• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.220-225
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• 2006

Background: Spontaneous pneumomediastinum is an uncommon, benign, self-limited disorders that usually occurs in young adults without any apparent precipitating factors or disease. The purpose of this study was to review our experience in dealing with this entity and describe a reasonable course of assessment and management. Material and Method: A retrospective case series was conducted to identify adults patients with SPM who were diagnosed and treated in a single institution between 2001 and 2005. Result: Fifteen patients were identified who included 14 men and 1 women with a mean age of 26 years. Presenting symptoms were chest pain in 12 patients ($80\%$), dyspnea in 5 patients ($33\%$), and throat discomfort in 4 patients ($26\%$). Two cases were associated with use of inhalational drugs and 3 cases were associated with exercise. The predisposing factors were asthma, excessive exercise, and vomiting in spontaneous pneumomediastinum. The physical findings were subcutaneous emphysema in 10 patients ($77\%$). Chest radiography and computerized tomography were the diagnostic methods in all cases with CT scan revealing six cases with associated pulmonary abnormalities. Esophagogram and flexible bronchoscopy were selectively used. Fifteen patients ($100\%$) were admitted to the hospital. Their mean hospital stay was 3 days. All patients were conservatively treated. In a follow-up of 3 years no complications or recurrences were observed. Conclusion: Most simple spontaneous pneumomediastinum cases were benign diseases and most of them ($77\%$) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use was not a major cause of SPM; however, increased use of bronchoinhalers was a suspicious cause of SPM.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.781-789
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• 1999

Background: Pulmonary artery banding(PAB) accompanies some risks in the aspect of band complications and mortality in the second-stage operation. To assess these risks of the second-stage operation after PAB, we reviewed the surgical results of the second-stage operation in the pediatric patients who had undergone PAB in infancy. Material and Method: From May 1988 to June 1997, a total of 29 patients with preliminary PAB underwent open heart surgery. Ages ranged from 2 to 45 months(mean 20.6$\pm$9.0 months). Preoperative congestive heart failure conditions were improved after PAB(elective operation group) in 27 patients, but early second-stage procedures were required in the remaining 2 patients due to sustaining congestive heart failure(early operation group). Preoperative surgical indications included 2 double outlet right ventricles(DORV group) and 27 ventricular septal defects as the main cardiac anomaly(VSD group). Result: The mean time interval from PAB to the second-stage operation was 15.5$\pm$8.7 months(range 5 days to 45 months). One patient in the DORV group underwent intraventricular tunnel repair and modified Glenn procedure in the other. In the VSD group, the VSD was closed with a Dacron patch in all patients. Concomitant procedures included a right ventricular infundibulectomy in 4 patients and a valvectomy of the dysplastic pulmonary valve in 1 patient. At the second-stage operations, pulmonary angioplasty was required due to the stenotic banding sites in 18 patients. One patient underwent complete ligation of the main pulmonary artery with the modified Glenn procedure. The mortality at the second-stage operation was 17.2%(5 patients). Causes of death were 4 low cardiac output, and 1 autoimmune hemolytic anemia. Diagnosis with DORV and the early operative group were the risk factors for operative death in this series. There was 1 late death. Conclusion: This study revealed the second-stage operation for pulmonary artery debanding and closure of VSD in children was complicated by the correction of the acquired lesions with a significantly high incidence of morbidity and early postoperative deaths. Primary repair is recommended for isolated VSD, if possible.

• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.17-24
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• 2007

Background: The aim of this study is to assess the clinical results of various procedures in congenital aortic stenosis. Material and Method: From August 1987 to June 2004, 53 patients of congenital aortic stenosis underwent procedures such as percutaneous balloon valvuloplasty, aortic valvuloplasty, Ross procedure, and aortic valve replacement. The mean age of initial procedures was $8.2{\pm}6.0$ years. Percutaneous balloon valvuloplasty was peformed in sixteen patients, aortic valvulopiasty in thirty two patients, Ross procedure in nineteen patients, and aortic valve replacement in fourteen patients. The mean follow duration was $80.6{\pm}60\;(0{\sim}207)$ months. Result: There was 15.1% (8/53) of early mortality and no late mortality. The six patients with critical aortic stenosis were died of left ventricular dysfunction in early series (before 1 year; 4 cases) and two patients died after the Ross procedure and aortic valve replacement respectively. After percutaneous balloon valvuloplasty, most patients needed reoperations (14/16). Thirteen patients needed reoperation, after aortic valvuloplasty. After Ross procedure, two patients needed reoperation due to aortic regurgitation caused by progressive aortic root dilatation. The actuarial survival rate after Ross procedure at 7 years was 90.5%. Conclusion: In young children before the age of one, percutaneous balloon valvuloplasty was considered as :he safe initial palliative procedure. But children over one year-old, aortic valvuloplasty were the effective procedure. Ross procedure can be preformed safely with good results.

