Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach. Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups. Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative $(292.7{\pm}61.7\;and\;264.0{\pm}47.9min$, respectively; p=0.01) and CPB times ($128.4{\pm}37.6\;and\;101.7{\pm}32.5min$, respectively; <0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times ($82.1{\pm}35.0\;and\;87.8{\pm}113.5min$, respectively; p=0.74) and ventilator times ($18.0{\pm}18.4\;and\;19.7{\pm}9.7$ hr, respectively; p=0.57) between the groups. The stay on the ICU $(53.2{\pm}40.2\;and\;72.8{\pm}42.1hr$, respectively; p=0.02) and the hospitalization time ($9.7{\pm}7.2\;and\;14.8{\pm}11.9days$, respectively; p=0.01) were shorter for group A. The Patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pair score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral ($0.7{\pm}1.0\;and\;0.9{\pm}0.9$, respectively; p=0.60) and tricuspid regurgitation ($1.0{\pm}0.9\;and\;1.1{\pm}1.0$, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group. Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that's done through a median sternotomy.
Intercomparisons between four kinds of data have been done to estimate the accuracy of satellite observations and model reanalysis for middle and lower tropospheric thermal state over regional oceans. The data include the Microwave Sounding Units (MSU) Channel 2 (Ch2) brightness temperatures of NOAA satellites and the vertically weighted corresponding temperature of ECMWF GCM (1980-93). The satellite data for midtropospheric temperatures are MSU2 (1980-98) in nadir direction and SC2 (1980-97) in multiple scans, and for lower tropospheric temperature SC2R (1980-97). MSU2 was derived in this study while SC2 and SC2R were described in Spencer and Christy (1992a, 1992b). Temporal correlations between the above data were high (r${\ge}$0.90) in the middle and high latitudes, but low(r${\sim}$0.65) over the low latitude and more convective regions. Their values with SC2R which included the noises due to hydrometeors and surface emission were conspicuously low. The reanalysis shows higher correlation with SC2 than with MSU2 partially because of the hydrometeors screening. SC2R in monthly climatological anomalies was more sensitive to surface thermal condition in northern hemisphere than MSU2 or SC2. The first EOF mode for the monthly mean data of MSU and ECMWF shows annual cycle over most regions except the tropics. The mode in MSU2 over the Pacific suggests the east-west dipole due to the Walker circulation, but this tendency is not clear in other data. In the first and second modes for the Ch2 anomalies over most regions, the MSU and ECMWF data commonly indicate interannual variability due to El Ni${\tilde{n}$o and La Ni${\tilde{n}$a. The substantial disagreement between observations and model reanalysis occurs over the equatorial upwelling region of the western Pacific, suggesting uncertainties in the model parameterization of atmosphere-ocean interaction.
The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
/
v.5
no.3
/
pp.208-215
/
2000
The estimated total material transports through the Cheju Strait using all data which investigated in 1997 and 1999 are as follows; A large amount of suspended sediments and dissovted inorganic nutrients are carried tothe South Sea through the Cheju Strait by a persistent eastward flow (Cheju Current) from the Y311ow Sea andthe East China Sea. The annual material Oanspous by the Cheju Current are as follows; 22.9${\times}$10$^6$ ton yr$^{-1}$(SS), 0.52${\times}$10$^{10}$ mol yr$^{-1}$ (NH$_4\;^+$), 6.05${\times}$10$^{10}$ mol yr$^{-1}$ (NO$_3\;^-$), 0.36${\times}$10$^{10}$ mol yr$^{-1}$ (PO$_4\;^{3-}$), 10.27${\times}$10$^{10}$ mol yr$^{-1}$ (Si(OH)$_4$). The annual suspended sediment flux per water transport in the Cheju Strait (44.48${\times}$10$^6$ ton yr$^{-1}$ Sv$^{-1}$) is about 1.7 larger than that in the Korean Strait (26.08${\times}$10$^6$ ton yr$^{-1}$ Sv$^{-1}$). The annual nitrate flux per water transport (11.60${\times}$10$^{10}$ mol yr$^{-1}$ Sv$^{-1}$) is about 1.2 larger than that in the Korean Strait (9.72${\times}$10$^{10}$ mol yr$^{-1}$ Sv$^{-1}$) and 2/3 of that by Kuroshio in the East China Sea (18.55${\times}$10$^{10}$ ton yr$^{-1}$ Sv$^{-1}$). It suggests that chemical rich Cheju Current will play a significant role in the biogeochemical processes in the South Sea where the huge land-based waste are introduced.
