• Journal of Christian Education in Korea
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• v.77
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• pp.203-223
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• 2024

This study aims to reflect on how the experiences in the interrelationship between parents and children affect the formation of God's image and how it affects the formation of healthy Christian identity. We will explore the implications of this research on education for the formation of healthy Christian identity for children. Based on the theories of God's image by Erickson, Freud, and Rizzuto, we examine in-depth how the parental image that children acquire in their relationship with their parents is related to the image of God, which is the basis of their lives. Parents are like caregivers, guardians, and absolute beings that enable their children's survival and safety from their birth. The parental image that a child has through interaction with their parents has a close relationship with the image of God. Amid the existential limitations and restrictions faced by children and parents, negative experiences such as oppression, punishment, and anger that children receive from their parents leave various psychological wounds inside the child. What is important here is that the summation of negative experiences inflicted on the child should not exceed the appropriate level that the child can endure. In addition, children should be guided to feel the following in their relationship with their parents. Children need to be nurtured to feel basic trust from their parents. If these important premise is not observed, the distorted parental image will lead to distorted God's image. Unreliable or violent images of parents will pose a serious threat to the formation of constructive faith or healthy Christian identity. Based on this premise, this study claims a substantial shift from oppressive, authoritarian, and one-directional ways of education to those of mutual, liberational, postconventional education. Finally, this study closes its inquiry by providing constructive direction and alternatives for the development of healthy Christian identity for Children.

• Journal of Internet Computing and Services
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• v.25 no.4
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• pp.121-130
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• 2024

As internet and communication technology (ICT) is improved exponentially, types and amount of available data also increase. Even though data analysis including statistics is significant to utilize this large amount of data, there are inevitable limits to process various and complex data in general way. Meanwhile, there are many attempts to apply machine learning (ML) in various fields to solve the problems according to the enhancement in computational performance and increase in demands for autonomous systems. Especially, data processing for the model input and designing the model to solve the objective function are critical to achieve the model performance. Data processing methods according to the type and property have been presented through many studies and the performance of ML highly varies depending on the methods. Nevertheless, there are difficulties in deciding which data processing method for data analysis since the types and characteristics of data have become more diverse. Specifically, multi-variate data processing is essential for solving non-linear problem based on ML. In this paper, we present a multi-variate tabular data processing scheme for ML-aided data analysis by using Titanic dataset from Kaggle including various kinds of data. We present the methods like input variable filtering applying statistical analysis and normalization according to the data property. In addition, we analyze the data structure using visualization. Lastly, we design an ML model and train the model by applying the proposed multi-variate data process. After that, we analyze the passenger's survival prediction performance of the trained model. We expect that the proposed multi-variate data processing and visualization can be extended to various environments for ML based analysis.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.19 no.4
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• pp.69-85
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• 2024

Social enterprises, hybrid organizations that blend the logic of the public and market economies, have emerged as an alternative to market failure. However, due to the government-led compressed growth of social enterprises, many social enterprises rely on government financial support, and when the support ends, the survival rate drops significantly and the scale remains at the microenterprise level, raising concerns about the quality growth and sustainability of social enterprises. Therefore, the purpose of this study is to identify the social entrepreneurial orientation that affects the sustainable management performance and to empirically analyze the moderating effect of network utilization capabilities in this process. To achieve the purpose of this study, a questionnaire was distributed to a random sample of member organizations in the metropolitan area, including the Incheon City Small Business Association, the Gyeonggi-do Small Business Association etc. The survey was conducted for about two months and a total of 1,300 questionnaires were distributed and 180 were returned, of which 173 were used for empirical analysis, excluding seven that were not returned. The collected survey data were subjected to structural equation modeling test using Smart PLS ver. 4.1 statistical package. The results showed that entrepreneurial value orientation and social value orientation positively influenced both economic and social performance. Convergent value orientation was only found to have an effect on economic performance, but not on social performance. Finally, the moderating effect of network capabilities was also found, suggesting that social entrepreneurial orientation positively affects organizational performance when social network capabilities are higher.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.10 no.2
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• pp.97-114
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• 1977