• Korean Journal of Soil Science and Fertilizer
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• v.33 no.2
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• pp.71-78
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• 2000

Preferential flow has recently been the subject of increasing interest because these phenomena contribute to solute transport in soils. Commonly, preferential flow paths are associated with macropores or highly structured soils. We presented an analysis of the measured breakthrough curves (BTCs) of $Cl^-$ and $Cu^{2+}$ ions to test the occurrence of preferential flow in soils using miscible displacement technique under steady flow conditions. We also analyzed soil water retention curves and from this curves induced cumulative pore size distribution of undisturbed soils, which sampled from Ap1, B1, and C horizons of Songjeong series soils (the fine loamy, mesic family of Typic Hapludults). In this study, miscible displacement experiment on C horizon was excluded, because it is structureless sandy loam with saturated hydraulic conductivity of $5.2cmhr^{-1}$. The saturated hydraulic conductivity of Ap1 horizon was $2.0cmhr^{-1}$, which was about 7 times higher than that of B1 horizon ($0.27cm hr^{-1}$). Cumulative pore size distribution predicted that Ap1 horizon had more macropores (pore diameter larger than $49{\mu}m$, equivalent to -6 kpa of soil matric potential) than B1 horizon. The hydrodynamic dispersion coefficient from chloride BTCs was estimated as $1.3cm^2hr^{-1}$ for B1 and $34cm^2hr^{-1}$ for Ap1 horizon. However the retardation factors of B1 and Ap1 horizon were significantly different, i.e. 1 and 0.6, respectively, which means that there was distinct partition between mobile water and immobile phase in Ap1 horizon. The copper retardation effect of Ap1 horizon was less than that of B1 horizon, even though cation exchange capacity of Ap1 horizon was higher than that of B1 horizon. Thus, breakthrough curves of $Cl^-$ and $Cu^{2+}$ obviously showed the probability that preferential flow would occur in Ap1 horizon.

• Korean Journal of Soil Science and Fertilizer
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• v.39 no.5
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• pp.292-297
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• 2006

A research was carried out to investigate the release pattern of slow release nitrogen fertilizer compound(SRNC) that is latex coated urea(LCU) and to recommend the application rate of the fertilizer at dry seeding rice culture in Honam plain area. The experiment was conducted at experimental field(Jeonbug series, fine silty, mixed, nonacid, mesic family of Fluvaquentic Endoaquepts) of National Honam Agricultural Research Institute. A medium late maturing rice variety (Dongjinbyeo) was seeded at the rate of $60kg\;ha^{-1}$ by drill seeder on April 1, 1997 and March 30, 1998. Fertilizer application rate was $160-90-110kg\;ha^{-1}$ for $N-P_2O_5-K_2O$. Soil ammonium nitrate($NH_4-N$) contents remained higher in all SRNC plots than conventional ones and higher with the increase of SRNC application rate until panicle formation stage, but the contents was higher in the conventional than NRNC plots at the heading stage. The plant hight was taller in SRNC than conventional plots until maximum tiller stage, but became similar in both conventional and SRNC plots at heading stage. The culm and panicle number was greater in SRNC than conventional plots throughout all growth stage, but the effective tiller rate was higher in conventional ones. Nitrogen efficiency was higher in the SRNC than conventional plots, but the efficiency was decreasing with the higher SRNC level. The spikelet number per unit area was greater in SRNC than conventional plots, and increased with higher SRNC level. The more spikelet number with higher NRNC level resulted in lower 1,000-grain weight. The rice yield in conventional plot was similar with only 60% SRNC level, but lower than 80% and 100% SRNC levels. However, slight lodging was observed in 100% SRNC level. In conclusions, we recommend NRNC application level as 80% of standard nitrogen application for early dry seeding culture of rice Honam plain area.

