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CLINICAL STUDY OF THE ABUSE IN PSYCHIATRICALLY HOSPITALIZED CHILDREN AND ADOLESCENTS (소아청소년 정신과병동 입원아동의 학대에 대한 임상 연구)

  • Lee, Soo-Kyung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.145-157
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    • 1999
  • This study was performed by the children and adolescents who were abused or neglected physically, emotionally that were selected in child & adolescents psychiatric ward. We investigated the number of these case in admitted children & adolescents, and also observed characteristics of symptoms, developmental history, characteristics of abuse style, characteristics of abusers, family dynamics and psychopathology. We hypothesized that all kinds of abuse will influnced to emotional, behavioral problems, developmental courses on victims, interactive effects on family dynamics and psychopathology. That subjects were 22 persons of victims who be determined by clinical observation and clinical note. The results of the study were as follows:1) Demographic characteristics of victims:ratio of sex was 1:6.3(male:female), mean age was $11.1{\pm}2.5$. According to birth order, lst was 12(54.5%), 2nd was 5(23%), 3rd was 2(9%) and only child was 3(13.5%). 2) Characteristics of family:According to socioeconomic status, middle to high class was 3(13.5%), middle one was 9(41.% ), middle to low one was 9(41%), low one was 1(0.5%). according to number of family, under the 3 person was 3(13.5%), 4-5 was 17(77.5%), 6-7 was 2(9%). according to marital status of parents, divorce or seperation were 5(23%), remarriage 2(9%), severe marital discord was 19(86.5%). In father, antisocial behavior was 7(32%), alcohol dependence was 10(45.5%). In mother, alcohol abuse was 5(23%), depression was 17(77.3%), history of psychiatric management was 6(27%). 3) Characteristics of abuse:Physical abuse was 18(81.8%), physical and emotional abuse and neglect were 4(18.2%). according to onset of abuse, before 3 years was 15(54.5%), 3-6 years was 5(27.5%), schooler was 1(15%). Only father offender was 2(19%), only mother offender was 8(35.4%), both offender was 8(35.4%), accompaning with spouse abuse was 7(27%), and accompaning with other sibling abuse was 4(18.2%). 4) General characteristics and developmental history of victims:Unwanted baby was 12(54.5%), developmental delay before abuse was9(41%), comorbid developmental disorder was 15(68%). there were 6(27.5%) who didn‘t show definite sign of developmental delay before abuse. 5) Main diagnosis and comorbid diagnosis:According to main diagnosis, conduct disorder 6(27.3%), borderline child 5(23%), depression4(18%), attention deficit hyperactivity disorder(ADHD) 4(18%), pervasive developmental disorder not otherwise specified 2(9%), selective mutism 1(5%). According to comorbid diagnosis, ADHD, borderline intelligence, mental retardation, learning disorder, developmental language disorder, oppositional defiant disorder, chronic tic disorder, functional enuresis and encoporesis, anxiety disorder, dissociative disorder, personality disorder due to medical condition. 5) Course of treatment:A mean duration of admission was $2.4{\pm}1.5$ months. 11(15%) showed improvement of symtoms, however 11(50%) was not changed of symtoms.

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Korean Local Maize Lines for New Germplasm (새로운 육종자원확보(育種資源確保)를 위(爲)한 재래종(在來種) 옥수수의 연구(硏究))