The fresh water prawn, Macrobrachium rosenbergi(de Man) is a very common species in Indopacific region, which inhaits both fresh and brackish water in low land area, most of rivers and especially aboundant in the lower reaches which are influenced by sea water. It is one of the largest and commercial species of genus Macrobrachium, which is commonly larger than $18\~21cm$ in body length, from the basis of eye-stalked to the distal of telson. As a part of the researches in order to investigate the possibilities on transplantation and propagation of this species, this work dealt with the problems on the effects of chlorinities upon zoeal larvae and post-larvae 1). metamorphosis rate and optimum chlorinity for metamorphosis to post-larve, 2). tolerance and comparative survival rate on various chlorinties, from fresh water to sea water $(19.38\%_{\circ}\;Cl)$, which reared for six days upon each stage of zoeal larvae, 3). accomodation rate on chlonities which reared for twelve days after transmigration into variant chlorinities of the range from $3.68\%_{\circ}$ Cl to $1.53\%_{\circ}$ Cl in the way of rearing of the range from $3.82\%_{\circ}$ Cl to $11.05\%_{\circ}$ upon each stage of zoea, 4). tolerance on both of fresh and sea water upon zoeal larva and post-larva under the condition of $28^{\circ}C{\pm}1$ in temperature and feeding on Artenia salina nauplii, 5). relationship between various chlorinities and grwth of post-larvae under the condition of $28^{\circ}C$ in tmperature and feeding on meat of clam. Thus these investigations were performed in order to grope for a comfortable method on seedmass production. Up to the present, the study on the effects of chlorinity upon earlier zoeal larvae and post-larvae of Macrobrachium species has been scarcely performed by workers with the exception of Lewis(1961) and Ling (1962,, 1967), even so their works were not so detailed. On the other hand, larvae of several species of this genus were reared at the water which mixed sea water so as to carry out complete metamorphosis to post-larva by workers in order to investigate on earlier 1 arval and earlier post-larval development, such as Macrobrachium lamerrei (Rajyalakshmi, 1961), M. rosenbergi and M. nipponense (Uno and Kwoa, 1969; Kwon and Uno, 1969), M. acanthurs (Choudhury, 1970; Dobkin, 1971), M. carcinus(Choudhury, 1970), M. formosense(Shokita, 1970), M. olfersii (Duggei et al., 1975), M. novaehallandiae (Greenwood et al., 1976), M. japonicum (Kwon, 1974) and M. lar (Shokita, personal communication), and there fore it is regarded that chlorinity is, generally, one of absolute factors to rear zoeal larvae of brackish species of Macrobrachium genus. Synthetic results on this work is summarized as the follwings: 1) Zoeal larvae required different chlorinities to grow according to each stage, and generally, it is regarded that optimum range of living and growing is from $7.63\%_{\circ}Cl\to\;7.63\%_{\circ}Cl$, and while differences of metamorphsis rate, from first zoea to post-larva, is rarely found in this range, and however it occurs apparently in both of situation at $7.63\%_{\circ}Cl$ below and $16.63\%_{\circ}Cl$ above and moreover, metamorphosis rate is delayed somewhat in case of lower chlorinity as compared with high chlorinity in these situations. 2) Accomodation in each chlorinity on the range, from fresh water to sea water, is different according to larval stages and while the best of it is, generally, on the range from $14.24\%_{\circ}Cl$ to $8.28\%_{\circ}Cl$ and favorite chlorinity of zoea have a tendency to remove from high chlorinity to lower chlorinity in order to advance larval age throughout all zoeal stages, setting a conversional stage for eighta zoea stage. 3) Optimum chlorinity of living and growth upon postlarvae is on the range of $4.25\%_{\circ}Cl$ below, and in proportion as approach to fresh water, growth rate is increased. 4) Post-large are able to live better in fresh water in comparison with zoeal larvae, which are only able to live within fifteen hours, and by contraries, post-larvae are merely able to live for one day as compared with ?미 larvar, which are able to live for six days more in sea water $19.38\%_{\circ}Cl\;above$. 5) Also, in case of transmigration into higher and lower chlorinities in the way of rearing in the initial chlorinities $ 3.82\%_{\circ}Cl,\;7.14%_{\circ}Cl\;and\;11.05%_{\circ}Cl$, accoodation rate is a follow: accomodation capacity in ease of removing into higher chlorinities from lower chlorinities is increased in proportion as earlier stages, setting a conversional stage for eighth zoea stage, and by contraries, in case of advanced stages from eighth zoea it is incraesed in proportion as approach to post-larva stage in the case of transmigration into lower chlorinity from higher chlorinity. On the other hand, it is interesting that in case of reciprocal transmigration between two different chlorinitiess, each survival rate is different, and in this case, also, its accomodation in each zoea stage has a tendency to vary according to larval stages as described above, setting a conversional stage for eighth zoea stage. 6) It is likely that expension of radish pigments on body surface is directly proportional to chlorinity during the period of zoea rearing, and therefore it seems like all body surfacts of zoea larvae be radish coloured in case of higher chlorinity. 7) By the differences that each zoeal larvae, postlarvae, juvaniles and adult prawn are required different chlorinity for inhabiting in each, it is regarded that this species migrats from up steam to near the estuary of the river which the prawns inhabits commonly in natural field for spawning and growth migration. 8) It had better maintainning chlorinities according to zoeal stage for a comfortable method on seed-mass production that earlier larva stages than eighth zoea are maintained on the range from $8\%_{\circ}Cl\;to\;12\%_{\circ}Cl$ to rear, and later larva stages than eighth zoea, by contraries, are gradually regula ted-to love chlorininity of the range from $7\%_{\circ}Cl\;to\;4\%_{\circ}Cl$ according to advance for post-larva stage.

