Background: Follow-up studies have shown that although outcomes have improved substantially over time, results of the Fontan operation and its modifications remain suboptimal. In this study, we reviewed our experience with the extracardiac conduit Fontan operation, with a focus early and midterm change of internal diameter of PTFE conduit. Material and Method: Between April 1997 and July 2000 were reviewed. Twelve patients (M:6, F:6, mean age 42.04 $\pm$ 12.43months, mean body weight 13.80$\pm$ 1.94kg) underwent extracardiac conduit Fontan operation with expanded PTFE graft. Mean cardiopulmonary bypass time was 109.7$\pm$26.99minute and mean operation time was 455$\pm$89.51minute. Intraoperative fenestration was performed in 10 patients. The aortic cross clamping was not performed in all patients. Result: There was no early deaths and no postoperative dysrhythmia. Postoperative protein losing enteropathy and prolonged pleural effusion occurred in 1(8.3%) and 4 patients(33.3%). Conduit patency was evaluated by magnetic resonance imaging studies. A 9.84$\pm$3.84% mean reduction in conduit internal diameter and there was no statistical correlation between the change of internal diameter of conduit and the postoperative duration after partial correlation analysis(r=0.019, p=0.955). Conclusion: These results demonstrate that the extracardiac conduit Fontan operation provies good early and midterm results and may reduce the prevalence of late arrhythmia. And there is no correlation between the change of internal diameter of conduit and the postoperative duration after extracardiac conduit Fontan operation with the expanded PTFE graft conduit.
It is known that the normal His-Purkinje system provides for nearly synchronous activation of right (RV) and left (LV) ventricles. When His-Purkinje conduction is abnormal, the resulting sequence of ventricular contraction must be correspondingly abnormal. These abnormal mechanical consequences were difficult to demonstrate because of the complexity and the rapidity of it's events. To determine the relationship of the phase changes and the abnormalities of ventricular conduction, we performed phase image analysis of $^{99m}Tc$-RBC gated blood pool scintigrams in patients with intraventricular conduction disturbances (24 complete left bundle branch block (C-LBBB), 15 complete right bundle branch block (C-RBBB), 13 Wolff-Parkinson-White syndrome (WPW), 10 controls). The results were as follows; 1) The ejection fraction (EF), peak ejection rate (PER), and peak filling rate (PFR) of LV in gated blood pool scintigraphy (GBPS) were significantly lower in patients with C-LBBB than in controls ($44.4{\pm}13.9%$ vs $69.9{\pm}4.2%,\;2.48{\pm}0.98$ vs $3.51{\pm}0.62,\;1.76{\pm}0.71$ vs $3.38{\pm}0.92$, respectively, p<0.05). 2) In the phase angle analysis of LV, Standard deviation (SD), width of half maximum of phase angle (FWHM), and range of phase angle were significantly increased in patients with C-LBBB than in controls ($20.6{\pm}18.1$ vs $8.6{\pm}1.8,\;22.5{\pm}9.2$ vs $16.0{\pm}3.9,\;95.7{\pm}31.7$ vs $51.3{\pm}5.4$, respectively, p<0.05). 3) There was no significant difference in EF, PER, PFR between patients with the Wolff-parkinson-White syndrome and controls. 4) Standard deviation and range of phase angle were significantly higher in patients with WPW syndrome than in controls ($10.6{\pm}2.6$ vs $8.6{\pm}1.8$, p<0.05, $69.8{\pm}11.7$ vs $51.3{\pm}5.4$, p<0.001, respectively), however, there was no difference between the two groups in full width of half maximum. 5) Phase image analysis revealed relatively uniform phase across the both ventricles in patients with normal conduction, but markedly delayed phase in the left ventricle of patients with LBBB. 6) In 13 cases of WPW syndrome, the site of preexcitation could be localized in 10 cases (77%) by phase image analysis. Therefore, it can be concluded that phase image analysis can provide an accurate noninvasive method to detect the mechanical consequences of a wide variety of abnormal electrical activation in ventricles.
