• Journal of Chest Surgery
• /
• v.30 no.11
• /
• pp.1062-1068
• /
• 1997

From August 1989 to January 1996, a total of 105 cases of bidirectional Glean operations have been done as the interim stage for the patien s with some risk of univentricular correction at Sejong General Hospital. From December 1992, we started the conversion to Fontal operations for them, and 42 cases underwent Fontal-stage operation till February 1996. Their diagnoses were univentricular heart in 19(right ventricular type : 14), tricuspid atresia 11, double outlet of right ventricle 9, and others in 3 cases. The median age of bidirectional Glerln-stage operation was 12.5 months(range 2 months to 8 years) and Fontan-stage operation was at 59.6 months of median age(range 1 year 5 months to ,9 year 7 months). The mean waiting interval between the two operations was 33.88 $\pm$ 17.85 months with a range of 10 months to 6 years 3 months. During the waiting periods, 18 patients developed significant systemic-pulmonary collaterals andfor systemic verso-veno collateral channels. There were 5 hospital deaths after operations due to low cardiac output in 4 and sepsis in one. Most of the Fontal-stage operations were done by the late al tunneling with Core-Tex tube graft patch and fenestrated with the size of 2.5 ~6 mm. All the patients were followed-up(7 months to 4 years 2 months, mean 21.97$\pm$10.82 months) and there were 5 late deaths(postoperatively 6 months to 2 years) due to thromboembolism in 1, after heart transplantation 1, plastic bronchitis 1, protein loosing enteropathy 1, and pneumonia in 1. Dividing the patients by the waiting interval of 2 years, the early correction to Fontal group (N=16) showed the better results(hospital mortality 1116, late mortality 1116, significant collateral development 2/16) compared to the other group(N=26) (4/26, 4/26, 16/26). In conclusion, after the bidirectional Glean-stage operation successfully got rid of the previous risk factors, we recommand to do the Fontan-stage operation no later than 2 years of interval.

• Journal of Chest Surgery
• /
• v.44 no.2
• /
• pp.115-122
• /
• 2011

Background: The intramural coronary artery has been known as a risk factor for early death after an arterial switch operation (ASO). We reviewed the morphological characteristics and evaluated the early and mid-term results of ASO for patients with an intramural coronary artery. Materials and Methods: From March 1994 to September 15th 2010, 158 patients underwent ASO at Dong-A and Pusan National University Hospitals for repair of transposition of the great arteries and double outlet right ventricle. Among these patients, 14 patients (8.9%) had an intramural coronary artery. Mean age at operation was $13.4{\pm}10.2$ days (4 to 39 days) and mean body weight was $3.48{\pm}0.33$ kg (2.88 to 3.88 kg). All patients except one were male. Eight patients had TGA/IVS and 4 patients had an aortic arch anomaly. Two patients (14.3%) had side-by-side great artery relation, of whom one had an intramural right coronary artery and the other had an intramural left anterior descending coronary artery. Twelve patients had anterior-posterior relation, all of whom had an intramural left coronary artery (LCA). The aortocoronary flap technique was used in coronary transfer in 8 patients, of whom one patient required a switch to the individual coronary button technique 2 days after operation because of myocardial ischemia. An individual coronary button implantation technique was adopted in 6, of whom 2 patients required left subclavian artery free graft to LCA during the same operation due to LCA injury during coronary button mobilization and LCA torsion. Results: There was 1 operative death (7.1%), which occurred in the first patient in our series. This patient underwent an aortocoronary flap procedure for coronary transfer combining aortic arch repair. Overall operative mortality for 144 patients without an intramural coronary artery was 13.2% (19/144). There was no statistical difference in operative mortality between the patients with and without an intramural coronary artery (p>0.1). There was no late death. The mean follow-up duration was $52.1{\pm}43.0$ months (0.5 to 132 months). One patient who had a subclavian artery free graft required LCA stenting 6.5 years after surgery for LCA anastomotic site stenosis. No other surviving patient needed any intervention for coronary problems. All patients had normal ventricular function at latest echocardiography and were in NYHA class 1. Conclusion: The arterial switch operation in Transposition of Great Arteries or Double Outlet Right Ventricle patients with intramural coronary can be performed with low mortality; however, there is a high incidence of intraoperative or postoperative coronary problems, which can be managed with conversion to the individual coronary button technique and a bypass procedure using a left subclavian free graft. Both aortocoronary flap and individual coronary button implantation techniques for coronary transfer have excellent mid-term results.

