• Korean Journal of Heritage: History & Science
• /
• v.57 no.2
• /
• pp.144-166
• /
• 2024

The Cultural Heritage Committee is an important organization that has been deliberating on important matters related to the preservation of cultural properties in the Republic of Korea for more than 60 years since 1962. The Cultural Heritage Preservation Committee was active in 1961, which was a short period of about a year, but the minutes prepared at the time confirmed that it had the following meanings. First of all, legally, it was meaningful in that the concept of cultural property or intangible cultural property was used for the first time in Korea in laws and regulations on the term of office of professional members. These matters became the basis for the operation of the current Cultural Heritage Protection Act and the Cultural Heritage Committee. The following confirms that, unlike previously known activities, they were active despite political upheaval at the time. In spite of rapid regime change at the time, the committee had no change in its members, and the meetings continued without interruption. At that time, there was an exclusive relationship between different groups in relation to the preservation of cultural heritage, and this relationship was confirmed by the minutes that disappeared with the establishment of the Cultural Heritage Management Bureau, which integrated these groups. Finally, the form of the minutes prepared then shows the form of documentation at the time, where it is confirmed that the traditional documentation format is changing into a new form. It can be good research material in terms of modern and contemporary bibliography. As discussed earlier, the Cultural Heritage Conservation Committee of 1961 has historical significance in terms of legal and actual activities. The reason why the committee's activities were low valued is presumed to be that the minutes and related documents prepared at the time were not organized well due to the lack of a related administrative system. The minutes of the Cultural Heritage Conservation Committee record various facts about cultural heritage policies and decisions at that time. Therefore, analysis and research on these contents can reveal more facts about the cultural heritage policies and perceptions of that time.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.10
• /
• pp.1210-1219
• /
• 2001

Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.

• Journal of Intelligence and Information Systems
• /
• v.24 no.3
• /
• pp.67-88
• /
• 2018

Until recently, as we recognize the significance of sustainable growth and competitiveness of small-and-medium sized enterprises (SMEs), governmental support for tangible resources such as R&D, manpower, funds, etc. has been mainly provided. However, it is also true that the inefficiency of support systems such as underestimated or redundant support has been raised because there exist conflicting policies in terms of appropriateness, effectiveness and efficiency of business support. From the perspective of the government or a company, we believe that due to limited resources of SMEs technology development and capacity enhancement through collaboration with external sources is the basis for creating competitive advantage for companies, and also emphasize value creation activities for it. This is why value chain network analysis is necessary in order to analyze inter-company deal relationships from a series of value chains and visualize results through establishing knowledge ecosystems at the corporate level. There exist Technology Opportunity Discovery (TOD) system that provides information on relevant products or technology status of companies with patents through retrievals over patent, product, or company name, CRETOP and KISLINE which both allow to view company (financial) information and credit information, but there exists no online system that provides a list of similar (competitive) companies based on the analysis of value chain network or information on potential clients or demanders that can have business deals in future. Therefore, we focus on the "Value Chain Network System (VCNS)", a support partner for planning the corporate business strategy developed and managed by KISTI, and investigate the types of embedded network-based analysis modules, databases (D/Bs) to support them, and how to utilize the system efficiently. Further we explore the function of network visualization in intelligent value chain analysis system which becomes the core information to understand industrial structure ystem and to develop a company's new product development. In order for a company to have the competitive superiority over other companies, it is necessary to identify who are the competitors with patents or products currently being produced, and searching for similar companies or competitors by each type of industry is the key to securing competitiveness in the commercialization of the target company. In addition, transaction information, which becomes business activity between companies, plays an important role in providing information regarding potential customers when both parties enter similar fields together. Identifying a competitor at the enterprise or industry level by using a network map based on such inter-company sales information can be implemented as a core module of value chain analysis. The Value Chain Network System (VCNS) combines the concepts of value chain and industrial structure analysis with corporate information simply collected to date, so that it can grasp not only the market competition situation of individual companies but also the value chain relationship of a specific industry. Especially, it can be useful as an information analysis tool at the corporate level such as identification of industry structure, identification of competitor trends, analysis of competitors, locating suppliers (sellers) and demanders (buyers), industry trends by item, finding promising items, finding new entrants, finding core companies and items by value chain, and recognizing the patents with corresponding companies, etc. In addition, based on the objectivity and reliability of the analysis results from transaction deals information and financial data, it is expected that value chain network system will be utilized for various purposes such as information support for business evaluation, R&D decision support and mid-term or short-term demand forecasting, in particular to more than 15,000 member companies in Korea, employees in R&D service sectors government-funded research institutes and public organizations. In order to strengthen business competitiveness of companies, technology, patent and market information have been provided so far mainly by government agencies and private research-and-development service companies. This service has been presented in frames of patent analysis (mainly for rating, quantitative analysis) or market analysis (for market prediction and demand forecasting based on market reports). However, there was a limitation to solving the lack of information, which is one of the difficulties that firms in Korea often face in the stage of commercialization. In particular, it is much more difficult to obtain information about competitors and potential candidates. In this study, the real-time value chain analysis and visualization service module based on the proposed network map and the data in hands is compared with the expected market share, estimated sales volume, contact information (which implies potential suppliers for raw material / parts, and potential demanders for complete products / modules). In future research, we intend to carry out the in-depth research for further investigating the indices of competitive factors through participation of research subjects and newly developing competitive indices for competitors or substitute items, and to additively promoting with data mining techniques and algorithms for improving the performance of VCNS.

