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Surgical Outcome of Tetralogy of Fallot in Adolt -Implication of Preoperative Cyanosis- (수술 전 청색증 정도에 따른 성인 활로씨 4징증의 임상 양상)

  • Kim Sang-hwa;Park Soon-Ik;Park Jung-Jun;Song Hyun;Lee Jae-Won;Seo Dong-Man;Song Meong-Gun;Song Jong-Min;Kang Duck-Hyun;Song Jae-Kwan;Jang Wan-Sook;Kim Young-Hwue;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.271-276
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    • 2005
  • We analysed differences in operative methods and postoperative outcome according to the severity of preoperative cyanosis in adult ToF (Tetralogy of Fallot) patients. Material and Method: From August 1989 to June 2001, thirty three adult patients, 18 females and 15 males, underwent total correction for ToF. Their age ranged from 15 years to 54 years (median: 34). Patients were divided into 2 groups by preoperative $SaO_2$ (arterial oxygen saturation): group I$(n=cyanotic,\;SaO_2\;\geq94\%)$ and group II $(acyanotic,\; SaO_2\geq95%)$. Preoperative median hemoglobin level was higher in group I compared to group II (17.5 g/dl vs 15 g/dl). Postoperative follow-up duration ranged from 1 to 94 months (670 patient-month, median: 14 months), and 63 two-dimensional echocardiographic examinations were done during this period. Result: There were no early or late mortality. With regard to RVOT (right ventricular outflow tract) reconstruction, trans-annular patch and RV-PA extracardiac conduit were used in 7 and 3 patients respectively, and all of them belonged to group I. In group I, cardiopulmonary bypass time, aortic cross-clamping time, ICU day, hospital day were significantly longer than in group II, and postoperative inotropic support was significantly greater than in group II. There was no ventricular arrhythmia in both groups, and one patient in group I suffered from atrial arrhythmia, which was resolved spontaneously after tricuspid and pulmonary valve replacement. During follow-up periods, functional class, residual RVOT stenosis and pulmonary regurgitation, tricuspid regurgitation, occurrence of ventricular and atrial arrhythmias were comparable between two groups. Conclusion: In adult ToF patients with severe preoperative cyanosis, more aggressive RVOT reconstruction and careful postoperative care are mandatory. However intermediate-term outcome of this group of patients is comparable to the patients with minimal or no preoperative cyanosis.

The Study on the Effect to the Yields with the Intermediate Cutting Periods of Mulberry Branch and at the Picking Levels of Leaf Remains in Autumn (추잠기 중간벌채시기 및 잔조에서의 적엽정도가 뽕의 수량에 미치는 영향에 관한 연구)