• KOREAN JOURNAL OF CROP SCIENCE
• /
• v.58 no.3
• /
• pp.308-318
• /
• 2013

Korean soybean varieties, 'Seonyu' and 'Hwangkeum' were planted in 2012, and three temperature gradient, Tc($19.8^{\circ}C$, ambient temperatured), $Tc+1.7^{\circ}C$, and $Tc+2.5^{\circ}C$, were artificially created by controlling the green house system during seed filling period. Mature seeds that developed under these conditions were analyzed for variances in physicochemical properties. The 100-seed weight and seed-coat ratio of soybean were decreased, but small seed rate was increased by high temperature during seed filling period. Protein content was increased, but oil content was decreased significantly with increasing the seed filling temperature. The decrement of carbon to nitrogen ratio (C/N), and the increment of monosaccharide, fructose and sucrose, in seeds explained that carbohydrate assimilation during seed filling was restricted by high temperature. Rapid increments of seed volume and weight were observed in the seeds of high seed filling temperature, but as soaking time increased the highest values were observed in the seeds of ambient seed filling temperature. The 100-seed weight and seed-coat ratio of soybean were closely related not only to the increment of soaking volume and weight, but also the increments of total dissolved solids (TDS) and electro conductivity (EC). Whereas protein content and C/N ratio showed less relationship with the soaking properties, but they had a positive correlation with TDS and EC. From the results, it was considered that high values of TDS and EC in the seeds of high temperature were mainly due to the incomplete conversion of assimilates into storage compounds. However, sugar content showed less influence on the soaking properties and the values of TDS and EC.

• Journal of Animal Science and Technology
• /
• v.53 no.2
• /
• pp.127-132
• /
• 2011

This study was conducted to investigate the effect of feeding colored barley (CB) and whole crop barley (WCB) on performance, egg quality and blood composition of laying hens. A total of 280, 35 weeks old Brown Nick laying hens were allocated into the individual cage for the period of four weeks. Experimental diets contained 2,750 kcal/kg ME and 16% CP, respectively. The treatments consisted of 5, 10, 15% CB and WCB as feed ingredients with control and there were five replications in each treatment. Higher egg production was noticed at 10% level of CB and 5% level of WCB in the diets, respectively. Feed intake was higher in WCB and CB treatments compared to those of the control (P<0.05), but the feed conversion was not different. Yolk color tended to increase both in WCB and CB groups. Haugh unit seemed to increase WCB treatments. When the CB and WCB were fed at 15% level, blood total proteins, albumin, total cholesterol and triglyceride contents were decreased than that of the control birds, but total cholesterol and HDL-cholesterol tended to be higher with the increasing level of WCB. As results, no significant differences were observed in performance and egg quality with different levels of dietary WCB and CB. Thus, CB and WCB can be substituted as a feed ingredient up to 15% level in the laying hens' diet. However, further studies are required by feeding more than 15% levels of CB and WCB in the diet of laying hens.