• Korean Journal of Soil Science and Fertilizer
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• v.36 no.5
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• pp.333-343
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• 2003

This experiment was carried out to improve the utilization of liquid pig manure (LPM) for rice at the two textures of valley soil in 2000 and 2001. The soil textures were coarse loamy and fine loamy in Sachon and Jisan series, respectively. Treatments consisted of no fertilized plot, chemical fertilized plot, LPM 150%, LPM 100%, LPM 100%+NK (top dressing) 30%, LPM 70%+NK 30%, LPM 50%+NK 50% plot. LPM was applied as basal fertilizer compare to nitrogen of chemical fertilized plot. Total N contents in the LPM were 6.0 and $4.5g\;kg^{-1}$ in 2000 and 2001, respectively. After the experiment, P and K contents of soils were not difference between chemical and LPM application plots. But heavy metal contents in soils were slightly higher in LPM application plots than in chemical fertilized plot. Immediately after LPM application, ammonia gas content was $18mg\;kg^{-1}$ in LPM 150% plot, but it was $3mg\;kg^{-1}$ in LPM 50% plot. Two days after LPM application, ammonia gas content was 3 times higher in coarse loamy than in fine loamy soil. After rotary tillage, ammonia gas was not detected at all LPM treatments. This result suggests that rotary tillage can reduce the nasty smell of LPM quickly. Inorganic nitrogen, $NO_3$ and $NH_4$, contents in water of paddy was higher at coarse loamy soil from rice transplanting to tillering stage. After that season, inorganic nitrogen contents of water were not different according to soil texture and treatments. Content of $NH_4-N$ in soil solution was higher at LPM plots than chemical fertilizer plot. Total nitrogen contents in rice plant after harvesting were higher at chemical fertilization plot than LPM application plot, but K contents showed an opposite tendency. Rice yield was decreased only in LPM plots at two soil textures. But yield was not significantly difference between chemical fertilizer and LPM+top dressing plots at coarse loamy soil and increased 5% at LPM 50%+NK 50% plot at fine loamy soil in 2001.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.271-276
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• 1991

A series of 510 patients with carcinoma of the uterine cervix given the curative radiation therapy from March 1979 through December 1986 was evaluated to determine the value of intravenous pyelography (IVP), cystoscopy, sigmoidoscopy, and abdomino-pelvic CT as staging work-up prior to treatment. On IVP and cystoscopy, $10.7\%$(49/456) and $5.3\%$(24/452) showed abnormality, respectively, but only $0.7\%$(3/413) did on sigmoidoscopy. As a result of these work-ups prerequisite to FIGO staging, twenty six ($5.1\%$) out of 510 patients were upstaged from the stage determined by the findings of physical examination alone. The proportions of upstaging in each stage were as follows; none in stage IB (35), IIA (89) and IIIA (8), $7.9\%$(20/252) in stage IIB (14 patients to FIGO stage IIIB, 6 patients to FIGO stage IVA), and $4.8\%$(6/126) in stage IIIB (all to FIGO stage IVA). Positive findings of staging work-ups were found only in patients with advanced stages of stage IIB or over determined by physical examination alone but not in those with earlier stages. CT was performed in 337 patients. CT detected pelvic lymph node (LN) enlargement in $25.2\%$ (85/337) and paraaortic LN enlargement in $7.4\%$(25/337). Pelvic LN positivity was well correlated with increasing stage but paraaortic LN positivity was not. In the evaluation of parametrial involvement, CT findings were in accordance with those of physical examination only in $65.6\%$ (442/674). When compared with endoscopic studeies, CT had much lower positive predictive value than negative predicitive value in the evaluation of adjacent organ invasion. The staging work-ups should be individualized by the disease extent of each patient, and then the efficiency of work-uus may be increased without compromising the appropriate FIGO staging and treatment.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.249-252
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• 1991

