph node metastasis of unknown origin (3/5) were frequently associated with malignant lesion (p<0.05). Conclusion: ATU was not infrequently observed on $^{18}F$-FDG PET/CT, and the malignant risk of ATU was low. However, ATU with cervical lymph node metastasis or with irregular pattern on PET/CT would be further evaluated by the histopathologic examination.
The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
/
v.6
no.3
/
pp.142-151
/
2001
Detailed interpretation of some high-resolution seismic profiles in Yosu Strait reveals that Late Quaternary deposits consist of three allostratigraphic units (UH, LH, PL) formed by fluvial and tidal controls. The top mud unit, UH, thins onshore, and overlies the backstepping modem Seomjin delta deposits, which is interpreted as a transgressive systems tract (757) related to Holocene relative sea-level rise. The unit LH below the unit UH is composed of delta, valley- and basin-fill facies. The delta facies (Unit $LH_1$) occurs only in Gwangyang Bay and shows two prograding sets retrogradationaly stacked, thus it is also interpreted as a transgressive systems tract(757). On the contrary, the valley- and basin-fill facies (Unit $LH_2$), interpreted as 757, occur between the units UH and PL (Pleistocene deposits) in Yosu Strait. The bounding surface between UH and $LH_2$ can be interpreted as a tidal ravinement surface on the basis of trends thinning toward inner bay and becoming young landward. Furthermore its geomorphological pattern is similar to that of recent tidal channels. This allostratigraphy in'ffsu Strait suggests that two 757 deposits (UH and $LH_2$), divided by tidal ravinement surface, have been formed in Yosu Strait, whereas in Gwangyang Bay backstepping delta deposits ($LH_1$) without tidal ravinement surface have been formed during Holocene sea-level rise. These characteristics indicate that different stacking patterns could be formed in these two areas according to different increasing rate of accommodation space caused by different geomorphology, sediment supply and tidal-current patterns even in the same period of Holocene sea-level rise.
This study is to evaluate the future climate change impact on turbidity water and eutrophication for Chungju Lake by using CE-QUAL-W2 reservoir water quality model coupled with SWAT watershed model. The SWAT was calibrated and validated using 11 years (2000~2010) daily streamflow data at three locations and monthly stream water quality data at two locations. The CE-QUAL-W2 was calibrated and validated for 2 years (2008 and 2010) water temperature, suspended solid, total nitrogen, total phosphorus, and Chl-a. For the future assessment, the SWAT results were used as boundary conditions for CE-QUAL-W2 model run. To evaluate the future water quality variation in reservoir, the climate data predicted by MM5 RCM(Regional Climate Model) of Special Report on Emissions Scenarios (SRES) A1B for three periods (2013~2040, 2041~2070 and 2071~2100) were downscaled by Artificial Neural Networks method to consider Typhoon effect. The RCM temperature and precipitation outputs and historical records were used to generate pollutants loading from the watershed. By the future temperature increase, the lake water temperature showed $0.5^{\circ}C$ increase in shallow depth while $-0.9^{\circ}C$ in deep depth. The future annual maximum sediment concentration into the lake from the watershed showed 17% increase in wet years. The future lake residence time above 10 mg/L suspended solids (SS) showed increases of 6 and 17 days in wet and dry years respectively comparing with normal year. The SS occupying rate of the lake also showed increases of 24% and 26% in both wet and dry year respectively. In summary, the future lake turbidity showed longer lasting with high concentration comparing with present behavior. Under the future lake environment by the watershed and within lake, the future maximum Chl-a concentration showed increases of 19 % in wet year and 3% in dry year respectively.