• Korean Journal of Agricultural and Forest Meteorology
• /
• v.2 no.2
• /
• pp.47-61
• /
• 2000

Agroclimatic zoning was done for paddy rice culture in North Korea based on a simulation experiment. Daily weather data for the experiment were generated by 3 steps consisting of spatial interpolation based on topoclimatological relationships, zonal summarization of grid cell values, and conversion of monthly climate data to daily weather data. Regression models for monthly climatological temperature estimation were derived from a statistical procedure using monthly averages of 51 standard weather stations in South and North Korea (1981-1994) and their spatial variables such as latitude, altitude, distance from the coast, sloping angle, and aspect-dependent field of view (openness). Selected models (0.4 to 1.6$^{\circ}C$ RMSE) were applied to the generation of monthly temperature surface over the entire North Korean territory on 1 km$\times$l km grid spacing. Monthly precipitation data were prepared by a procedure described in Yun (2000). Solar radiation data for 27 North Korean stations were reproduced by applying a relationship found in South Korea ([Solar Radiation, MJ m$^{-2}$ day$^{-1}$ ] =0.344 + 0.4756 [Extraterrestrial Solar Irradiance) + 0.0299 [Openness toward south, 0 - 255) - 1.307 [Cloud amount, 0 - 10) - 0.01 [Relative humidity, %), $r^2$=0.92, RMSE = 0.95 ). Monthly solar irradiance data of 27 points calculated from the reproduced data set were converted to 1 km$\times$1 km grid data by inverse distance weighted interpolation. The grid cell values of monthly temperature, solar radiation, and precipitation were summed up to represent corresponding county, which will serve as a land unit for the growth simulation. Finally, we randomly generated daily maximum and minimum temperature, solar irradiance and precipitation data for 30 years from the monthly climatic data for each county based on a statistical method suggested by Pickering et a1. (1994). CERES-rice, a rice growth simulation model, was tuned to accommodate agronomic characteristics of major North Korean cultivars based on observed phenological and yield data at two sites in South Korea during 1995~1998. Daily weather data were fed into the model to simulate the crop status at 183 counties in North Korea for 30 years. Results were analyzed with respect to spatial and temporal variation in yield and maturity, and used to score the suitability of the county for paddy rice culture.

• Sleep Medicine and Psychophysiology
• /
• v.3 no.1
• /
• pp.85-95
• /
• 1996

Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

• Journal of Gastric Cancer
• /
• v.7 no.1
• /
• pp.1-8
• /
• 2007

Purpose: There has been increased the number of early gastric cancer and laparoscopy-assisted gastrectomy (LAG), due to early detection through mass screening program. We started the LAG in April 2004 and performed 119 cases of gastric cancer in 2005, so we report a surgical outcome compared with that of open gastrectomy (OG). Materials and Methods: 119 patients underwent LAG in 2005, and for open group, 126 patiens of early gastric cancer were selected sequentially from January 2005 to March 2005. We compared clinicopathologic characteristics, postoperative courses and complications between two groups. Results: There was no significant difference between age, a length of hospital stay, distal resection margin and a number of retrived lymph nodes. The operation time was longer in LAG group (239.2 vs 123.3 mins, P<0.001) and a diet progression was faster in LAG group (first flatus: 3.05 vs 3.70 days, SOW: 2.86 vs 3.22 days, liquid diet: 3.87 vs 4.19 days, soft diet: 4.84 vs 5.26 days, P<0.001). But there was no difference statistically in postoperative discharge date (7.73 vs 8.25 days, P=0.229). The additional requirement of analgesic injection was less frequent in LAG group (2.97 vs 4.92 times, P<0.001). The harvested lymph nodes were similar in both groups (23.9 vs 23.1, P=0.563). A complication rate was lower in LAG group (4.9% vs 9.5%), but there was no statistical significance (P=0.179). There was no mortality in both groups and no conversion to open gastrectomy in the LAG group. Conclusion: LAG can be performed safely and accepted in view of curative procedure in treatment of early gastric cancer. But we need the follow up of long-term period to evaluate the survival rate and recurrence, and a prospective randomized controlled study should be done to establish that LAG will be a standard operation for early gastric cancer.

• Tuberculosis and Respiratory Diseases
• /
• v.49 no.6
• /
• pp.676-683
• /
• 2000

Background : Surgery may have a role when medical treatment alone is not successful in patients with multidrug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. Methods : A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). Results : The thirteen patients were $37.5{\pm}12.4$ years old (mean${\pm}$S.D.)(M : F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods ($109.7{\pm}132.0$ months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative $FEV_1$ was $2.37{\pm}0.83$ L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After $41.5{\pm}58.9$ days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. Conclusion : When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.