Background: Despite recent advances in surgical technique and perioperative care of total anomalous pulmonary venous return (TAPVR), post-repair pulmonary vein stenosis (PVS) remains as a serious complication. We thought that the most important factors of TAPVR repair to prevent PVS were good exposure, proper alignment, and sufficient stoma size. We analyzed our experience retrospectively. Material and Method: Between Jan. 1995 and Feb. 2005, we studied 74 patients diagnosed with TAPVR suitable for biventricular repair. Supra-cardiac type (n=41, 55.4%) was the most common. Mean CPB time, ACC time, and TCA (40.5%, 30/74) time were $92.1{\pm}25.9\;min,\;39.1{\pm}10.6\;min$, and $30.2{\pm}10.7\;min$, respectively. Mean follow-up duration was $41.4{\pm}29.1$ months and follow-up was possible in all patients. Result: The median age and body weight at operation were 28.5 days ($0{\sim}478$ days) and 3.4 kg $(1.4{\sim}9\;kg)$. Early mortality was 4.1% (3/74). Causes of death were pulmonary hypertensive crisis, sepsis, and sudden death. There was PR-PVS in 2 patients (early: 1, late: 1). Both patients were cardiac type TAPVR drained to coronary sinus. Re-operations were done but only one patient survived. Cumulative survival rate in 5 year and percent freedom from PVS were $94.5{\pm}2.7%\;and\;97.2{\pm}2.0%$, respectively. Conclusion: There was no PVS in patients who underwent extra-cardiac anatomosis between LA and CPVC. Therefore it could be said that our principle might be effective in preventing PR-PVS in patients suitable two-ventricle.
Background: Postoperative atrial fibrillation (AF) is a common complication after coronary artery bypass graft (CABG) surgery. Although postoperative AF is regarded as benign, transient and self-limited, it has been associated with increased morbidity, thromboembolic events and an increased duration and cost of hospitalization. Material and Method: From January 1994 to December 2007, 190 patients that had isolated CABG surgery were divided into two groups. Group 1 (n=139) involved those who had postoperative atrial fibrillation, and group 2 (n=51) did not have any such events. We reviewed the medical records retrospectively including the incidence of postoperative AF, patient characteristics, surgery related factors and the outcome of the patients with postoperative AF. Result: The frequency of postoperative AF was 26.8%, the conversion rate to regular sinus rhythm before discharge was 82.4%; 82.4% of the AF developed within the first three postoperative days. Although the postoperative AF group was significantly older and had a prolonged postoperative Intensive care unit (ICU) stay, there was no difference in the aortic crossclamp time or duration of hospitalization. No spontaneous defibrillation at declamping, and longer duration of cardiopulmonary bypass were significantly related to the development of postoperative AF. However, postoperative treatment with a beta blocker was associated with a decreased incidence of postoperative AF. The multivariate analysis showed that age and ICU stay were significantly associated with the development of POAF. Spontaneous defibrillation and postoperative beta blocker treatment were significantly associated with a decreased frequency of POAF. Conclusion: AF after CABG surgery is a common complication associated with increased morbidity and a longer ICU stay. Therefore, various strategies aimed at reducing AF, and its complications, such as postoperative treatment with a beta blocker should be considered.
Korean Journal of Agricultural and Forest Meteorology
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v.7
no.1
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pp.57-65
/
2005
In a forest ecosystem, the major source of soil carbon input is from litterfall and its decomposition. To understand the effect of litterfall and litter decomposition on seasonal variation of soil respiration and litter decomposition rates were measured in temperate deciduous forest in Korea. Annual litterfall collected from litter trap (1m x 1m) were 147.5 ± 8.2g Cm/sup -2/ yr/sup -1/ in 2003. About 47% of litterfall were Quercus serrata leaf followed by Carpinus laxiflora leaf (27 %), Carpinus cordata leaf (7 %), and others, such as other leaf, bark, branch, and acorn, were 20%. The decomposition rate was the highest in C. cordata (33.03%, k = 0.46), followed by C. laxiflora (25.73%, k = 0.30), and Q. serrata (24.17%, k = 0.28). The continuous measurement of soil respiration from January 2004 to December 2004 was carried out using AOCC (Automatic Open-Closed multi-Chamber system). The annual soil respiration rate was 629.6g Cm/sup -2/ yr/sup -1/ and the litter decomposition was 30.0g Cm/sup -2/ yr/sup -1/. The portion of litter decomposition rate on soil respiration rate was about 5%. From January to February, when the soil respiration rate was the lowest, about 11 % of soil respiration (7.4 ± l.4g Cm/sup -2/ month/sup -1/) were effected by litter decomposition rate (0.8g Cm/sup -2/ month/sup -1/). The highest soil respiration rate (111.5 ± 16.2g Cm/sup -2/ month/sup -1/) and litter decomposition rate (11.4g Cm/sup -2/ month/sup -1/) were showed in July to August. According to the regression analysis between soil respiration rate and litter decomposition, the soil respiration rate were related to litter decomposition with the correlations (r = 0.63).