  • Choe, Bong Ho;Lee, In Sup;Park, Jong Seong;Kim, Yong Rae
    • Korean Journal of Agricultural Science
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    • v.7 no.1
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    • pp.12-26
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    • 1980
  • A new, improved maize varieties are greatly needed to meet the national demand for the maize, and a new germplasm should be investigated to supply necessary breeding materials for the required maize breeding. The Korean local maize lines, which has never been wholly studied for the purpose of breeding should be enough to supply such breeding materials at least in Korea. The objectives of this study were to maintain useful Korean local lines, to investigate good plant characters and to analyze the Korean local maize lines in the respect of genetic make-up. A total of 820 lines and 200 lines were used for the present study. Lines to maintain were planted at experimental farm of the Crop Experiment Station, Office of Rural Development, Suwon and the lines to study genetic make-up were planted in Dae-jon. The summarized results are as follows : 1. A total of 1200 lines from 820 collections were sibbed for future use. 2. Two hundred collection were sibbed, selfed and testcrossed for genetic study in 1980. 3. Ten lines were surely confirmed as resistant lines to virus disease epidemic in most introduced maize varieties. 4. A dozen Lines were having three to four ears per plant. 5. Five lines were showing three to four tillers per plant. 6. One of the most significant and important finding through the study was to obtain the lines with three to four tillers bearing all together eight to nine ears. The lines of multi-ears and multi-tillers must have great breeding potential for the future use. 7. A great variation was observed in the tasselling days, 100 kernel weight and protein content. 8. From the genetic study of local maize lines for plant height and 100 kernel weight, the following findings were obtained. a. On the average six percent of inbreeding depression expressed in percent decrease over sibbed counterpart were found for the plant height. b. Fourty percent of heterosis expressed in percent increase over sibbed counterpart were observed in the plant height. c. The homogeneity or degree of homozygosity calculated from heterosis minus inbreeding depression was on the average 34 percent for plant height. d. The average inbreeding depression expressed in percent decrease over sibbed counterpart was 15 percent for 100 kernel weight. e. The average heterosis expressed in percent increase over sibbed counterpart was 43 percent for 100 kernel weight. f. The degree of homozygosity calculated from the heterosis minus inbreeding depression was 28 percent for 100 kernel weight.

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The Characteristics of Rural Population, Korea, 1960~1995: Population Composition and Internal Migration (농촌인구의 특성과 그 변화, 1960~1995: 인구구성 및 인구이동)

  • 김태헌
    • Korea journal of population studies
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    • v.19 no.2
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    • pp.77-105
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    • 1996
  • The rural problems which we are facing start from the extremely small sized population and the skewed population structure by age and sex. Thus we analyzed the change of the rural population. And we analyzed the recent return migration to the rural areas by comparing the recent in-migrants with out-migrants to rural areas. And by analyzing the rural village survey data which was to show the current characteristics of rural population, we found out the effects of the in-migrants to the rural areas and predicted the futures of rural villages by characteristics. The changes of rural population composition by age was very clear. As the out-migrants towards cities carried on, the population composition of young children aged 0~4 years was low and the aged became thick. The proportion of the population aged 0~4 years was 45.1% of the total population in 1970 and dropped down to 20.4% in 1995, which is predicted to become under 20% from now on. In the same period(1970~1995), the population aged 65 years and over rose from 4.2% to 11.9%. In 1960, before industrialization, the proportion of the population aged 0~4 years in rural areas was higher than that of cities. As the rural young population continuously moves to cities it became lower than that in urban areas from 1975 and the gap grew till 1990. But the proportion of rural population aged 0~4 years in 1995 became 6.2% and the gap reduced. We can say this is the change of the characteristics of in-migrants and out-migrants in the rural areas. Also considering the composition of the population by age group moving from urban to rural area in the late 1980s, 51.8% of the total migrants concentrates upon age group of 20~34 years and these people's educational level was higher than that of out-migrants to urban areas. This fact predicted the changes of the rural population, and the results will turn out as a change in the rural society. However, after comparing the population structure between the pure rural village of Boeun-gun and suburban village of Paju-gun which was agriculture centered village but recently changed rapidly, the recent change of the rural population structure which the in-migrants to rural areas becomes younger is just a phenomenon in the suburban rural areas, not the change of the total rural areas in general. From the characteristics of the population structure of rural village from the field survey on these villages, we can see that in the pure rural villages without any effects from cities the regidents are highly aged, while industrialization and urbanization are making a progress in suburban villages. Therefore, the recent partial change of the rural population structure and the change of characteristics of the in-migrants toward rural areas is effecting and being effected by the population change of areas like suburban rural villages. Although there are return migrants to rural areas to change their jobs into agriculture, this is too minor to appear as a statistic effect.