• Korean Journal of Environment and Ecology
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• v.28 no.5
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• pp.542-549
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• 2014

This study was conducted to investigate the body size, sexual size dimorphism (SSD), and related environmental factors between Red-tongued viper snakes (Gloydius ussuriensis) inhabiting two different places, i.e., Jeju Island and its islet Gapado, and to provide data required to maintain species diversity from May, 2006 until June, 2009. The snout-vent length of the Red-tongued viper snake population inhabiting Jeju Island was found to be 242-532 mm ($422.0{\pm}46.7mm$, n = 100) in females and 296-580 mm ($434.5{\pm}51.7mm$, n = 63) in males. In contrast, the snout-vent length was observed to be 205-395 mm ($335{\pm}43.6mm$, n = 55) in female and 215-430 mm ($328{\pm}39.4mm$, n = 73) in male Red-tongued viper snakes inhabiting Gapado. These data demonstrated the snout-vent length of both female and male Red-tongued viper snakes on Jeju Island to be larger than those on Gapado (Female t = 17.343, df = 115, P<0.001; Male = 19.128, df = 101, P<0.001). SSD was measured to be -0.03 in the Red-tongued viper snake population on Jeju Island, with more or less larger sizes in the males, while it was 0.02 in the Red-tongued viper snake population in the Gapado, with a little larger sizes in the females. The reason for this difference in the snake populations between Jeju Island and Gapado may be due to adaption to the different ecological environments. In addition, as SSD, the snout-vent length of the Red-tongued viper snake populations and in young vipers was somewhat higher in the males than in the females on Jeju Island (t = -2.011, df = 117, P<0.05). However, no significant differences were observed in the snout-vent length of the young and the general Red-tongued viper snake populations on Gapa Island. For the population on Jeju island, the head length (F = 6.318, $df_{1,2}$=1,117, P<0.05), head width (F=8.090, $df_{1,2}$=1,117, P<0.01), inter eye length (F=15.898, $df_{1,2}$=1,117, P<0.001), and tail length (F=238.488, $df_{1,2}$=1,111, P<0.001) were all larger in the males, while females showed higher body mass (F=64.111, $df_{1,2}$=1,114, P<0.001). In the case of the Gapa Island population, no significant differences in the head length, head width, and inter eye length between females and males were observed, while the males had a longer tail length (F=168.555, $df_{1,2}$=1,74, P<0.001) and the females were heavier (F=17.812, $df_{1,2}$=1,76, P<0.001). Though no significant differences were found in the head length, head width, and inter eye length, the tail length (F=67.793, $df_{1,2}$=1,72, P<0.001) and body mass (F=4.558, $df_{1,2}$=1,72, P<0.05) were higher in the young male Red-tongued viper snakes than in the females. The snout-vent length, head length, head width, and inter eye length, which did not display SSD in the young Red-tongued viper snake populations, were higher in the male Red-tongued viper snake populations than in the female population from Jeju Island, implying that SSD in the Red-tongued viper snake population on Jeju Island is expressed due to environmental effects during their growth.

• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1105-1113
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• 1997

Background : Prone position improves oxygenation in some patients with ARDS. According to some authors, prone position can also improve the deteriorated hemodynamics induced by PEEP. But these respiratory and hemodynamic effects of prone position has not yet been fully established. Methods : Twentythree consequtive patients with ARDS(M : F= 11 : 12, $62.1{\pm}20.8yrs$) were the subjects for this study. ABGA, static compliance of the respiratory system, mean arterial pressure and pulse rate were obtained in supine position and at 5min, 0.5h and 2h of prone position. Positive respiratory response was defined as 20mmHg or more increase in $PaO_2/FIO_2$ within 2h of prone position. Early of late respiratory responses were defined if the positive response was observed within of after 3 day of ARDS onset, respectively. Positive hemodynamic response was defined as 10mmHg or more increase in mean arterial pressure at 5min of prone position. Results : Fifteen patients (65%) showed positive respiratory response. In the respiratory responders, $PaO_2$ was $69.8{\pm}17.6mmHg$ in supine position, $83.2{\pm}22.6mmHg$ in prone position 0.5h, $96.8{\pm}22.7mmHg$ in prone position 2h(p<0.001), and $PaO_2/FIO_2$ was $108{\pm}41mmHg$, $137{\pm}57mmHg$, $158{\pm}50mmHg$, respectively(p=0.001). Age, sex, cause of ARDS, supine $PaO_2$ and $PaO_2/FIO_2$ were not different between the respiratory responders and the nonresponders. The respiratory responders, however, showed higher mean arterial pressure than the nonresponders($91.1{\pm}13.1mmHg$ vs. $76.0{\pm}18.7mmHg$, p=0.035), and tendency of higher survival rate(9/15 vs. 2/8, p=0.074). Static compliance of the respiratory system was decreased in prone position 0.5h($28.4{\pm}7.9ml/cm$ $H_2O$ vs. $23.8{\pm}7.6ml/cm$ $H_2O$, p=0.007). The overall rate of early response(n=23) and late response(n=11) were similar(14/23 vs. 7/11, p>0.05). But patient without early response showed late response only in 25%(1/4), while patient with early response showed late response in 85.7%(6/7)(p=0.072). Five patients(22%) showed positive hemodynamic response, two of them being respiratory nonresponders. There were no differences in the baseline mean arterial pressure or the level of PEEP applied in supine between the hemodynamic responders and the hemodynamic nonresponders. Conclusions : Prone position either improved oxygenation or increased arterial pressure in significant proportion of patients with ARDS. And the respiratory response to prone position was thought to be determined in the early stage of ARDS.

• Journal of Korean Society of Forest Science
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• v.45 no.1
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• pp.26-36
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• 1979

Through several trials that has done for making the fertilizing-counter plan on the soil improving species, some results have been got as follows; 1. In the non-phosphorus dressing plots soil improving species have very poor survial ratio and show us to be died step by step. It may be resons that root can not make the nodule in case of non-phosphorus dressing and so tree could not absorb the nitrogen nutrient fixed by the nodule. And root competition with the weedy speces for utilizing the nutrient and oxygen in the soil could be reasons when planting in the heavy weedy rooting site. 2. Triple super phosphate, Fused Mg Phosphate and Fused super phosphate have showed the remarkable effects on the growth of soil improving species within 3rd year after planting. But Koreaan tablet fertilizer(9-12-4) for forest purpose have reacted considerably lower effect in comparision with the above powder and grain type phosphorous fertilizer. 3. In case of tablet type fertilizer tree root will have very little phosphorus absorbing surface because phosphorus can be utilized only from the tablet surface and root can not penetrate into the tablet. This my be reson to show the poor dressing reaction of tablet fertilizer but tablet fertilizer has a possibility to be utilized during long years as a sympton in photo 6. So tablet fertilizer can have a recommendation to dress much fertilizer at p]anting year and then tree root can get much more chance for absorbing the phosphorus that could keep the high survival and for utilizing it during many years without after dressing. 4. The granurar and powder type phosphate can develop the dense root mat like photo 8 because of giving the large surface for absorbing the phosphorus and weedy root can approch to the nodule for taking the nitrogen element. So this type seems to present better effect than tablet type to control the soil movement, stem weight as 200g per meter(l meter long${\times}$0.1m width). When added the lime any effect could not be found and rather give the negative effect. So Lespedeza seed sowing and phosphorus dressing system seems us to be very reasonable method for covering the raw material of basket making, fodder and fuel wood supply. 7. Fused Mg phosphate and Fused super phosphate are good fertilizer to the soil improving species and dressing more than 30g per seedling can be recommendable amount. 5. In the unproductive and dry soil with phosphorus fertilizer Robinia pseudoacacia and Alnus firnui can grow more than 2.3m in height at 3rd year and Alnus inokumae have the rapid height growth that is more than 1.8m at 2nd year. Depending on the growth situation like the above example minirotated management has possibilities and rapid covering of erosed land can be done with the soil improving species and phosphorus fertilizer. 6. In the Lespedeza sowing plot with 40g Fused Mg phosphate dressing per meter in the eroded and unproductive forest soil Lespedeza have completely covered this poor land and produced the green.