  • 김문협;김호락;최하자
    • Journal of Sericultural and Entomological Science
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    • v.13 no.2
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    • pp.81-94
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    • 1971
  • This research is conducted to study the effect to rebbuding, death atop, yielding and occurrence of twig blight disease with the interemediate cutting periods of mulberry branch and at the picking levels of leaf remains in autumn. The results obtained are as follows: 1. Re-budding branches are decreased with delaying of interval cutting period, and that more leaves remained lesser both re-budding branches and buds are observed. Therefore, it is better that leaves remained are placed on the upper part of branch, practically with 3-5 leaf remains. It has decreased re-budding branches, in case cutting is conducted in Sept. 20 with picking leaving 3-5 leaf on. 2. With regard that all picking increases the percentage of death atop of the branch and upper half part picking increases slightly over the other treats. Although it seems unlikely to be different in the other treats with cutting period, exception of all picking, it is elucidated better that the all picking after cutting in Sept. 15 represents unusually high, seemingly effected by the temperature contition preferable to the life of twig blight disease along with the lack of branch nutrition caused by the all picking. 3. In view of yielding, it has no difference in autumn yielding with cutting period, but more picking levels of leaf remains, more yielding. In spring yield, both no picking and all picking is the lowest, in spite of cutting period. Each treat produces high yielding except the no picking if rutting is done in Sept. 15 and Sept. 20, respectively; otherwise it is done earlier or later, each treat produces low yielding. It is suggested that yielding ability in following spring affected by the autumn picking because all picking treats represent lower yielding ability than no picking ones except of cutting in Sept. 15 and Sept. 20. With respect to total yield in spring and autumn, it is represented that other treats, among which cutting in Sept. 15 and Sept. 20 is especially high, produce higher yielding than both no picking and all picking. But no difference seemed in leaf remained treats. In these respects, it may be concluded that 3-5 leaf remains after the interval cutting in Sept. 15 to Sept. 20 increases the yielding throughout two seasons and it is suggested that 3-5 leaf remains after cutting in Sept. 5 to Sept. 10 has no difference with no picking and cutting after that day. 4. Diseases in the branch remained are twig blight, massaria-bye, and Die-back, of which twig blight attacks tremendously and slight ouurence in messaria-byo and Die-back. In ouurence of twig blight, it is appeared much in all picking and seasonal occurence high in Sept. 15 with 92.9, and in Sept. 30 with 100 as index, respectively. Also it occurs ,considerably in upper part picking but little occurrence in no picing. 5. It is considered that negative correlation among re-budding percentage. No. of re-budding leaf, and spring yielding is found, seemingly without heavy correlation at -0.42, and -0.27, respectively. However, death atop of branch and occurence of twig blight has little correlation with spring yield. On the other hand, positive correlation highly appeared with the correlation coefficient at 0.8 between occurence of twig blight and death atop of branch.

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Discussion on the Necessity of the Study on the Principle of 'How to Mark an Era in Almanac Method of Tiāntǐlì(天體曆)' Formed until Han dynasty (한대(漢代) 이전에 형성된 천체력(天體曆) 기년(紀年) 원리 고찰의 필요성에 대한 소론(小論))

  • Seo, Jeong-Hwa
    • (The)Study of the Eastern Classic
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    • no.72
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    • pp.365-400
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    • 2018
  • The signs of $G{\bar{a}}nzh{\bar{i}}$(干支: the sexagesimal calendar system) almanac, which marked each year, month, day and time with 60 ordinal number marks made by combining 10 $Ti{\bar{a}}ng{\bar{a}}ns$(天干: the decimal notation to mark date) and 12 $D{\grave{i}}zh{\bar{i}}s$(地支 : the duodecimal notation to mark date), were used not only as the sign of the factors affecting the occurrence of a disease and treatment in the area of traditional oriental medicine, but also as the indicator of prejudging fortunes in different areas of future prediction techniques.(for instance, astrology, the theory of divination based on topography, four pillars of destiny and etc.) While theories of many future predictive technologies with this $G{\bar{a}}nzh{\bar{i}}$(干支) almanac signs as the standard had been established in many ways by Han dynasty, it is difficult to find almanac discussion later on the fundamental theory of 'how it works like that'. As for the method to mark the era of $Ti{\bar{a}}nt{\check{i}}l{\grave{i}}$(天體曆: a calendar made with the sidereal period of Jupiter and the Sun), which determines the name of a year depending on where $Su{\grave{i}}x{\bar{i}}ng$(歲星: Jupiter) is among the '12 positions of zodiac', there are three main ways of $$Su{\grave{i}}x{\bar{i}}ng-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(歲星紀年法: the way to mark an era by the location of Jupiter on the celestial sphere), $$T{\grave{a}}isu{\grave{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$ (太歲紀年法: the way to mark an era by the location facing the location of Jupiter on the celestial sphere) and $$G{\bar{a}}nzh{\bar{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(干支紀年法: the way to mark an era with Ganzhi marks). Regarding $$G{\bar{a}}nzh{\bar{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(干支紀年法), which is actually the same way to mark an era as $$T{\grave{a}}isu{\grave{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(太歲紀年法) with the only difference in the name, there are more than three ways, and one of them has continued to be used in China, Korea and so on since Han dynasty. The name of year of $G{\bar{a}}nzh{\bar{i}}$(干支) this year, 2018, has become $W{\grave{u}}-X{\bar{u}}$(戊戌) just by 'accident'. Therefore, in this discussion, the need to realize this situation was emphasized in different areas of traditional techniques of future prediction in which distinct theories have been established with the $G{\bar{a}}nzh{\bar{i}}$(干支) mark of year, month, day and time. Because of the 1 sidereal period of Jupiter, which is a little bit shorter than 12 years, once about one thousand years, 'the location of Jupiter on the zodiac' and 'the name of a year of 12 $D{\grave{i}}zh{\bar{i}}s$(地支) marks' accord with each other just for about 85 years, and it has been verified that recent dozens of years are the very period. In addition, appropriate methods of observing the the twenty-eight lunar mansions were elucidated. As $G{\bar{a}}nzh{\bar{i}}$(干支) almanac is related to the theoretical foundation of traditional medical practice as well as various techniques of future prediction, in-depth study on the fundamental theory of ancient $Ti{\bar{a}}nt{\check{i}}l{\grave{i}}$(天體曆) cannot be neglected for the succession and development of traditional oriental study and culture, too.