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A Methodology to Develop a Curriculum based on National Competency Standards - Focused on Methodology for Gap Analysis - (국가직무능력표준(NCS)에 근거한 조경분야 교육과정 개발 방법론 - 갭분석을 중심으로 -)

  • Byeon, Jae-Sang;Ahn, Seong-Ro;Shin, Sang-Hyun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.1
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    • pp.40-53
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    • 2015
  • To train the manpower to meet the requirements of the industrial field, the introduction of the National Qualification Frameworks(hereinafter referred to as NQF) was determined in 2001 by National Competency Standards(hereinafter referred to as NCS) centrally of the Office for Government Policy Coordination. Also, for landscape architecture in the construction field, the "NCS -Landscape Architecture" pilot was developed in 2008 to be test operated for 3 years starting in 2009. Especially, as the 'realization of a competence-based society, not by educational background' was adopted as one of the major government projects in the Park Geun-Hye government(inaugurated in 2013) the NCS system was constructed on a nationwide scale as a detailed method for practicing this. However, in the case of the NCS developed by the nation, the ideal job performing abilities are specified, therefore there are weaknesses of not being able to reflect the actual operational problem differences in the student level between universities, problems of securing equipment and professors, and problems in the number of current curricula. For soft landing to practical curriculum, the process of clearly analyzing the gap between the current curriculum and the NCS must be preceded. Gap analysis is the initial stage methodology to reorganize the existing curriculum into NCS based curriculum, and based on the ability unit elements and performance standards for each NCS ability unit, the discrepancy between the existing curriculum within the department or the level of coincidence used a Likert scale of 1 to 5 to fill in and analyze. Thus, the universities wishing to operate NCS in the future measuring the level of coincidence and the gap between the current university curriculum and NCS can secure the basic tool to verify the applicability of NCS and the effectiveness of further development and operation. The advantages of reorganizing the curriculum through gap analysis are, first, that the government financial support project can be connected to provide quantitative index of the NCS adoption rate for each qualitative department, and, second, an objective standard is provided on the insufficiency or sufficiency when reorganizing to NCS based curriculum. In other words, when introducing in the subdivisions of the relevant NCS, the insufficient ability units and the ability unit elements can be extracted, and the supplementary matters for each ability unit element per existing subject can be extracted at the same time. There is an advantage providing directions for detailed class program and basic subject opening. The Ministry of Education and the Ministry of Employment and Labor must gather people from the industry to actively develop and supply the NCS standard a practical level to systematically reflect the requirements of the industrial field the educational training and qualification, and the universities wishing to apply NCS must reorganize the curriculum connecting work and qualification based on NCS. To enable this, the universities must consider the relevant industrial prospect and the relation between the faculty resources within the university and the local industry to clearly select the NCS subdivision to be applied. Afterwards, gap analysis must be used for the NCS based curriculum reorganization to establish the direction of the reorganization more objectively and rationally in order to participate in the process evaluation type qualification system efficiently.

Studies on the Biochemical Features of Soybean Seeds for Higher Protein Variety -With Emphasis on Accumulation during Maturation and Electrophoretic Patterns of Proteins- (고단백 대두 품종 육성을 위한 종실의 생화학적 특성에 관한 연구 -단백질의 축적과 전기영동 유형을 중심으로)

  • Jong-Suk Lee
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.22 no.1
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    • pp.135-166
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    • 1977
  • Some biochemical features of varietal variation in seed protein and their implications for soybean breeding for high protein were pursued employing 86 soybean varieties of Korea, Japan, and the U.S.A. origins. Also, studied comparatively was the temporal pattern of protein components accumulation during seed development characteristic to the high protein variety. Seed protein content of the 86 soybean varieties varied 34.4 to 50.6%. Non-existence of variety having high content of both protein and oil, or high protein content with average oil content as well as high negative correlation between the content of protein and oil (r=-0.73$^{**}$) indicate strongly a great difficulty to breed high protein variety while conserving oil content. The total content of essential amino acids varied 32.82 to 36.63% and the total content of sulfur-containing amino acids varied 2.09 to 2.73% as tested for 12 varieties differing protein content from 40.0 to 50.6%. The content of methionine was positively correlated with the content of glutamic acid, which was the major amino acid (18.5%) in seed protein of soybean. In particular, the varieties Bongeui and Saikai #20 had high protein content as well as high content of sulfur-containing amino acids. The content of lysine was negatively correlated with that of isoleucine, but positively correlated with protein content. The content of alanine, valine or leucine was correlated positively with oil content. The seed protein of soybean was built with 12 to 16 components depending on variety as revealed on disc acrylamide gel electrophoresis. The 86 varieties were classified into 11 groups of characteristic electrophoretic pattern. The protein component of Rm=0.14(b) showed the greatest varietal variation among the components in their relative contents, and negative correlation with the content of the other components, while the protein component of Rm=0.06(a) had a significant, positive correlation with protein content. There was sequential phases of rapid decrease, slow increase and stay in the protein content during seed development. Shorter period and lower rate of decrease followed by longer period and higher rate of increase in protein content during seed development was of characteristic to high protein variety together with earlier and continuous development at higher rate of the protein component a. Considering the extremely low methionine content of the protein component a, breeding for high protein content may result in lower quality of soybean protein.n.