Purpose: Human astrovirus (HAstV) is known to be an important etiologic agent of acute gastroenteritis in infants worldwide. However, the prevalence of HAstV infection varies according to geographic region and patient age. The purpose of our study was to investigate the incidence of HAstV infection among hospitalized children at a tertiary hospital in Seoul. Methods: Fecal samples were collected from hospitalized children up to five years of age with acute gastroenteritis. A total of 812 fecal samples were collected from hospitalized children with acute gastroenteritis between February 2004 and January 2005. Fecal specimens were screened for rotavirus, enteric adenovirus and norovirus by enzyme immunoassay (EIA) or reverse transcriptase polymerase chain reaction (RT-PCR). HAstV positive samples were characterized by RT-PCR. Results: Rotavirus was detected in 16.9% (138/812), norovirus in 11.6% (94/812), and adenovirus in 4.0% (33/812) of the study population. HAstV was detected in 4.0% (33/812) samples by RT-PCR. The age distribution of HAstV positive patients was as follows: <12 month old, 82.0% (27/33); 1~2 years old, 6.0% (2/33); 2~5 years old, 12.0% (4/33). The seasonal distribution of HAstV positive samples was as follows; April (3), May (5), June (4), August (12), September (4), October (2), November (2), and December (1). The peak rate of HAstV infection was observed during the summer season, 2004. A mixed infection of viral agents was confirmed in 2.7% (22 /812) of the study population, most commonly with rotavirus and norovirus, and with rotavirus and HAstV. Genotype 1 was the predominant type (91%, 20/22) and genotype 8 was detected in two cases. Conclusion: The prevalence of HAstV infection was 4.0% in hospitalized children with acute gastroenteritis, and was especially high in infants. HAstV can be considered as an important etiologic agent of gastroenteritis in children.
Kim, Do-Kyun;Yoo, Kyung-Jong;Youn, Young-Nam;Yi, Gi-Jong;Lee, Sak;Chang, Byung-Chul;Kang, Meyun-Shick
Journal of Chest Surgery
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v.40
no.3
s.272
/
pp.209-214
/
2007
Background: Failed percutaneous transluminal coronary angioplasty (PTCA) is occasionally required for emergency coronary artery bypass grafting (CABG). The aim of this study was to assess the outcome of patients receiving emergency CABG after failed PTCA. Material and Method: Between May 1988 and May 2005, 5712 patients underwent PTCA, where 84 (1.4%) failed. 27 patients underwent emergency CABG after failed PTCA. The mean age was $63.7{\pm}8.9\;(46{\sim}80)$ years, with 14 male patients (51.9%). Result: All patients underwent emergent surgical revascularization within 6 hours. 22 patients underwent conventional CABG and 5 underwent off-pump CABG. The causes of PTCA failure were coronary obstruction due to new thrombi formation during the procedure (n=4), coronary dissection (n=17), coronary artery rupture (n=3) and 3 due to other causes. The rate of in-hospital operative mortality after emergent operation was 18.5% (5/27). A univariate analysis revealed that patients who died more often had left anterior descending artery disease, a preprocedural shock status, postoperative use of multiple isotropics and postoperative use of intra-aortic balloon pump. The mean follow up duration was $53.6{\pm}63.4$ months. Conclusion: Although PTCA is known to be life saving, there is still a high risk for morbidity and mortality following emergency CABG after failed PTCA, despite the advancement in PTCA techniques. This result will help identify and more effectively treat patients selected for PTCA when emergency CABG is required.
Background: Descending necrotizing mediastinitis (DNM) is a serious disease originating in odontogenic or oropharyngeal infection with high mortality despite adequate antibiotics and aggressive surgery. We analyzed results of treatment for DNM. Material and Method: We studied 8 cases diagnosed as DNM from 1998 to 2007. All patients received emergent surgical drainage and debridement with broad spectrum antibiotics just after diagnosis. Antibiotics were changed after bacterial susceptibility testing. The surgical approach included 2 cases of cervicotomy, 6 cases of cervicotomy, and a thoracotomy. Result: The interval between symptom onset and hospitalization was $4.6{\pm}1.8$ days ($1{\sim}9$ day). DNM originated in 4 cases of odontogenic infection (50%), 2 cases of oropharyngeal infection (25%), and 2 cases of unknown origin (25%). Causative organisms were found in 6 cases; Streptococcus in 4 cases, Staphylococcus in 1 case, and Klebsiella in 1 case. The Endo DNM classification was type I (2 cases), IIA (3 cases), and IIB (3 cases). The incidence of thoracotomy was 75%. The surgical mortality rate was 25% (2/8). The cause of death was multiple organ failure caused by septic shock. All mortality cases received only cervicotomy and aggravated infections after initial drainage. Conclusion: Early diagnosis, immediate surgical drainage, and adequate antibiotics, including covered anaerobes, are required. Thoracotomy should be performed with cervicotomy even for localized DNM.