• Journal of Gastric Cancer
• /
• v.7 no.3
• /
• pp.132-138
• /
• 2007

Purpose: In Korea, the number of laparoscopy-assisted distal gastrectomies for early gastric cancer patients has been on the increase. Although minimally invasive surgery is more beneficial, no reported case of a total laparoscopic gastrectomy has been reported because of difficulty with intracorporeal anastomosis. This study attempts, through our experience, to determine the safety and feasibility of a total laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linears stapler in treating early gastric carcinomas. Materials and Methods: We investigated the surgical results and clinicopatholgical characteristics of 81 patients that underwent a totally laparoscopic distal gastrectomy at our department between June 2004 and May 2007. The intracorporeal anastomoses were performed by using laparoscopic linear staplers. Results: The mean operative time was 287 minutes, the mean anastomotic time was 40 minutes, and the mean number of laparoscopic linear staplers used for an operation was 7.5. The mean time to the first flatus, the first food intake, and discharge from hospital was 2.9, 3.6, and 10.3 days respectively. There were 11 cases of postoperative complications, but no case of postoperative mortality or conversion to an open procedure. In 75 patients with an adenocarcinoma, the mean number of lymph nodes harvested was 38.1 and the stage distribution was as follows: stage I, 72 patients; stage II, 2 patients; stage IV, 1 patient. During the mean follow-up period of 14 months, 5 patients died of other causes and there were no cases of cancer recurrence. Conclusion: A total laparoscopic gastrectomy with intracorporeal anastomosis by using a laparoscopic linear stapler was found to be safe and feasible. We were able to obtain acceptable surgical outcomes in terms of minimal invasiveness.

• Journal of Legislation Research
• /
• no.44
• /
• pp.611-653
• /
• 2013

An whistle-blowing is recognition of acts of misconduct or corruption by individuals(laborers) or party which belongs to a certain organization and it refers to the act of informing to the senior organization or to the outside public agency to avoid jeopardies that could be potentially lead against benefit of the public. These whistle-blowings can be a Ansatz that improve corporation's transparency and accountability by prevention of enterprise's misconduct as well, it has been recognized as an important role for the establishment of corporate ethics, moreover, social justice. What to be treated primarily as labor law problem is arousing some controversies of the possibility that the public announcement could be whether a disciplinary punishment or not because it brings some mischievous effects for the honor and the reputation to the company which conducted the illegal actions and the action of the contrary to the social value. And futhermore, recently, the matter of compensational responsibility according to the arrangement conversion, bullying followed by the informant has been brought up. The fundamental standpoint of precedent related with the judgement of justification for the punishment as reason of the whistle-blowing ought to do the sincere duty for the labor contract which is the employees are supposed to consider the employer's profits. For that reason, if the emploee release the inside fact to the public and give any damages to employer's secret or confidence or honor, it will be a causing reasong of the disciplinary punishment, but in specific cases, the relevant and level of punishment limitation can be judged by the contents of public announcement and the truth, the purpose of the acts and details and the way of announcement. Precisely, on the assumption that there are necessity of the characteristic profit or the freedom of expression for the informant, with overall consideration whether or the basis part of the informant is true or there is a fair reason which make the informant believe is true or the purpose of informant has the public profit or the contents of the whistle-blowing are important for relevant organization or the means and the way was suitable, if the whistle-blowing are approved to be resonable, the organization are not permitted the reprimand or dismiss Futhermore, to find the solution for the issues of the disciplinary punishment and the treatment of all sorts of disadvantages, for the reason of whistle-blowing, since the protection law for public declarer which was enacted in last 2011 have the position as the general law, the purport of the equal law has to be considered sytematically and also the judicial precedent which is related to the justification of whistle-blowing are needed to be considered as well.