• The Korean Journal of Nuclear Medicine
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• v.1 no.1
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• pp.55-66
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• 1967

In view of its prevalence in the Far East area, a more detailed knowledge on the hookworm infection is one of the very important medical problems. The present study was aimed to; determine the infectivity of the artificially hatched ancylostoma duodenale larvae in man after its oral administration, evaluate the clinical symptomatology of such infection, determine the date of first appearance of the ova in the stool, calculate the blood loss per worm per day, assess the relation-ships between the ova count, infectivity(worm load), blood loss and severity of anemia. An erythrokinetic study was also done to analyse the characteristics of hookworm anemia by means of $^{59}Fe\;and\;^{51}Cr$. Materials and Methods Ten healthy male volunteers(doctors, medical students and laboratory technicians) with the ages ranging from 21 to 40 years were selected as the experimental materials. They had no history of hookworm infection for preceding several years, and care was taken not to be exposed to reinfection. A baseline study including a through physical examinations and laboratory investigations such as complete blood counts, stool examination and estimation of the serum iron levels was done, and a vermifuge, bephenium hydroxynaphoate, was given 10 days prior to the main experiment. The ancylostoma duodenale filariform larvae were obtained in the following manner; The pure ancylostoma duodenale ova were obtained from the hookworm anemia patients and a modified filter paper method was adopted to harvest larger number of infective larvae, which were washed several times with saline. The actively moving mature larvae were put into the gelatine capsules, 150 in each, and were given to the volunteers in the fasting state with 300ml. of water. The volunteers were previously treated with intramuscular injection of 15mg. of chlorpromazine in order to prevent the eventual nausea and vomiting after the larvae intake. The clinical symptoms and signs mainly of the respiratory and gastrointestinal tracts, appearance of the ova and occult blood in the stool etc. were checked every day for the first 20 days and then twice weekly until the end of the experiment, which usually lasted for about 3 months. Roentgenological survey of the lungs was also done. The hematological changes such as the red blood cell, white blood cell and eosinophil cell counts, hemoglobin content and serum iron levels were studied. The appearance of the ova in the stool was examined by the formalin ether method and the ova were counted in triplicate on two successive days using the Stoll's dilution method. The ferrokinetic data were calculated by the modified Huff's method and the apparent half survival time of the red blood cells by the modified Gray's method. The isotopes were simultaneously tagged and injected intravenously, and then the stool and blood samples were collected as was described by Roche et al., namely, three separate 4-day stool samples with the blood sample drawing before each 4-day stool collection. The radio-activities of the stools ashfied and the blood were separately measured by the pulse-height analyser. The daily blood loss was calculated with the following formula; daily blood loss in $ml.=\frac{cpm/g\;stool{\times}weight\;in\;g\;of\;4-day\;stool}{cpm/ml\;blood{\times}4}$ The average of these three 4-day periods was given as the daily blood loss in each patient. The blood loss per day per worm was calculated by simply dividing the daily blood loss by the number of the hookworm recovered after the vermifuge given twice a week at the termination of the experiment. The iron loss in mg. through the gastrointestinal tract was estimated with the daily iron loss in $mg=\frac{g\;Hgb/100ml{\times}ml\;daily\;blood\;loss{\times}3.40}{100}$ 3.40=mg of iron per g Hgb following formula; Results 1. The respiratory symptoms such as cough and sputum were noted in almost all cases within a week after the infection, which lasted about 2 weeks. The roentgenological findings of the chest were essentially normal. A moderate degree of febril reaction appeared within 2 weeks with a duration of 3 or 4 days. 2. The gastrointestinal symptoms such as nausea, epigastric fullness, abdominal pain and loose bowel appeared in all cases immediately after the larvae intake. 3. The reduction of the red blood cell count was not remarkable, however, the hemoglobin content and especially the serum iron level showed the steady decreases until the end of the experiment. 4. The white blood cells and eosinophil cells, on the contrary, showed increases in parallel and reached peaks in 20 to 30 days after the infection. A small secondary rise was noted in 2 months. 5. The ova first appeared in the stool in 40. 1 days after the infection, ranging from 29 to 51 days, during which the occult blood reaction of the stool became also positive in almost cases. 6. The number of ova recovered per day was 164, 320 on the average, ranging from 89,500 to 253,800. The number of the worm evacuated by vermifuge was in rough correlation with the number of ova recovered. 7. The infectivity of ancylostoma duodenale was 14% on the average, ranging from 7.3 to 20.0%, which is relatively lower than those reported by other workers. 8. The mean fecal blood loss was 5.78ml. per day, with a range of from 2.6 to 11.7ml., and the mean blood loss per worm per day was 0.30ml., with a range of from 0.13 to 0.73ml., which is in rough coincidence with those reported by other authors. There appeared to exist, however, no correlation between the blood loss and the number of ova recovered. 9. The mean fecal iron loss was 2.02mg. per day, with a range of from 1.20 to 3.89mg., which is less than those appeared in the literature. 10. The mean plasma iron disappearance rate was 0.80hr., with a range of from 0.62 to 0.95hr., namely, a slight accerelation. 11. The hookworm anemia appeared to be iron deficiency in origin caused by continuous intestinal blood loss.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.471-479
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• 1999