The work performance and the factor contributing to the work performance of nutrition teacher & school dieticians (영양교사 (정규직)와 학교영양사 (비정규직)의 직무수행도 및 직무수행에 영향을 미치는 요인)

  • Han, Jang-Il
    • Journal of Nutrition and Health
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    • v.48 no.6
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    • pp.558-570
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    • 2015
  • Purpose: The objective of this study is to investigate the work performances and the factors contributing to the work performance of nutrition teachers and school dieticians according to employment status in Daejeon and Chungcheongnamdo. Methods: A survey was conducted among 415 school dieticians from selected elementary, middle, and high schools in the area. This survey was used for analysis of the general characteristics and the status of working and foodservice environments. The frequency of occurrence was measured using the ${\chi}^2$-test while analysis of differences in work performance of 57 variables grouped according to 12 categories by mean ${\pm}$ SD was performed using student t-test. In addition, a regression analysis was performed to assess the influence of occupational (working and foodservice) environment on work performances. Results: All 14 environmental factors including general characteristics were different between nutrition teachers and school dieticians. In 12 of 57 variables there were significant differences in work performance between the two groups. When compared using average work performance, 5 domains showed significant difference in work performance between the two groups. These 5 domains were other works (T = 6.050), dietary habit guide (T = 4.789), menu (nutrition) management (T = 3.524), foodservice administration and evaluation (T = 2.757), and production and service management (T = 2.588). Overall, the work performances of nutrition teachers were comparably higher than those of school dietitians. A correlation analysis between occupational (working or foodservice) environments and work performances of the two groups showed that the work performances of nutrition teachers were influenced by the number of employees, number of students, meal frequency a day, annual salary, age, foodservice years of school, and school type. Conclusion: Meanwhile, the work performances of school dieticians were influenced by the number of students, number of employees, meal frequency a day, work hour, education level, age, school type, and service years as a dietitian.

Forming and Changing the Concept of 'Cultural Property' before the Enactment of the Cultural Heritage Protection Act (문화재보호법 제정 이전 '문화재' 개념의 형성과 변화)