• Journal of Korean Society of Forest Science
• /
• v.25 no.1
• /
• pp.13-47
• /
• 1975

Among the many species of bamboo, it is well known that the dwarf-type is widely distributed in the tropical regions, and the slender type in temperated zone. In the temperated zone the trees have extensively differentiated into one hundred species in 50 genera. In many oriental countries, the bamboo wood is being used as a material for construction and for the manufacture of technical instruments. The bamboo shoot is also regarded as a good and delicious edible resource. Moreover, recent medical investigation verifies that the sap of certain species of the bamboo is an antibiotic effect against cancer. Fortunately, it is very easy to propagate the bamboo trees by using cutting from southeastern Asian countries. This important resource can further be used as a significant source of pulp, which is becoming increasingly important. The classification system of this significant resource has not been completely established to date, even though its importance has been emphasized. Initiated by Canlevon Linne in the 18th century, a classification method concerning the morphological characteristics of flowers was the first step in developing a classification. But it was not an easy task to accomplish, because this type of classification system is based on the sexual organs in bamboo trees. Because the bamboo has a long life cycle of 60-120 years and classification according to this method was very difficult as the materials for the classification are not abundant and some species have changed, even though many references related to the morphological classification of bamboo trees are available nowadays. So, the certification of bamboo trees according to the morphological classification system is not reasonable for us. Consequently, the classification system of bamboo trees on the basis of endomorphological characteristics was initiated by Chinese-born Liese. And classification method based on the morphological characteristics of the vascular bundle was developed by Grosser. These classification methods are fundamentally related to Holltum's classification method, which stressed the morphology of the ovary. The author investigated to re-establish a new classification method based on the vascular sheath. Twenty-six species in 11 genera which originated from Formosa where used in the study. The results obtained from the investigation were somewhat coordinated with those of Crosser. Many difficulties were found in distinguishing the species of Bambusa and Dendrocalamus. These two species were critically differentiated under the new classification system, which is based on the existence of a separated vascular bundle sheath in the bamboo. According to these results, it is recommended that Babusa divided into two groups by placing it into either subspecies or the lower categories. This recommendation is supported by the observation that the evolutional pattern of the bamboo thunk which is from outward to inward. It is also supported by the viewpoint that the fundamental hypothesis in evolution is from simple to complex. There remained many problems to be solved through more critical examination by comparing the results to those of the classification based on the sexual organs method. The author observed the figure of the cross-sectional area of vascular trunk of bamboo tree and compared the results with those of Grosser and Liese, i.e. A, $B_1$, $B_2$, C, and D groups in classification. Group A and $B_2$ were in accordance with the results of those scholars, while group D showed many differences, Grosser and Liese divided bamboo into "g" type and "h" type according to the vascular bundle type; and they included Dendrocalamus and Bambusa in Group D without considering the type of vascular bundle sheath. However, the results obtained by the author showed that Dendrocalamus and Bambusa are differentiated from each other. By considering another group, "i" identified according to the existence of separated vascular bundle sheath. Bambusa showed to have a separated vascular bundle sheath while Dendrocalamus does not have a separated vascular bundle sheath. Moreover, Bambusa showed peculiar characteristics in the figure of vascular development, i.e., one with an inward vascular bundle sheath and the other with a bivascular bundle sheath (inward and outward). In conclusion, the bamboo species used in this experiment were classified in group D, without any separated vascular bundle sheath, and in group E, with a vascular bundle sheath. Group E was divided into two groups, i.e., and group $E_1$, with bivascular sheath, and group $E_2$, with only an inward vascular sheath. Therefore, the Bambusa in group D as described by Grosser and Liese was included in group E. Dendrocalamus seemed to be the middle group between group $E_l$ and group $E_2$ under this classification system which is summarized as follows: Phyllostachys-type: Group A - Phyllostachys, Chymonobambus, Arundinaria, Pseudosasa, Pleioblastus, Yashania Pome-type: Group $B_2$ - Schizostachyum, Melocanna Hemp-type: Group D - Dendrocalamu Bambu-type: Group $E_1$ - Bambusa ghi.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.25 no.1
• /
• pp.34-40
• /
• 2021