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A Hybrid SVM Classifier for Imbalanced Data Sets (불균형 데이터 집합의 분류를 위한 하이브리드 SVM 모델)

  • Lee, Jae Sik;Kwon, Jong Gu
    • Journal of Intelligence and Information Systems
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    • v.19 no.2
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    • pp.125-140
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    • 2013
  • We call a data set in which the number of records belonging to a certain class far outnumbers the number of records belonging to the other class, 'imbalanced data set'. Most of the classification techniques perform poorly on imbalanced data sets. When we evaluate the performance of a certain classification technique, we need to measure not only 'accuracy' but also 'sensitivity' and 'specificity'. In a customer churn prediction problem, 'retention' records account for the majority class, and 'churn' records account for the minority class. Sensitivity measures the proportion of actual retentions which are correctly identified as such. Specificity measures the proportion of churns which are correctly identified as such. The poor performance of the classification techniques on imbalanced data sets is due to the low value of specificity. Many previous researches on imbalanced data sets employed 'oversampling' technique where members of the minority class are sampled more than those of the majority class in order to make a relatively balanced data set. When a classification model is constructed using this oversampled balanced data set, specificity can be improved but sensitivity will be decreased. In this research, we developed a hybrid model of support vector machine (SVM), artificial neural network (ANN) and decision tree, that improves specificity while maintaining sensitivity. We named this hybrid model 'hybrid SVM model.' The process of construction and prediction of our hybrid SVM model is as follows. By oversampling from the original imbalanced data set, a balanced data set is prepared. SVM_I model and ANN_I model are constructed using the imbalanced data set, and SVM_B model is constructed using the balanced data set. SVM_I model is superior in sensitivity and SVM_B model is superior in specificity. For a record on which both SVM_I model and SVM_B model make the same prediction, that prediction becomes the final solution. If they make different prediction, the final solution is determined by the discrimination rules obtained by ANN and decision tree. For a record on which SVM_I model and SVM_B model make different predictions, a decision tree model is constructed using ANN_I output value as input and actual retention or churn as target. We obtained the following two discrimination rules: 'IF ANN_I output value <0.285, THEN Final Solution = Retention' and 'IF ANN_I output value ${\geq}0.285$, THEN Final Solution = Churn.' The threshold 0.285 is the value optimized for the data used in this research. The result we present in this research is the structure or framework of our hybrid SVM model, not a specific threshold value such as 0.285. Therefore, the threshold value in the above discrimination rules can be changed to any value depending on the data. In order to evaluate the performance of our hybrid SVM model, we used the 'churn data set' in UCI Machine Learning Repository, that consists of 85% retention customers and 15% churn customers. Accuracy of the hybrid SVM model is 91.08% that is better than that of SVM_I model or SVM_B model. The points worth noticing here are its sensitivity, 95.02%, and specificity, 69.24%. The sensitivity of SVM_I model is 94.65%, and the specificity of SVM_B model is 67.00%. Therefore the hybrid SVM model developed in this research improves the specificity of SVM_B model while maintaining the sensitivity of SVM_I model.