  • OH Chunyoung
    • Korean Journal of Heritage: History & Science
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    • v.56 no.4
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    • pp.288-318
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    • 2023
  • This work began with the aim of examining the history of the concept "cultural property" that is expected to disappear, and the main subject of research was the history that preceded the spread of this notion throughout society. The phrase "cultural property" first appeared in the 1920s, and was used in various fields such as literature, history, music, and philosophy in the context of cultural resources. Until immediately following liberation from the Japanese colonial era, the meaning of cultural assets was widely applied in the range of "cultural resources," and during this period, it was often used to help supplant the reality and history of Japanese occupation. Immediately after the Korean War, it was also employed for the purpose of 'restoration of cultural resources through war'. Recognition of cultural property directly influenced by Japan's Cultural Heritage Protection Act has occurred since 1950s. In the early 1960s, the enactment of various laws related to cultural properties and the establishment of the Cultural Heritage Administration caused the meaning of cultural property to be limited to 'cultural heritage'. In this way, the definition of state-led cultural property has continued to apply to this day. It has not been clearly confirmed whether the concept of cultural properties was imported from Japan through means such as the Cultural Heritage Protection Act. Cases in which several Japanese students endorsed the concept of cultural property within Korea serve to increase the likelihood that the concept was indeed imported from Japan. However, "coined language using multiple Chinese characters," "the phenomenon of cultural complex words in the 1920s,", and "cases of non-Japanese international students using the concept of cultural property" also open up the possibility of their own occurrence. Apart from the general importance of the concept of cultural property, intellectuals at the time used this concept to promote internal development and the overcoming of colonial Joseon. In this research, it was confirmed that the conceptual word cultural property was older and had a wider history than the general perception had indicated previously. The history of the conceptual term "cultural property" may appear to be more than 60 years old based on the enactment of the Cultural Heritage Protection Act, but in fact it is nearly 100 years old when traced back to on 1925, as established here. In general, the creation and disappearance of terms may proceed naturally with social change, but such terms may alternatively be created or erased through national policy. Identifying the origins of a phrase that is about to disappear represents a significant task for purposes of establishing its historical meaning.

Latest Supreme Court Decision on Proof of Causation in Medical Malpractice Cases - Focusing on Supreme Court decision 2022da219427 on August 31, 2023 and the Supreme Court decision 2021Do1833 on August 31, 2023 - (의료과오 사건에서 인과관계 증명에 관한 최신 대법원 판결 - 대법원 2023. 8. 31. 선고 2022다219427 판결 및 대법원 2023. 8. 31. 선고 2021도1833 판결을 중심으로 -)

  • HYEONHO MOON
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.3-36
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    • 2023
  • The main issue in medical malpractice civil litigation is medical negligence and the causal relationship between medical negligence and damages. Regarding the presumption of causality in cases where medical negligence is proven, there is a previous Supreme Court decision 93da52402 on February 10, 1995, but it is difficult to find a case that satisfies the textual requirements of the above decision, and yet, in practice, the above decision is cited. In many cases, causal relationships were assumed, and criticism was consistently raised that it was inconsistent with the text of the above judgment. In its ruling, the Supreme Court reorganized and presented a new legal principle regarding the presumption of causality when medical negligence is proven in a civil lawsuit. According to this, If the patient proves ① the existence of an act that is assessed as a medical negligence, that is, a violation of the duty of care required of an ordinary medical professional at the level of medical care practiced in the field of clinical medicine at the time of medical practice, and ② that the negligence is likely to cause damages to the patient, the burden of proving the causal relationship is alleviated by presuming a causal relationship between medical negligence and damage. Here, the probability of occurrence of damage does not need to be proven beyond doubt from a natural scientific or medical perspective, but if recognizing the causal relationship between the negligence and the damage does not comply with medical principles or if there is a vague possibility that the negligence will cause damage, causality cannot be considered proven. Meanwhile, even if a causal relationship between medical negligence and damage is presumed, the party that performed the medical treatment can overturn the presumption by proving that the patient's damage was not caused by medical negligence. Meanwhile, unlike civil cases, the standard is 'proof beyond reasonable doubt' in criminal cases, and the legal principle of presuming causality does not apply. Accordingly, in a criminal case of professional negligence manslaughter that was decided on the same day regarding the same medical accident, the case was overturned and remanded for not guilty due to lack of proof of a causal relationship between medical negligence and death. The above criminal ruling is a ruling that states that even if 'professional negligence' is recognized in a criminal case related to medical malpractice, the person should not be judged guilty if there is a lack of clear proof of 'causal relationship'.