Purpose If a new test is introduced or reagents are changed in the laboratory of a medical institution, the characteristics of the test should be analyzed according to the procedure and the assessment of reagents should be made. However, several necessary conditions must be met to perform all required comparative evaluations, first enough samples should be prepared for each test, and secondly, various reagents applicable to the comparative evaluations must be supplied. Even if enough comparative evaluations have been done, there is a limit to the fact that the data variation for the new reagent represents the overall patient data variation, The fact puts a burden on the laboratory to the change the reagent. Due to these various difficulties, reagent changes in the laboratory are limited. In order to introduce a competitive bid, the institute conducted a full investigation of Radioimmunoassay(RIA) reagents for each test and established the range of reagents available in the laboratory through comparative evaluations. We wanted to share this process. Materials and Methods There are 20 items of tests conducted in our laboratory except for consignment tests. For each test, RIA reagents that can be used were fully investigated with the reference to external quality control report. and the manuals for each reagent were obtained. Each reagent was checked for the manual to check the test method, Incubation time, sample volume needed for the test. After that, the primary selection was made according to whether it was available in this laboratory. The primary selected reagents were supplied with 2kits based on 100tests, and the data correlation test, sensitivity measurement, recovery rate measurement, and dilution test were conducted. The secondary selection was performed according to the results of the comparative evaluation. The reagents that passed the primary and secondary selections were submitted to the competitive bidding list. In the case of reagent is designated as a singular, we submitted a explanatory statement with the data obtained during the primary and secondary selection processes. Results Excluded from the primary selection was the case where TAT was expected to be delayed at the moment, and it was impossible to apply to our equipment due to the large volume of reagents used during the test. In the primary selection, there were five items which only one reagent was available.(squamous cell carcinoma Ag(SCC Ag), β-human chorionic gonadotropin(β-HCG), vitamin B12, folate, free testosterone), two reagents were available(CA19-9, CA125, CA72-4, ferritin, thyroglobulin antibody(TG Ab), microsomal antibody(Mic Ab), thyroid stimulating hormone-receptor-antibody(TSH-R-Ab), calcitonin), three reagents were available (triiodothyronine(T3), Tree T3, Free T4, TSH, intact parathyroid hormone(intact PTH)) and four reagents were available are carcinoembryonic antigen(CEA), TG. In the secondary selection, there were eight items which only one reagent was available.(ferritin, TG, CA19-9, SCC, β-HCG, vitaminB12, folate, free testosterone), two reagents were available(TG Ab, Mic Ab, TSH-R-Ab, CA125, CA72-4, intact PTH, calcitonin), three reagents were available(T3, Tree T3, Free T4, TSH, CEA). Reasons excluded from the secondary selection were the lack of reagent supply for comparative evaluations, the problems with data reproducibility, and the inability to accept data variations. The most problematic part of comparative evaluations was sample collection. It didn't matter if the number of samples requested was large and the capacity needed for the test was small. It was difficult to collect various concentration samples in the case of a small number of tests(100 cases per month or less), and it was difficult to conduct a recovery rate test in the case of a relatively large volume of samples required for a single test(more than 100 uL). In addition, the lack of dilution solution or standard zero material for sensitivity measurement or dilution tests was one of the problems. Conclusion Comparative evaluation for changing test reagents require appropriate preparation time to collect diverse and sufficient samples. In addition, setting the total sample volume and reagent volume range required for comparative evaluations, depending on the sample volume and reagent volume required for one test, will reduce the burden of sample collection and planning for each comparative evaluation.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.3
• /
• pp.235-245
• /
• 2008