The Langmuir adsorption isotherms of the under-potentially deposited hydrogen (UPD H) and the over-potentially deposited hydrogen (OPD H) at the poly-Pt/0.5M $H_2SO_4$ and 0.5 M LiOH aqueous electrolyte interfaces have been studied using cyclic voltammetric and ac impedance techniques. The behavior of the phase shift $(0^{\circ}{\leq}{-\phi}{\leq}90^{\circ})$ for the optimum intermediate frequency corresponds well to that of the fractional surface coverage $(1{\geq}{\theta}{\geq}0)$ at the interfaces. The phase-shift method, i.e., the phase-shift profile $({-\phi}\;vs.\;E)$ for the optimum intermediate frequency, can be used as a new electrochemical method to determine the Langmuir adsorption isotherms $({\theta}\;vs.\;E)$ of the UPD H and the OPD H for the cathodic $H_2$ evolution reactions at the interfaces. At the poly-Pt/0.5M $H_2SO_4$ aqueous electrolyte interface, the equilibrium constant (K) and the standard free energy $({\Delta}G_{ads})$ of the OPD H are $2.1\times10^{-4}$ and 21.0kJ/mol, respectively. At the poly-Pt/0.5M LiOH aqueous electrolyte interface, K transits from 2.7(UPD H) to $6.2\times10^{-6}$ (OPD H) depending on the cathode potential (E) and vice versa. Similarly, ${\Delta}G_{ads}$ transits from -2.5kJ/mol (UPD H) to 29.7kJ/mol (OPD H) depending on I and vice versa. The transition of K and ${\Delta}G_{ads}$ is attributed to the two distinct adsorption sites of the UPD H and the OPD H on the poly-Pt surface. The UPD H and the OPD H on the poly-Pt surface are the independent processes depending on the H adsorption sites themselves rather than the sequential processes for the cathodic $H_2$ evolution reactions. The criterion of the UPD H and the OPD H is the H adsorption sites and processes rather than the $H_2$ evolution reactions and potentials. The poly-Pt wire electrode is more efficient and useful than the Pt(100) disc electrode for the cathodic $H_2$ evolution reactions in the aqueous electrolytes. The phase-shift method is well complementary to the thermodynamic method rather than conflicting.
This study was conducted to assess the morbidity and medical facilities utilization patterns of the residents in urban low income area. Study population included 2,002 family members of 468 households in the low income area (LA) of Nam-san 4 Dong, Jung Gu of Taegu city and 1,709 family members of 374 households in surrounding neighbourhood control area (CA). Well trained nursing school students interviewed mainly with housewives according to the pretested questionaire between July 1 and July 30, 1984. Age-sex distribution of the study population in LA was similar to that in CA. The average monthly income of a household in LA was 236,000 won and 356,000 won in CA. Educational level of the residents in LA was lower than that in CA; average years of school education of the 20 years old or above in LA was 6.9 years compared with 8.5 years in CA. The average family members per room in LA was 2.6 and 2.2 in CA, and proportion of Medicaid program beneficiary was 29.4% in LA and 1.9% in CA. Prevalence rate of illness during 15-day period was 131 per 1,000 population in LA and 71 in CA(p<0.01) and that of the chronic illness for 1 year was 134 per 1,000 population in LA and 89 in CA(p<0.01). The most common illness experienced during 15 days was respiratory disease(24.0% in LA ana 29.8% in CA) and followed by gastro-intestinal disorders(21.0% in LA, 20.6% in CA). Injury or poisoning was 10.3% in LA and 3.3% in CA. Castro-intestinal disorder was the most common chronic illness in both LA (22.7%) and CA (21.7%), and followed by musculoskeletal disease in LA and neuralgia in CA. Mean activity restricted days among the persons with illness during 15-day period was 4.0 days in LA and 2.2 days in CA. Among persons with illness during 15 days, 17.9% in LA and 11.6% in CA did not seek any medical treatment and the most frequently utilized medical facility was pharmacy in LA (35.5%) and local clinic or hospital OPD in CA (42.1%). Among persons with chronic illness, 15.2% in LA and 9.2% in CA did not seek for medical treatment, and residents in LA as well as residents in CA utilized local clinic or hospital OPD more frequently than pharmacy or drugstores, especially those who have medical insurance. The most common reason for not treating illness experienced during 15-day period and chronic illness was economical constraint in both LA and CA. The higher prevalence rate of illness during 15-day period and chronic illness in LA than that in CA seems to be highly correlated with their lower economic status and educational level and crowded living condition. The utilization pattern of medical facilities was associated with the medical security status. A program to improve the economic status and living condition should be integrated with the health program to promote the health of the population in low income area.