Dong-Mu Lee Je-Ma and The Rising of Choi Moon-Hwan (동무(東武) 이제마(李齊馬)와 최문환(崔文煥)의 난(亂))

  • Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.9 no.2
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    • pp.39-55
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    • 1997
  • Purpose : Dong-Mu(東武) Lee Je-Ma(李濟馬) was designated as a member of fifty persons 'The Wise Ancestors of Korean Culture and Art' in 1984 and the december of 1996 was appointed as 'The Month of Lee Je-Ma'. Though his achivements was valued like this, some historian criticized that he suppressed the righteous army. So this study was for clarifing the background, the motive, and the course of 'The Rising of Choi Moon-Hwan' occurred in Hamhung on february in 1896, and for the correct appraisement about this event. And also through this, author tried to make clear the origin of Lee Je-Ma's thought. Method : After studing the background of the end of Chosun dynasty and the righteous army in 1895(乙未義兵). Author made a comparative study through the historical materials of the goverment side, the Choi Moon-Hwan side, and the Lee Je-Ma side about 'The Rising of Choi Moon-Hwan' occurred in Hamhung on februrary in 1896. Results & Conclusion : The event occurred in Hamhung on february in 1896 was a part of rebellion of the righteous army in 1895 which had risen against The startling Occurrence of 1895'(乙未義兵) and 'The Royal Commands To Cut Off People's Hair'(斷髮令). Lee Je-Ma suppressed the Rising and put Choi Moon-Hwan in the prison, and which was criticized that he suppressed the righteous army later day. That time was a conflict period between conservatism and civilization, and the Lee Je-Ma's act was the best way to protect the security of residents from the attack which maybe occurred by Japanese army in Wonsan. Judging from this events, author could find Lee Je-Ma's thought was quite different from righteous army's neo-confucianism and conservatism. In the aspect of the history of 'Korean National Movement', further study about Choi Moon-Hwan, the chief of righteous army will be need.

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A Case Study of Strong Wind Event over Yeongdong Region on March 18-20, 2020 (2020년 3월 18일-20일 영동지역 강풍 사례 연구)

  • Ahn, Bo-Yeong;Kim, Yoo-Jun;Kim, Baek-Jo;Lee, Yong-Hee
    • Journal of the Korean earth science society
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    • v.42 no.5
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    • pp.479-495
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    • 2021
  • This study investigates the synoptic (patterns of southern highs, northern lows, and lows rapidly developed by tropopause folding), thermodynamic, and kinematic characteristics of a strong wind that occurred in the Yeongdong region of South Korea on March 18-20, 2020. To do so, we analyzed data from an automatic weather station (AWS), weather charts, the European Centre for Medium-range Weather Forecasts (ECMWF) reanalysis, rawinsonde, and windprofiler radars. The daily maximum instantaneous wind speed, exceeding 20 m s-1, was observed at five weather stations during the analysis period. The strongest instantaneous wind speed (27.7 m s-1) appeared in the Daegwallyeong area. According to the analysis of weather charts, along with the arrangement of the north-south low-pressure line, the isobars were moved to the Yeongdong area. It showed a sine wave shape, and a strong wind developed owing to the strong pressure gradient. On March 19, in the northern part of the Korean Peninsula, with a drop in atmospheric pressure of 19 hPa or more within one day, a continuous strong wind was developed by the synoptic structure of the developing polar low. In the adiabatic chart observed in Bukgangneung, the altitude of the inversion layer was located at an altitude of approximately 1-3 km above the mountaintop, along with the maximum wind speed. We confirmed that this is consistent with the results of the vertical wind field analysis of the rawinsonde and windprofiler data. In particular, based on the thermodynamic and kinematic vertical analyses, we suggest that strong winds due to the vertical gradient of potential temperature in the lower layer and the development of potential vorticity due to tropopause folding play a significant role in the occurrence of strong winds in the Yeongdong region.