Development of Intelligent Job Classification System based on Job Posting on Job Sites (구인구직사이트의 구인정보 기반 지능형 직무분류체계의 구축)

  • Lee, Jung Seung
    • Journal of Intelligence and Information Systems
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    • v.25 no.4
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    • pp.123-139
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    • 2019
  • The job classification system of major job sites differs from site to site and is different from the job classification system of the 'SQF(Sectoral Qualifications Framework)' proposed by the SW field. Therefore, a new job classification system is needed for SW companies, SW job seekers, and job sites to understand. The purpose of this study is to establish a standard job classification system that reflects market demand by analyzing SQF based on job offer information of major job sites and the NCS(National Competency Standards). For this purpose, the association analysis between occupations of major job sites is conducted and the association rule between SQF and occupation is conducted to derive the association rule between occupations. Using this association rule, we proposed an intelligent job classification system based on data mapping the job classification system of major job sites and SQF and job classification system. First, major job sites are selected to obtain information on the job classification system of the SW market. Then We identify ways to collect job information from each site and collect data through open API. Focusing on the relationship between the data, filtering only the job information posted on each job site at the same time, other job information is deleted. Next, we will map the job classification system between job sites using the association rules derived from the association analysis. We will complete the mapping between these market segments, discuss with the experts, further map the SQF, and finally propose a new job classification system. As a result, more than 30,000 job listings were collected in XML format using open API in 'WORKNET,' 'JOBKOREA,' and 'saramin', which are the main job sites in Korea. After filtering out about 900 job postings simultaneously posted on multiple job sites, 800 association rules were derived by applying the Apriori algorithm, which is a frequent pattern mining. Based on 800 related rules, the job classification system of WORKNET, JOBKOREA, and saramin and the SQF job classification system were mapped and classified into 1st and 4th stages. In the new job taxonomy, the first primary class, IT consulting, computer system, network, and security related job system, consisted of three secondary classifications, five tertiary classifications, and five fourth classifications. The second primary classification, the database and the job system related to system operation, consisted of three secondary classifications, three tertiary classifications, and four fourth classifications. The third primary category, Web Planning, Web Programming, Web Design, and Game, was composed of four secondary classifications, nine tertiary classifications, and two fourth classifications. The last primary classification, job systems related to ICT management, computer and communication engineering technology, consisted of three secondary classifications and six tertiary classifications. In particular, the new job classification system has a relatively flexible stage of classification, unlike other existing classification systems. WORKNET divides jobs into third categories, JOBKOREA divides jobs into second categories, and the subdivided jobs into keywords. saramin divided the job into the second classification, and the subdivided the job into keyword form. The newly proposed standard job classification system accepts some keyword-based jobs, and treats some product names as jobs. In the classification system, not only are jobs suspended in the second classification, but there are also jobs that are subdivided into the fourth classification. This reflected the idea that not all jobs could be broken down into the same steps. We also proposed a combination of rules and experts' opinions from market data collected and conducted associative analysis. Therefore, the newly proposed job classification system can be regarded as a data-based intelligent job classification system that reflects the market demand, unlike the existing job classification system. This study is meaningful in that it suggests a new job classification system that reflects market demand by attempting mapping between occupations based on data through the association analysis between occupations rather than intuition of some experts. However, this study has a limitation in that it cannot fully reflect the market demand that changes over time because the data collection point is temporary. As market demands change over time, including seasonal factors and major corporate public recruitment timings, continuous data monitoring and repeated experiments are needed to achieve more accurate matching. The results of this study can be used to suggest the direction of improvement of SQF in the SW industry in the future, and it is expected to be transferred to other industries with the experience of success in the SW industry.

