For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.
We study metamorphism of metasedimetary rocks and origin and evolution of leucogranite form Samcheok area, northeastern Yeongnam massif, South Korea. Metamorphic rocks in this area are composed of metasedimentary migmatite, biotite granitic gneiss and leucogranite. Metasedimentary rocks, which refer to major element feature of siliclastic sediment, are divided into two metamorphic zones based on mineral assemblages, garnet and sillimanite zones. According to petrogenetic grid of mineral assemblages, metamorhpic P-T conditions are $740{\sim}800^{\circ}C$ at $4.8{\sim}5.8\;kbar$ in the garnet zone and $640-760^{\circ}C$ at 2.5-4.5kbar in sillimanite zone. The leucogranite (Imwon leucogranite) is peraluminous granite which has high alumina index (A/CNK=1.31-1.93) and positive discriminant factor value (DF > 0). Thus, leucogranite is S-type granite generated from metasedimentary rocks. Major and trace element diagram ($R_1-R_2$ diagram and Rb vs. Y+Nb etc.) show collisional environment such as syn-collisional or volcanic arc granite. Because Rb/sr ratio (1.8-22.9) of leucogranites is higher than Sr/Ba ratio (0.21-0.79), leucogranite would be derived from muscovite dehydrate melting in metasedimentary rocks. Leucogranites have lower concentration of LREE and Eu and similar that of HREE relative to metasedimentary rocks. To examine difference of REEs between leucogranites and metasedimentary rocks, we perform modeling using volume percentage of a leucogranite and a metasedimenatry rock from study area and REE data of minerals from rhyolite (Nash and Crecraft, 1985) and melanosome of migmatite (Bea et al., 1994). Resultants of modeling indicate that LREE and HREE are controlled by monazites and garnet, respectively, although zircon is estimated HREE dominant in some leucogranite without garnet. Because there are many inclusions of accessary phases such as monazite and zircon in biotites from metasedimentary rocks. leucogranitic magma was mainly derived from muscovite-breakdown in metasedimenary rocks. Leucogranites can be subdivided into two types in compliance with Eu anomaly of chondrite nomalized REE pattern; the one of negative Eu anomaly is type I and the other is type II. Leucogranites have lower Eu concetnrations than that of metasedimenary rocks and similar that of both type. REE modeling suggest that this difference of Eu value is due to that of components of feldspars in both leucogranite and metasedimentary rock. The tendency of major ($K_2O$ and $Na_2O$) and face elements (Eu, Rb, Sr and Ba) of leucogranites also indicate that source magma of these two types was developed by anatexis experienced strong fractionation of alkali-feldspar. Conclusionally, leucogranites in this area are products of melts which was generated by muscovite-breakdown of metasedimenary rock in environment of continetal collision during high temperature/pressure metamorphism and then was fractionated and crystallized after extraction from source rock.
In this study, we investigate the performance of Global Seasonal Forecasting System version 5 (GloSea5) in Korea Meteorological Administration on the relationship between El $Ni{\tilde{n}}o$ and East Asian climate for the period of 1991~2010. It is found that the GloSea5 has a great prediction skill of El $Ni{\tilde{n}}o$ whose anomaly correlation coefficients of $Ni{\tilde{n}}o$ indices are over 0.96 during winter. The eastern Pacific (EP) El $Ni{\tilde{n}}o$ and the central Pacific (CP) El $Ni{\tilde{n}}o$ are considered and we analyze for EP El $Ni{\tilde{n}}o$, which is well simulated in GloSea5. The analysis period is divided into the developing phase of El $Ni{\tilde{n}}o$ summer (JJA(0)), mature phase of El $Ni{\tilde{n}}o$ winter (D(0)JF(1)), and decaying phase of El $Ni{\tilde{n}}o$ summer (JJA(1)). The GloSea5 simulates the relationship between precipitation and temperature in East Asia and the prediction skill for the East Asian precipitation and temperature varies depending on the El $Ni{\tilde{n}}o$ phase. While the precipitation and temperature are simulated well over the equatorial western Pacific region, there are biases in mid-latitude region during the JJA(0) and JJA(1). Because the low level pressure, wind, and vertical stream function are simulated weakly toward mid-latitude region, though they are similar with observation in low-latitude region. During the D(0)JF(1), the precipitation and temperature patterns analogize with observation in most regions, but there is temperature bias in inland over East Asia. The reason is that the GloSea5 poorly predicts the weakening of Siberian high, even though the shift of Aleutian low is predicted. Overall, the predictability of precipitation and temperature related to El $Ni{\tilde{n}}o$ in the GloSea5 is considered to be better in D(0)JF(1) than JJA(0) and JJA(1) and better in ocean than in inland region.