In this study, we determined the relative clay mineral composition of 51 surface sediments from SEYSM (Southeastern Yellow Sea Mud) (northern part 25, southern part 26) and 30 river sediments inflow to Yellow Sea using the semi-quantitative X-ray diffraction analyses. In addition to we analyzed illite characteristics of the same samples. The clay-mineral assemblage is composed of illite (61~75%), chlorite (14~24%), kaolinite (9~14%), and smectite (1~7%), in decreasing order. The average composition of each clay mineral is not different from northern part to southern part of SEYSM except a little higher kaolinite and lower smectite content in northern part. Smectite content generally has reverse relationship with illite content. Mineralogical characteristics of illite such as illite crystallinity index also is not different between two areas and show very narrow range (0.18~0.24 ${\Delta}^{\circ}2{\theta}$). Our results reveal that clay mineral composition and illite characteristics are nearly the same between northern and southern part of SEYSM. Characteristics of surface sediments in SEYSM is closer to Korean river sediments than Chinese Hanghe sediments, however it is necessary to investigate further study including Yangtze river sediments. This study conclude that most of surface sediments in SEYSM attribute to the supply of considerable amount of sediments from the nearby Korean rivers. The large sediment budget and high accumulation rate in the SEYSM can be explained by erosion and reworking of surface sediments in this area. Tidal and regional current system around SEYSM might contribute these erosional and depositional regimes.
Cho, Kyung-Soon;Park, Sun-Mee;Kim, Seang-Joon;Jung, Myung-Ju;Lee, Joo-Yeon;Kang, Chun
Korean Journal of Microbiology
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v.43
no.3
/
pp.173-178
/
2007
The occurrence of acute respiratory infections caused by the influenza virus are particularly high during the winter season in Busan, Korea. In 2004 and 2005, a study of the rate of occurrences of the influenza virus was conducted. The results reveal that in 2004, of the 1,869 people with an acute respiratory infection that 154 (8.2%) people were infected by the influenza virus. In 2005, of the 1,579 people infected with an acute respiratory infection that 19 people (1.2%) were infected with the influenza virus. The study shows a decrease in the numbers of an influenza virus infection from 2004 to 2005. Data was collected by inspecting throat swabs and nasal discharge from those with an acute respiratory infection. Further inspection of the throat swab and nasal discharge from the infected individuals during 2004 and 2005 study show the occurrence of the different types of influenza virus in the population: 6 cases (3.5%) of influenza type A/H1N1, 129 cases (74.5%) of A/H3N2, and 38 cases (22.0%) of type B. The study conducted in 2004 and 2005 reveal that children between the ages of two and five were more likely to be infected than any other age group. In the study, about 62.2% of the infected individuals were between two and five years old. The detection rates between males and females are similar. However, it is notable that females are slightly more likely to develop an acute respiratory infection caused by the influence virus compared to their male counterparts.
Journal of the Korean association of regional geographers
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v.2
no.2
/
pp.49-73
/
1996
This study produces quantitatively weather entropy and information ratio using information theory about frequency in the appearance of precipitation phenomenon and monthly change, and then applies them to observation of the change of their space scale by time. As a result of these, this study defines Pusan, Chongju and Kwangju's weather representativeness and then establishes the range of weather representativeness. Based on weather entropy (statistical parameter)-the amount of average weather information-and information ratio, we can define each area's weather representativeness, which can show us more constant form included topographical, geographical factors and season change. The data used for this study are the daily precipitotion and cloudiness during the recent five years($1990{\sim}1994$) at the 69 stations in Korea. It is divided into class of no precipitation, that of precipitation. The results of this study can be summarized as follows: (1) The four season's mean value of information ratio is the highest value. as 0.641, on the basis of Chongju. It is the lowest as 0.572, on the basis of Pusan. On a seasonal basis, the highest mean value of information rate is April's (spring) in Chongju, and the lowest is October's(fall) in Pusan. Accordingly weather representativeness has the highest in Chongju and the lowest in Pusan. (2) To synthesize information ratio of decaying tendancy and half-decay distance, Chonju's weather representativeness has the highest in April, July and October. And kwangju has the highest value in January and the lowest in April and July. Pusan's weather representativeness is not high, that of Pusan's October is the lowest in the year. (3) If we establish the weather representative character on the basis of Chongju-Pusan, the domain of Chongju area is larger than that of Pusan area in October, July and April in order. But Pusan's is larger than Chongju's in January. In the case of Chongju and Kwangju, the domain of Chongju area is larger than that of Kwangju in October, July and April in order, but it is less than that of Kwangju area in January. In the case of Kwangju-Pusan, the domain of Kwangju is larger than that of Pusan in October, July in order. But in April it is less than Pusan's.
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