This study attempts to develop a theory on the evolving process of wealthy major donors' sharing lives in Korea through a grounded theory approach. To conduct this study, the researchers have in-depth interviews with 11 exemplary wealthy major donors who have more than one million US dollars in his or her own asset and donate more than ten thousand US dollars annually. In data analysis, this study identifies 161 concepts on the evolving process of wealthy major donors' sharing lives; and the concepts are categorized with 33 sub-categories and 14 categories. In the paradigm model on the evolving process of wealthy major donors' sharing lives, it is identified that the central phenomenon, 'practicing sharing lives as noblesse oblige', is related with the causal conditions such as 'learning through memories and observation', 'realizing my duties', and 'emphasizing'; and the central phenomenon is related with the contingent conditions such as 'being sensitive to external evaluation', 'having limited information on giving', 'distrusting donation related environments'. The action/interactional sequences such as 'utilizing relationships' and 'strengthening active participation' are accomplished by moderating conditions such as 'having internal and external supports' and 'guiding by firm conviction'. It reveals that as a result, wealthy major donors enjoy the feeling of becoming a ideal and true wealthy person, establish sharing lives as firm and major parts of overall lives, and experience strong desires for better future and society. In this study, 'generous sharing that shares personal heritages and social benefits' is analyzed as a core category; it shows that sharing of wealthy major donors is related to the characteristics of generosity practice based on moral self-benefiting rather than complete altruistic characteristics or self-sacrificial characteristics. The process analysis reveals that it has the following stages: first, initial giving by exposure to causes or requests; second, routine practice of giving; third, evolution of practice of giving with gradual expansion in quantities and qualities; and fourth, living with giving. In the process, the following four types are identified: devoted wealthy donors for sharing, wealthy donors practicing sharing in daily life, wealthy donors practicing sharing with learning on external stimulus, and wealthy donors practicing sharing on empathy. Finally, this study discusses both meanings of identifying and developing a theory on the evolving process of wealthy major donors' sharing lives and implications of the research results in cultivating and developing potential wealthy major donors in Korea.
In this study we have attempted to evaluate the technical feasibility of "BB-HY", which is depleted gas reservoir as a gas storage field, using the commercial compositional simulator "ECLIPSE 300". The "BB-HY" reservoir has an initial gas in place of 143 BCF which is relatively small, and its porosity and permeability are 19.5% and 50 md, respectively. For "BB-HY" gas reservoir, we have performed a feasibility analysis by investigating the cushion gas (or working gas), converting time to gas storage field, operation cycle, number of wells and the possible application of horizontal borehole as well. From the simulation results, it was found that the amount of cushion gas in "BB-HY" reservoir is required at least 50% of IGIP in order to operate stably as gas storage field. When one produces gas for longer time and hence the remaining gas in reservoir is less than optimal cushion gas, no technical problem was occurred as long as additional cushion gas is injected up to the optimal cushion gas. In the case of changing the operation cycle into producing gas for three months during winter season from producing five months, the result shows that either the cushion gas should be greater than 60% or the more number of wells should be drilled. Meanwhile, from the results of sensitivity analysis for the number of wells, in cases of operating six or eight vertical wells, the stable reproduction of the injected gas can not be possible in "BB-HY" gas reservoir since the remaining gas in reservoir is increased. Therefore, in "BB-HY" reservoir, at least ten vertical wells should be drilled for the stable operation of gas. This time, when three horizontal wells are additionally drilled including the existing two vertical wells, it was found that the operation of injection and reproduction of gas is relatively stable in "BB-HY" gas reservoir.
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