Background: Patients with tetralogy of Fallot(TOF), pulmonary atresia(PA) and major aortopulmonary collateral arteries(MAPCAs) have been managed by heterogenous surgical strategies. We have taken 5 different surgical approaches to this lesion. In this study, relative advantages and disadvantages of each strategy were discussed by analyzing our surgical results. Material and Method: Between January 1986 and June 1998, 50 patients aged 1 to 177(39${\pm}$31) months at a various morphologic spectrum of this lesion were treated at our institution. The groups, which were classified according to the initial approaches, consisted of one-stage unifocalization(A-1, n=9), staged unifocalization(A-2, n=11), right ventricle to pulmonary artery connection(RV-PA)(B-1, n=11), one-stage RV-PA plus unifocalization (B-2, n=11), and one-stage definitive repair(C, n=8). Morphologic charateristics, operative mortalities, and probabilities of definitive repair were compared between the groups and the causes of death, complications and the follow-up results were described. Result: Mean ages at the first operation were 57${\pm}$18(A-1), 42${\pm}$48(A-2), 18${\pm}$14(B-1), 52${\pm}$55(B-2), and 32${\pm}$34(C) months (p<0.05). Mean numbers of MAPCAs were least in group C (A-1=4.3${\pm}$1.0, A-2=4.5${\pm}$1.3, B-1=4.1${\pm}$1.9, B-2=4.1${\pm}$1.6, C=3.4${\pm}$1.8 : p<0.05). The ratios of the direct and the indirect MAPCAs in each group were not different between the grousps (A-1=91%/9%, A-2=78%/22%, B-1=80%/20%, B-2=80%/20%, C=81%/19% : p>0.05). Nineteen patients had more than 1 dependent MAPCAs. True pulmonary arteries were not present 13 patients and they were confluent in 29. A total of 101 operations were performed. Operative mortalities of initial procedures were 33%(3/9, A-1), 18%(2/11, A-2), 0%(0/11, B-1), 36%(5/11, B-2) and 13%(1/8, C) (p<0.05). Percentages of the definitive repair among the patients of each group were 22%(2/9, A-1), 18%(2/11, A-2). 45%(5/11, B-1), 27%(4/11, B-2), and 100%(8/8, C)(p<0.05). Hypoxic respiratory and cardiac failure(6), hypoxic encephalopathy(2) and sepsis(4) were the major causes of death. Phrenic nerve palsy occured in 5 patients. Thirty-one patients among the survivals have been followed up for a mean duration of 74${\pm}$42(3-145) months. One and five year actuarial survival rates were 73% and 73 %. Conclusion: In conclusion, Right ventricle to pulmonary artery connection used in patients with TOF/PA/MAPCA as an inital procedure appeared to be highly successful in enhancing the chance of satisfactory definitive repair without the significant surgical risks. One-stage total repair at an ealier age group could be performed safely with the resonable outcomes. Unifocalization approach, whether it was performed in a single stage or in the multiple stages, resulted in the high operative mortality and the lowest chance of definitive repair, however more tailored selection of the patients and the long follow-up is mandatory to prove the usefulness of this approach.