Purpose: The HSV1-tk gene has been extensively studied as a type of reporter gene. In hepatocellular carcinoma (HCC), only a small proportion of patients are eligible for surgical resection and there is limitation in palliative options. Therefore, there is a need for the development of new treatment modalities and gene therapy is a leading candidate. In the present study, we investigated the usefulness of substrate, 2'-fluoro-2'-deoxy-1-${\beta}$-D-arabino-furanosyi-5-[$^{124/125}I$]iodo- uracil ([$I^{124/125}I$]FIAU) as a non-invasive imaging agent for HSV1-tk gene therapy in hepatoma model using small animal PET. Material and Methods: With the Morris hepatoma MCA cell line and MCA-tk cell line which was transduced with the HSV1-tk gene, in vitro uptake and correlation study between [$^{125}I$]FIAU uptake according to increasing numeric count of percentage of MCA-tk cell were performed. The biodistribution data and small animal PET images with [$^{124}I$]FIAU were obtained with Balb/c-nude mice bearing both MCA and MCA-tk tumors. Results:, Specific accumulation of [[$^{125}I$]FIAU was observed in MCA-tk cells but uptake was low in MCA cells. Uptake in MCA-tk cells was 15 times higher than that of MCA cells at 480 min. [$^{125}I$]FIAU uptake was linearly correlated (R2 =0.964, p =0.01) with increasing percentage of MCA-tk numeric cell count. Biodistribution results showed that [$^{125}I$]FIAU was mainly excreted via the renal system in the early phase. Ratios of MCA-tk tumor to blood acting were 10, 41, and 641 at 1 h, 4 h, and 24 h post-injection, respectively. The maximum ratio of MCA-tk to MCA tumor was 192.7 at 24 h. Ratios of MCA-tk tumor to liver were 13.8, 66.8, and 588.3 at 1 h, 4 h, and 24 h, respectively. On small animal PET, [$^{124}I$]FIAU accumulated in substantial higher levels in MCA-tk tumor and liver than MCA tumor. Conclusion: FIAU shows selective accumulation to HSV1-tk expressing hepatoma cell tumors with minimal uptake in normal liver. Therefore, radiolabelled FIAU is expected to be a useful substrate for non-invasive imaging of HSV1-tk gene therapy and therapeutic response monitoring of HCC.

• Journal of Preventive Medicine and Public Health
• /
• v.33 no.3
• /
• pp.285-298
• /
• 2000

Objectives : To investigate the positive rate of Helicobacter pylori in patients with dyspepsia; medical compliance and related factors; the eradication rate a year after screening and related factors; the relationship between the eradication of Helicobacter pylori and the improvement of symptoms; and the estimated cost of three alternative approaches to treat Helicobacter pylori in the community. Methods : A total of 510 subjects with dyspeptic symptoms were selected and given the serological test in March 1998. The subjects were all adults over 30 years of age residing in Kyongju city. Results : Of the 510 selected subjects, 375 (73.5%) subjects proved positive for Helicobacter pylori on serological testing. Of these 304 (81.1%) who consented to an endoscopic examination, underwent a Campylobacter-like organism (CLO) test. Of these 304 subjects, 204 (67.1%), who had positive CLO test results, were given the triple therapy - tripotassium dicitrato bismuthate, amoxicillin, and metronidazole. To determine the eradication rate of Helicobacter pylori, 181 (88.1%) out of the 204 subjects who were given the triple therapy completed a follow-up urea breath test one year later. Of these, the Helicobacter pylori of 87(48.1%) subjects was eradicated. Among the 122 subjects who were medication compliant, the Helicobacter pylori eradication rate was 57.4% (70 subjects), while the eradication rates was only 28.8% (17subjects) in the non-compliant group. The Helicobacter pylori eradication was significantly related to compliance (p<0.01), but not to other characteristics and habits. The symptom improvement rate tended to be higher 62.1%), in the Helicobacter pylori eradicated group than in the non-eradicated group (59.6%). Conclusions : When the advantages and disadvantages of each alternative treatment were considered in the light of cost, antibiotic tolerance and the number of patients to be treated, alternative II was favorable in terms of cost. Alternative III was favorable in terms of the number of patients to be treated, antibiotic tolerance and early detection of gastric cancer. Further long-term research analyzing the cost-benefit and cost-effectiveness of each treatment will be needed as supporting material in creating new policies.