Water distribution system (WDS) pipe bursts are caused from excessive pressure, pipe aging, and ground shift from temperature change and earthquake. Prompt detection of and response to the failure event help prevent large-scale service interruption and catastrophic sinkhole generation. To that end, this study proposes a improved Western Electric Company (WECO) method to improve the detection effectiveness and efficiency of the original WECO method. The original WECO method is an univariate Statistical Process Control (SPC) technique used for identifying any non-random patterns in system output data. The improved WECO method multiples a threshold modifier (w) to each threshold of WECO sub-rules in order to control the sensitivity of anomaly detection in a water distribution network of interest. The Austin network was used to demonstrated the proposed method in which normal random and abnormal pipe flow data were generated. The best w value was identified from a sensitivity analysis, and the impact of measurement frequency (dt = 5, 10, 15 min etc.) was also investigated. The proposed method was compared to the original WECO method with respect to detection probability, false alarm rate, and averaged detection time. Finally, this study provides a set of guidelines on the use of the WECO method for real-life WDS pipe burst detection.
The synoptic and kinematic characteristics of a heavy rainfall that occurred in Gangneung region on 22 to 24 October 2006 were investigated using weather maps, infrared images, AWS observation data and NCEP global final analyses data. The total amount of rainfall observed in the region for the period was 316.5 mm, and the instanteneous maximum wind speed was $63.7m\;s^{-1}$. According to the analysis of weather maps, before the starting of the heavy rainfall, an extratropical low pressure system was developed in the middle region of the Korean Peninsula, and an inverted trough was formed in the northern region of the peninsula. In addition, a jet stream on the upper charts of 300 hPa was located over the Yellow Sea and the southern boundary of the peninsula. A cutoff low in the cyclonic shear side of the upper jet streak, which was linked to an anomaly of isentropic potential vorticity, was developed over the northwestern part of the peninsula. And there are analyzed potential vorticity and wind, time-height cross section of potential vorticity, vertical air motion, maximums of the divergence and convergence and vertical distribution of potential temperature in Gangneung region. The analyzed results of the synoptic conditions and kinematic processes strongly suggest that the tropopause folding made a significant role of initializing the heavy rainfall.
Median cleft of the lower lip and/or mandible is a rare congenital anomaly, first mentioned by Couronne in 1819. Monroe(1966), Fujino(1970), Ranta(1984) and Oostrom(1996) conducted comprehensive reviews and list cases in literature. Median cleft varies greatly, from a simple vermilion notch to a complete cleft of the lip involving the tongue, the chin, the mandible, the supporting structures of the median of the neck, and the manubrium sterni. The associated anomalies include ankyloglossia, cleft tongue, neck contraction, heart lesion, absence of hyoid bone, and so on. The etiology of median cleft is unknown. Various possibilities, such as failure of mesodermal penetration into the midline, failure of fusion of mandibular processes, external factors apart from the embryogenic pattern such as pressure, position in utero, circulatory failure caused placental adhesion, diseases in pregnancy, and so on, have been discussed. A 8-year-old girl was referred to the Dept. of Oral & Maxillofacial Surgery, Kyungpook National University Hospital and had been aware of the fact that at birth "she had something wrong with her mouth." Shortly after birth she had been examined by a plastic surgeon and at that time surgical procedure had been performed to release the tongue from the lower jaw and lip at local hospital. On admission, she had a slight notching of lower lip and two fibrous frenum ran from the lip along the ventral surface of the tongue, diastema between her mandibular central incisors, and slightly constricted bifid mandible associated independent movement of the two halves of mandible. The patient had autogenous iliac bone graft to reconstruct the mandibular midline defect. The postoperative result was uneventful. In future, the correction of the soft tissue deformities such as notching of the lower lip and partial ankyloglossia will be required for the esthetic and functional improvement.