• Journal of Chest Surgery
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• v.32 no.7
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• pp.621-627
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• 1999

Background: Sixty five cases with congenitally corrected transposition of the great arteries (CCTGA) indicated for biventricular repair were operated on between 1984 and september 1998. Comparison between the results of the conventional(classic) connection(LV-PA) and the anatomic repair was done. Material and Method: Retrospective review was carried out based on the medical records of the patients. Operative procedures, complications and the long-term results accoding to the combining anomalies were analysed. Result: Mean age was 5.5$\pm$4.8 years(range, 2 months to 18years). Thirty nine were male and 26 were female. Situs solitus {S,L,L} was in 53 and situs inversus{I,D,D} in 12. There was no left ventricular outflow tract obstruction(LVOTO) in 13(20%) cases. The LVOTO was resulted from pulmonary stenosis(PS) in 26(40%)patients and from pulmonary atresia(PA) in 26(40%) patients. Twenty-five(38.5%) patients had tricuspid valve regurgitation(TR) greater than the mild degree that was present preoperatively. Twenty two patients previously underwent 24 systemic- pulmonary shunts previously. In the 13 patients without LVOTO, 7 simple closure of VSD or ASD, 3 tricuspid valve replacements(TVR), and 3 anatomic corrections(3 double switch operations: 1 Senning+ Rastelli, 1 Senning+REV-type, and 1 Senning+Arterial switch opera tion) were performed. As to the 26 patients with CCTGA+VSD or ASD+LVOTO(PS), 24 classic repairs and 2 double switch operations(1 Senning+Rastelli, 1 Mustard+REV-type) were done. In the 26 cases with CCTGA+VSD+LVOTO(PA), 19 classic repairs(18 Rastelli, 1 REV-type), and 7 double switch operations(7 Senning+Rastelli) were done. The degree of tricuspid regurgitation increased during the follow-up periods from 1.3$\pm$1.4 to 2.2$\pm$1.0 in the classic repair group(p<0.05), but not in the double switch group. Two patients had complete AV block preoperatively, and additional 7(10.8%) had newly developed complete AV block after the operation. Other complications were recurrent LVOTO(10), thromboembolism(4), persistent chest tube drainage over 2 weeks(4), chylothorax(3), bleeding(3), acute renal failure(2), and mediastinitis(2). Mean follow-up was 54$\pm$49 months(0-177 months). Thirteen patients died after the operation(operative mortality rate: 20.0%(13/65)), and there were 3 additional deaths during the follow up period(overall mortality: 24.6%(16/65)). The operative mortality in patients underwent anatomic repair was 33.3%(4/12). The actuarial survival rates at 1, 5, and 10 years were 75.0$\pm$5.6%, 75.0$\pm$5.6%, and 69.2$\pm$7.6%. Common causes of death were low cardiac output syndrome(8) and heart failure from TR(5). Conclusion: Although our study could not demonstrate the superiority of each classic or anatomic repair, we found that the anatomic repair has a merit of preventing the deterioration of tricuspid valve regurgitations. Meticulous selection of the patients and longer follow-up terms are mandatory to establish the selective advantages of both strategies.