A Retrospective study to analyze the failure pattern in locally advanced stomach cancer, treated with radical surgery and post-op chemotherapy was perfomed. Among 107 patients who underwent radical gastrectomy in Asan Medical Center between June 1989 and August 1990. there were 20 stage II(T2NO, T2N1) and 87 stage III(T3N1, T3N2) and 91 patients were eligible for study. 57 patients treated with 6 cycles of postop adjuvant chemotherapy. Among 57 patients treated with postop adjuvant chemotherapy, local failure occurred in $21\%$ and distant failure in $12\%$. Among 34 patients who were not treated with postop chemotherapy, local failure occurred in $24\%$ and distant failure in $26\%$. Among 29 failures including 13 locoregional, 9 distant metastasis and 7 locoregional and distant metastasis, 11 cases recurred in the anastomotic site, 3 in the gastric bed,7 in the regional lymph nodes and peritoneal seeding occurred in 6 cases. The true incidences of gastric bed, nodal and peritoneal failures may be higher in the longer follow-up or reoperative or autopsy series. Our data sugest that postop chemocherapy is beneficial by reducing distant failure rate. Our data suggest that postop chemocherapy is beneficial by reducing distant failure rate. Postop adjuvant locoregional radiotherapy in addition to the systemic adjuvant therapy may reduce the local failure rate and potentially benefit in at least $20\%$ of patients who developed the local failure only.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.185-195
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• 1991

Seventy four patients with pituitary adenoma received radiation therapy (RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five ($88\%$) patients were treated postoperatively and 9 ($12\%$) primary RT, To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin (PRL), growth hormone (GH), adrenocorticotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone (FSH) and thyroid stimulating hormone (TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with invasive tumor mass around supra- and/or parasella area. The patients were classified as 23 ($29\%$) prolactinomas and 20 ($26\%$) growth hormone (GH) secreting tumors, and 6 ($8\%$ ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine ($37\%$) had nonfunctioning tumor and four ($5\%$) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15 ($65\%$) of 23 PRL and 3 ($15\%$) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively. Fifteen ($20\%$) patients were lost to follow up after RT.

• Korean Journal of Veterinary Research
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• v.33 no.4
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• pp.657-664
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• 1993

To reveal the immunogenicity of ${\gamma}-irradiated$ E tenella and its progeny, a series of experiments on the effects of Cobalt-to ${\gamma}-irradiation$ was performed. The SPF chickens inoculated with diffenrt doses of inoculum were challenged with $1{\times}10^5$ oocysts of virulent E tenella. The levels of 100 Gy ${\gamma}-irradiation$ from $^{60}Co$ and of inoculum with $1{\times}10^4$ oocysts were recognized as proper as immunogen by comparison of survival rates, body weight gains, blood in feces and lesion scores in the chickens. In these trials of challenge with virulent E tenella after inoculation with $1{\times}10^4$ oocysts of the ${\gamma}-irradiated$ E tenella and its progeny, the survival rates of the chickens challenged with the virulent E tenella after immunization with the 1st and the 3rd progeny groups of ${\gamma}-irradiated$ E tenella oocysts were higher(l00%) than that(87.0%) of the challenged control group. The signs of blood in feces and the lesion scores were seen markedly lower with the ourput of the smaller number of oocysts, i.e. OPG 103,900 and 25,800 in the groups of the 1st and the 3rd progeny, respectively, than those(OPG 1,658,900) of the challenged control group. The body weight gains of the 1st and the 3rd progeny groups, the 1st week and the 2nd week after challenge, were higher (2.6g and 155.4g, 11.6g and 168.9g respectively) than those(-85.8g and 63.6g, respectively) of the challenged control group, and the feed conversion ratios(FCR 3.28 and 2.96) of the 1st and the 3rd progeny groups were lower than that(FCR 5.60) of the groups challenged control group. The anticoccidial indices(70.5 and 93.9) of the groups challenged with the virulent oocysts of E tenella after immunization with the 1st and the 3rd progeny of the ${\gamma}-irradiated$ E tenella were significantly higher than that (ACI -81.9) of the challenged control group. It was thought that the immunogenicity of ${\gamma}-irradiated$ E tenella would be increase according to increase the number of generation passaged in chicken. That might be because of increasing the pathogenicity of ${\gamma}-irradiated$ E tenella according to increase the number of generation passaged in chicken.