Between October 1979 and June 1986, modified Fontan procedures have been performed on 22 patients by the Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine. Twelve patients had tricuspid atresia; one, congenital tricuspid stenosis; five, single ventricle; two, I-transposition of the great vessels; one, double outlet right ventricle, and one, pulmonary atresia with an intact ventricular septum. There were 9 operative deaths [mortality; 40.9%]. The causes of death were right heart failure in six patients and pulmonary venous hypertension in one who misdiagnosed preoperatively. Another two were deceased due to sepsis and cerebrovascular accident at postoperative 35 and 34 days in each. There were 7 patients below 4 years of age at the time of operation and among them 4 patients were deceased. The operative death was not related with patients` age above and below 4[p=0.211]. The relation between operative death of tricuspid anomaly and another cardiac malformations was statistically significant [p=0.048]. The operative procedures with or without valved conduit [woven dacron] was related significantly [p=0.043] in the case of the 21 of the patients, but the modified Fontan operation with a valved conduit was performed early stage in this series. Since 1982, we operated on 4 patients, doing a right atrium-right ventricle anastomosis without a conduit. All survived and remained in functional class I [NYHA]. The right atrial pressure [RAP] was elevated significantly after operation [mean 9.9$\pm$4.8 ~16.9$\pm$3.6 mmHg, p<0.001]. The relation between the postoperative RAP of the survival group [16.5$\pm$4.3 mmHg] and the group who died [17.4$\pm$2.2 mmHg] was statistically significant [p=0.047]. There was no relation between any operative death and any previous palliation. All patients were followed for 4 months to 80 months, except one who was lost to follow up at 2 months following surgery [mean 11.4 months, 238 patient. months]. All were in functional class I with 5 on medications and 7 not. One was reoperated at 70 months following the first operation, due to conduit stenosis. She was moderately impaired in activity, with hepatomegaly after the second operation.
Kim, Jin-Guk;Kim, Jin-Young;Kim, Yoon-Hee;Kwon, Hyun-Han
Journal of Korea Water Resources Association
/
v.50
no.2
/
pp.75-87
/
2017
In recent decades, extreme events have been significantly increased over the Korean Peninsula due to climate variability and climate change. The potential changes in hydrologic cycle associated with the extreme events increase uncertainty in water resources planning and designing. For these reasons, a reliable changing point analysis is generally required to better understand regime changes in hydrologic time series at watershed scale. In this study, a hierarchical changing point analysis approach that can apply in a watershed scale is developed by combining the existing changing point analysis method and hierarchical Bayesian method. The proposed model was applied to the selected stations that have annual rainfall data longer than 40 years. The results showed that the proposed model can quantitatively detect the shift in precipitation in the middle of 1990s and identify the increase in annual precipitation compared to the several decades prior to the 1990s. Finally, we explored the changes in precipitation and sea level pressure in the context of large-scale climate anomalies using reanalysis data, for a given change point. It was concluded that the identified large-scale patterns were substantially different from each other.
Kim, Young Don;Hwang, Sung Kyoo;Hwang, Jeong Hyun;Sung, Joo Kyung;Hamm, In Suk;Park, Yeun Mook;Kim, Seung Lae
Journal of Korean Neurosurgical Society
/
v.30
no.sup1
/
pp.79-84
/
2001
To investigate contributory factors of CSF shunt failure, 237 patients, who underwent shunt placement from January 1995 to December 1998 at our hospital, were reviewed retrospectively. The causes of the hydrocephalus were tumor, hemorrhage, infection, congenital anomaly, normal pressure hydrocephalus, trauma and others. One hundred nine revisions of CSF shunting were done during follow up periods. The causes of shunt revisions were mechanical obstruction, malposition, infection and others. The contributory factors of CSF shunt failure and shunt survival rate were analyzed using SPSS. The shunt survival rate at 1, 2 and 3 years after procedure was 77.1%, 75.4%, 74.1% respectively. In the young age group below 10 years old, postinfectous hydrocephalus was the most common high risk factor for shunt revision. In conclusion, the most shunt failures developed in the first year after surgery and the age and causes of the hydrocephalus were major determinant factors of shunt revision.
A pattern of tropical cyclone (TC) movement in the western North Pacific area was studied using the empirical orthogonal function (EOF) and the best track data from 1951 to 2007. The independent variable used in this study was defined as the frequency of tropical cyclone passage in 5 by 5 degree grid. The $1^{st}$, $2^{nd}$ and $3^{rd}$ modes were the east-west, north-south and diagonal variation patterns. Based on the time series of each component, the signs of first and second mode changed in 1997 and 1991, respectively, which seems to be related to the fact that the passage frequency was higher in the South China Sea for 20 years before 1990s, and recent 20 years in the East Asian area. When the eigen vectors were negative values in the first and second modes and TC moves into the western North Pacific, TC was formed mainly at the east side relatively compared to the case of the positive eigen vectors. The first mode seems to relate to the pressure pattern at the south of Lake Baikal, the second mode the variation pattern around $30^{\circ}N$, and the third mode the pressure pattern around Japan. The first mode was also closely related to the ENSO and negatively related to the $Ni\tilde{n}o$-3.4 index in the correlation analysis with SST anomalies.
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