• Journal of Science of Art and Design
• /
• v.11
• /
• pp.221-249
• /
• 2007

Today, photography is facing to the crisis of identity and dilemma of ontology from the digital imaging process in the new technology form. It is very important points to say rethinking of the traditional photographic medium, that has changed the way we view the world and ourselves is perhaps an understatement and that photography has transformed our essential understanding of reality. Now, no longer are photographic images regarded as the true automatic recording, innocent evidence and the mirror to the reality. Rather, photography constructs the world for our entertainment, helping to create the comforting illusions by which we live. The recognition that photographs are not constructions and reflections of reality, is the basis for the actual presence within the contemporary photographic world. It is shock. This thesis's aim is to look for the problems of photographic identity and ontological crisis that is controlling and regulating digital photographic imagery, allowing the reproduction of the electronic simulations era. Photography loses its special aesthetic status and becomes no more true information and, exclusively evidence by traditional film and paper that appeared both as a technological accuracy and as a medium-specific aesthetic. The result, photography is facing two crises, one is the photographic ontology(the introduction of computerized digital images) and the other is photographic epistemology(having to do broader changes in ethics, knowledge and culture). Taken together, these crises apparently threaten us with the death of photography, with the 'end' of photography and the culture it sustains. The thesis's meaning is to look into the dilemma of photography's ontology and epistemology, especially, automatical index and digital codes from its origin, meaning, and identity as the technological medium. Thus, in particular, thesis focuses on the analog imagery presence, from the nature in the material world, and the digital imagery presence from the cultural situations in our society. And also thesis's aim is to examine the main issues of the history of photography has been concentrated on the ontological arguments since the discovery of photography in 1839. Photography has never been only one static technology form. Rather, its nearly two centuries of technological development have been marked by numerous, competing of technological innovation and self revolution from the dual aspects. This thesis examines recent account of photography by the analysis of the medium's concept, meaning, identity between film base image and digital base image from the aspects of photographic ontology and epistemology. Thus, the structure of thesis is fairy straightforward to examine what appear to be two opposing view of photographic conditions and ontological situations. Thesis' view contrasts that figure out the value of photography according to its fundamental characteristic as a medium. Also, it seeks a possible solution to the dilemma of photographic ontology through the medium's origin from the early years of the nineteenth century to the raising questions about the different meaning(analog/digital) of photography, now. Finally, this thesis emphasizes and concludes that the photographic ontological crisis reflects to the paradoxical dynamic structure, that unsolved the origins of the medium, itself. Moreover, even photography is not single identity of the photographic ontology, and also can not be understood as having a static identity or singular status from the dynamic field of technologies, practices, and images.

• Journal of Chest Surgery
• /
• v.36 no.9
• /
• pp.651-658
• /
• 2003

Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52％ of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5％) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1％. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6％; bleeding events, 90.2$\pm$4％; paravalvular leakage 92.3$\pm$4％; and overall valve-related morbidity at 1 year was 76.6$\pm$3％. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8％) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9％, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.

• Journal of Chest Surgery
• /
• v.36 no.3
• /
• pp.182-188
• /
• 2003

Background: Although ramicotomy (division of the rami communicantes of the thoracic sympathetic ganglia) is a selective and physiological surgical method for essential hyperhidrosis, it has some problems such as higher recurrence rates and the different surgical results among the patients and between left and right sides in the same individual. As one of the factors that are related to the differences in surgical result and recurrences, we investigated the anatomical variations of the rami communicantes. The purpose of this study is to help develop new surgical methods to decrease surgical differences among the patients or between the left and right sides of the same individual and recurrence rates in the clinical application of ramicotomy. Material and Method: We dissected 118 thoracic sympathetic chains in 59 adult Korean cadavers (male: 33, female: 26) to examine the anatomical variations of the rami communicantes from the second to the fourth thoracic sympathetic ganglia that have major components innervating to the hands. After the dissection of bilateral thoracic sympathetic chains, we compared the anatomy of left and right sides and examined the anatomical variations of rami communicantes. Result: The number and variation of communicating rami connecting the spinal nerves and the second sympathetic thoracic ganglion were much larger than lower levels. There was considerably less variability in the anatomy of the rami communicantes at successive levels. Among the 59 cadavers dissected, only 14.3% (9/59) had similar anatomy of thoracic sympathetic chains at both sides. As the components related to the essential palmar hyperhidrosis, intrathoracic nerve of Kuntz from the second thoracic sympathetic ganglion to the first intercostal nerve or brachial plexus were observed in 55.9% (66/118). The incidence of descending rami communicates from the second thoracic sympathetic ganglion to the third intercostal nerve and from the third thoracic sympathetic ganglion to the fourth intercostal nerve were 49.2% (58/118) and 28.0% (33/118). And the incidence of ascending rami communicates from the third thoracic sympathetic ganglion to the second intercostal nerve and from the fourth thoracic sympathetic ganglion to the third intercostal nerve were 6.8% (8/118) and 3.4% (4/118), respectively. Conclusion: Based on the various anatomical evidences of the rami communicantes from this study, only the ramicotomy at the third sympathetic ganglion level is insufficient for the treatment of the essential palmar hyperhidrosis to decrease the difference of surgical results and recurrences. When one is planning to perform the ramicotomy for the essential palmar hyperhidrosis, it is advantageous to divide the intrathoracic nerve of Kuntz on the second rib and the descending or ascending rami communicantes on the third and the fourth ribs as well as all the communicating rami from the third sympathetic ganglion.