Spatial Composition and Landscape Characteristics of Shimwon-Pavilion Garden in Chilgok - Focusing on 'Shimwon-pavilion Poem of 25 Sceneries' and 「Shimwon-pavilion Soosukgi(心遠亭水石記)」 - (칠곡 심원정원림의 공간구성과 경관특성 - '심원정 25영(心遠亭 二十五詠)'과 「심원정수석기(心遠亭水石記)」를 중심으로 -)

  • Kim, Hwa-Ok;Park, Yool-Jin;Rho, Jae-Hyun;Shin, Sang-Seop;Cho, Ho-Hyeon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.2
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    • pp.27-34
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    • 2016
  • The results of investigation on the spatial composition and landscape characteristics of Shimwon-pavilion garden built and enjoyed by Jo Byeong-sun in 1937 during the period of Japanese colonialism based on 'Shimwon-pavilion Soosukgii(水石記)' and 'Shimwon-pavilion Poem of 25 Sceneries(二十五詠)' contained in 'Anthology of Giheon(寄軒)' are as follows. 1. Shimwon-pavilion garden is assumed as Byeol-Seo garden based on the planning background and contents of Gimun and the observations on spot. By its location, it is classified as 'Planted forest' with a pine forest in the north and 'Byeol-Seo of mooring type' with Guyacheon flowing in the garden. It is about 400m away from the main house in the straight-line distance. 2. The meaning and attributes of reclusiveness are well represented in the 'screening structures' all around Shimwon-pavilion garden with Hakrimsan, a Gasan(假山) in the north, vines on Chwibyeong(翠屛) in the east and west, Eunbyeong(隱屛) of stone walls along with Guyacheon in the south, which shows the spirit of Giheon who adored the Taoistic life. 3. Shimwon-pavilion garden, located in the Songrimsa, a temple of thousand years, is a place of consilience where Buddhism was accepted, Taoistic life was pursued with Tao Yuan-ming's philosophy regarding rural areas and romantic sensibilities of Li Po, called poem master(詩仙), the confucian values of Zhu Xi were realized. Giheon intended to build and enjoy this place as a microcosm and shelther where he unfolded his own view of learning and cultivated his mind. 4. 25 sceneries on Shimwon-pavilion consist of 5 sceneries in the space of pavilion(architecture) and 20 sceneries in the outer garden. First, 5 sceneries consist of ancillary rooms for various uses, including Jeongunru, Amsushil, Wiryujae, Iyeoldang, and Jeong-Gak Shimwon-pavilion embracing them, which shows that Shimwon-pavilion is a place to foster younger students. And 20 scenary is divided into 9 sceneries on the natural spaces and 11 artificially created facilities. 9 sceneries are engraved on the rocks as described in 'Seokgyeonggi'. 5. 4 sceneries of the indoor scenery lexemes(亭閣 心遠亭 怡悅堂 停雲樓 闇修室) were intended to be recognized by the framed pictures, 5 places among the scenery lexemes in garden(龜巖 醒石 隱屛 兩忘臺 東槃) by letters carved on the rocks, and 8 places(君子沼 杞泉 天光雲影橋 芳園 槐岡 柳堤 石扉 東翠屛) by sign stones, but signs of 8 sceneries are not currently identified because they have been be swept away and demolished. 6. A variety of plant landscapes with various meanings and water landscape with various types are contained in 25 sceneries - Sophora symbolizing a tree for scholar in Gehgang(槐岡), Willow symbolizing Tao Yuanming and continued vitality in Yooje(柳堤), Boxthorn symbolizing family togetherness in spring(杞泉), vines and herbal plants and waterfalls(隱瀑), shallow pond(君子沼), pond(湯池), water hole(杞泉), water flowing in the middle of rock(盤陀石), water flowing between the rocks(水口巖). 7. While Shimwon-pavilion garden is a garden near the water, the active involvements with 11 sceneries directly built is distinguished. The other pavilion gardens are faithful in engraving the names by setting the scenery lexemes of the nature-oriented Gyeong(景) and Gok(曲) near and far, but Shimwon-pavilion garden is a garden for active learning(修景) with the spaces built to match with the beautiful nature and to show the depths of space off.