A Review of Recent Climate Trends and Causes over the Korean Peninsula (한반도 기후변화의 추세와 원인 고찰)

  • An, Soon-Il;Ha, Kyung-Ja;Seo, Kyong-Hwan;Yeh, Sang-Wook;Min, Seung-Ki;Ho, Chang-Hoi
    • Journal of Climate Change Research
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    • v.2 no.4
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    • pp.237-251
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    • 2011
  • This study presents a review on the recent climate change over the Korean peninsula, which has experienced a significant change due to the human-induced global warming more strongly than other regions. The recent measurement of carbon dioxide concentrations over the Korean peninsula shows a faster rise than the global average, and the increasing trend in surface temperature over this region is much larger than the global mean trend. Recent observational studies reporting the weakened cold extremes and intensified warm extremes over the region support consistently the increase of mean temperature. Surface vegetation greenness in spring has also progressed relatively more quickly. Summer precipitation over the Korean peninsula has increased by about 15% since 1990 compared to the previous period. This was mainly due to an increase in August. On the other hand, a slight decrease in the precipitation (about 5%) during Changma period (rainy season of the East Asian summer monsoon), was observed. The heavy rainfall amounts exhibit an increasing trend particularly since the late 1970s, and a consecutive dry-day has also increased primarily over the southern area. This indicates that the duration of precipitation events has shortened, while their intensity became stronger. During the past decades, there have been more stronger typhoons affecting the Korean peninsula with landing more preferentially over the southeastern area. Meanwhile, the urbanization effect is likely to contribute to the rapid warming, explaining about 28% of total temperature increase during the past 55 years. The impact of El Nino on seasonal climate over the Korean peninsula has been well established - winter [summer] temperatures was generally higher [lower] than normal, and summer rainfall tends to increase during El-Nino years. It is suggested that more frequent occurrence of the 'central-Pacific El-Nino' during recent decades may have induced warmer summer and fall over the Korean peninsula. In short, detection and attribution studies provided fundamental information that needed to construct more reliable projections of future climate changes, and therefore more comprehensive researches are required for better understanding of past climate variations.

Effects of Mowing (Beolcho) Timing and Height on Growth Characteristics of Zoysia japonica and Z. matrella before Chuseok (추석 전 잔디 깍기(벌초) 시기 및 높이에 따른 들잔디와 금잔디의 생육)

  • Chang, Seog-Won;Koo, Jun-Hak;Sung, Chang-Hyun;Lee, Jeong-Ho;Park, Sho-Jun;Jee, Jae-Uk;Youn, Jeong-Ho
    • Weed & Turfgrass Science
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    • v.7 no.2
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    • pp.140-147
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    • 2018
  • In Korea, mowing the grass of a grave (Beolcho) is a very important event preceded by Chuseok (Korean thanks giving day) and Si-Hyang (annual ancestral feast). Because Beolcho usually takes place one or two weeks before Chuseok, the traffic accidents on roads are getting worse and safety accidents are getting more and more. Erroneous Beolcho methods can cause the soil to be exposed and cause the loss of soil or the low shoot density of graveyard grass or weed occurrence. Therefore, the dispersion of the Beolcho timing and the approprite method can be import issues. The present study assessed the effects of grass mowing timing and height before Chuseok on the growth of Zoysia japonica and Z. matrella. The mowing timing was evaluated at 1 week, 2 weeks, 3 weeks, and 4 weeks before Chuseok, and the mowing height differently according to the two type of grass. In Z. japonica, the faster mowing before Chuseok, the longer the plant height, and the coverage rate and shoot density were higher. In Z. matrella, the faster mowing, the longer the shoot length, but the coverage rate and shoot density did not show any difference or tendency. As compared to Z. japonica, the plant height of Z. matrella was kept short regardless of the time of mowing. In both grasses, the plant height was shortened when mowing was done at low cutting height, but the coverage rate and shoot density were decreased. In addition, it was shown that it is advantageous to maintain the shoot density of graveyard lawn by 40-50 mm or 30-40 mm cutting above the ground for Z. japonica or Z. matrella, respectively.