Changes in Immunogenicity of Preserved Aortic Allograft (보존된 동종동맥편 조직의 면역성 변화에 관한 연구)

  • 전예지;박영훈;강영선;최희숙;임창영
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1173-1181
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    • 1996
  • The causes of degenerative changes in allograft cardiac valves are not well known to this day. Today's preserved allografts possess highly viable endothelial cells and degeneration of allografts can be facilitated by immune reaction which may be mediated by these viable cells. To test the antigenicity of endothelial cells, pieces from aortic wall were obtained from fresh and cryo-preserved rat allograft. Timings of sampling were prior to sterilization, after sterilization, after 1, 2, 7, 14 days of fresh preservation and cryopreservation. Endothelial cells were tested by immunohistochemical methods using monoclonal antibodies to MHC class I(MRC OX-18), class II(MRC OX-6) and ICAM-1 antigens. After transplantation of each group of aortic allograft at the subcutaneous layers of rats, population of CD4$^{+}$ T cell and CD8$^{+}$ T cell were analyzed with monoclonal antibodies after 1, 2, 3, 4, 6 and 8 weeks. MHC class I expression was 23.95% before preservation and increased to 35.53~48.08% after preservation(p=0.0183). MHC Class II expression was 9.72% before preservation and 10.13~13.39% after preservation(P=0.1599). ICAM-1 expression was 15.02% before preservation and increased to 19.85~35.33% after preservation(P=0.001). The proportion of CD4$^{+}$ T-cell was 42.13% before transplantation. And this was 49.23~36.8% after transplantation in No treat group (p=0.955), decreased to 29.56~32.80% in other group(p=0.0001~0.008). In all the groups, the proportion of CD8$^{+}$ T-cell increased from 25.57% before transplantation to 42.32~58.92% after transplantation(p=0.000l~0.0002). The CD4$^{+}$/CD8$^{+}$ ratio decreased from 1.22~2.28 at first week to 0.47~0.95 at eighth week(p=0.0001). The results revealed that the expression of MHC class I and ICAM-1 in aortic allograft endothelium were increased but that of MHC class II were not changed, despite the different method of preservation. During 8 weeks after transplantation of aortic allograft, the subpopulations of CD4$^{+}$ T cell were not changed or only slightly decreased but those of CD8$^{+}$ T cell were progressively increased.ely increased.

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Risk Factor Analysis for Operative Death and Brain Injury after Surgery of Stanford Type A Aortic Dissection (스탠포드 A형 대동맥 박리증 수술 후 수술 사망과 뇌손상의 위험인자 분석)

  • Kim Jae-Hyun;Oh Sam-Sae;Lee Chang-Ha;Baek Man-Jong;Hwang Seong-Wook;Lee Cheul;Lim Hong-Gook;Na Chan-Young
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.289-297
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    • 2006
  • Background: Surgery for Stanford type A aortic dissection shows a high operative mortality rate and frequent postoperative brain injury. This study was designed to find out the risk factors leading to operative mortality and brain injury after surgical repair in patients with type A aortic dissection. Material and Method: One hundred and eleven patients with type A aortic dissection who underwent surgical repair between February, 1995 and January 2005 were reviewed retrospectively. There were 99 acute dissections and 12 chronic dissections. Univariate and multivariate analysis were performed to identify risk factors of operative mortality and brain injury. Resuit: Hospital mortality occurred in 6 patients (5.4%). Permanent neurologic deficit occurred in 8 patients (7.2%) and transient neurologic deficit in 4 (3.6%). Overall 1, 5, 7 year survival rate was 94.4, 86.3, and 81.5%, respectively. Univariate analysis revealed 4 risk factors to be statistically significant as predictors of mortality: previous chronic type III dissection, emergency operation, intimal tear in aortic arch, and deep hypothemic circulatory arrest (DHCA) for more than 45 minutes. Multivariate analysis revealed previous chronic type III aortic dissection (odds ratio (OR) 52.2), and DHCA for more than 45 minutes (OR 12.0) as risk factors of operative mortality. Pathological obesity (OR 12.9) and total arch replacement (OR 8.5) were statistically significant risk factors of brain injury in multivariate analysis. Conclusion: The result of surgical repair for Stanford type A aortic dissection was good when we took into account the mortality rate, the incidence of neurologic injury, and the long-term survival rate. Surgery of type A aortic dissection in patients with a history of chronic type III dissection may increase the risk of operative mortality. Special care should be taken and efforts to reduce the hypothermic circulatory arrest time should alway: be kept in mind. Surgeons who are planning to operate on patients with pathological obesity, or total arch replacement should be seriously consider for there is a higher risk of brain injury.