BACKGROUND : Dyspnea is common among patients with cardiopulmonary disease, and "daily disability" is defined as a functional impairment resulting from exercise intolerance. The maximal oxygen uptake(VO2max) during exhausting work is not only the best single physical indicator of the capacity of a man for sustaining hard muscular work, but also the most objective method by which one can determine the physical fitness of an individual as reflected by his cardiovascular system. However, the expense, time and personnel requirements make this procedure prohibitive for testing large group. The walking test is well-known type of exercise and it cost nothing to perform and have good reproducibility. Thus we performed the walking test and investigated correlations with spirometry, ABG and exercise test. METHOD: We observed the walking test and exercise test by cycle ergometer in 37 patients who visited our hospital because of dyspnea. Arterial blood gas analysis and spiromety, dyspnea index were performed, too. RESULT : (1) The VO2max was significantly lower in patients with COPD and cardiovascular disease than asthma and dyspnea on exertion group(p<0.05). The walking test distance was also lower in former. (2) The 12 minute walking test was significantly correlated with VO2max, PaCO2, FVC(%), FEV1(%) in all patients(p<0.05), and the walking test was only conelated with VO2max in patients with COPD(p<0.05). (3) In COPD patients, the VO2max was best correlated with FEV1(%) and FVC(%) and significantly correlated with walking test. But there was no correlation between walking test and FEV1(%) & FVC(%). (4) The 6 minute walking test was well correlated with 12 minute walking test(r=0.92. p<0.01). CONCLUSION : The walking test is the simple method for assessing exercise performance in patient with cardiopulmonary disease and a reliable indicator for VO2max. And the walking test is practical method for assessing on everyday disability rather than maximal exercise capacity. The 6 minute walking test is highly correlated with 12 minute walking test and a less exhausting for the patients and a time-saving for the investigator.
Choi, Soon Young;Kim, Chang Hwan;Park, Chan Hong;Kim, Hyung Rae
Geophysics and Geophysical Exploration
/
v.23
no.1
/
pp.22-37
/
2020
We analyze the comprehensive three-dimensional (3D) magnetic structure characteristics from the seafloor to the deep layer of the Tofua Arc (TA) 12 seamount in the Tonga Arc, Southwestern Pacific, using bathymetric and geomagnetic data, and magnetization vector inversion (MVI) results. The seafloor features surrounding TA 12 highlight a NW-SE-oriented elliptical caldera at the summit of the seamount, two small cones in the depressed area. A large-scale sea valley is present on the western flank of the seamount, extending from these caldera cones to the southwestern base of the seamount. TA 12 seamount exhibits a low magnetic anomaly in the caldera depression, whereas a high magnetic anomaly is observed surrounding the low magnetic anomaly across the caldera summit. It is therefore presumed that there may be a strong magnetic material distribution or magma intrusion in the caldera. The 3D MVI results show that the high anomaly zones are mainly present in the surrounding slopes of the seamount from the seafloor to the -3,000 m (below the seafloor) level, with the magnetic susceptibility intensity increasing as the seafloor level increases at the caldera depression. However, small high anomaly zones are present across the study area near the seafloor level. Therefore, we expect that the magma ascent in TA 12 seamount migrated from the flanks to the depression area. Furthermore, we assume that the complex magnetic distribution near the seafloor is due to the remnant magnetization.
Park, Kiwoong;Prasanajit, Naik Sambit;Gwon, Ohsang;Shin, Hyeon-Cho;Kim, Young-Seog
Journal of the Korean earth science society
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v.43
no.1
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pp.151-164
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2022
According to the records of historical and instrumental earthquakes, the southeastern part of the Korean Peninsula is considered the highest seismic activity area. Owing to recent reports of numerous Quaternary faults along the Yangsan and Ulsan fault zones, paleoseismological studies are being actively conducted in these areas. The study area is located in the central part of the Ulsan fault zone, where the largest number of active faults have been reported. Based on lineament and geomorphic analysis using LiDAR images and aerial photographs, fault-related landforms showing topographic relief were observed and a trench survey was conducted. The trench length 20 m, width 5 m, depth 5 m is located approximately 300 m away to the northeast from the previously reported Malbang fault. From the trench section, we interpreted the geometric and kinematic characteristics of the fault based on the deformed features of the Quaternary sedimentary layers. The attitude of the reverse fault, N26°W/33°NE, is similar to those of the reported faults distributed along the Ulsan fault zone. Although a single apparent displacement of approximately 40 cm has been observed, the true displacement could not be calculated due to the absence of the slickenline on the fault plane. Based on the geochronological results of the cryogenic structure proposed in a previous study, the most recent faulting event has been estimated as being earlier than the late Wurm glaciation. We interpreted the thrust fault system of the study area as an imbrication structure based on the previous studies and the fault geometry obtained in this additional trench. Although several previous investigations including many trench surveys have been conducted, they found limited success in obtaining the information on fault parameters, which could be due to complex characteristics of the reverse fault system. Additional paleoseismic studies will contribute to solving the mentioned problems and the comprehensive fault evolution.
To obtain fundamental informations on cotton breeding efficiences for Korea, individual genetic relationships and interrelationships between the agronomic characteristics of Upland cotton were investigated. These experiments were couducted at the Mokpo Branch Station $(34^{\circ}48'N, $$126^{\circ}23'E$ and altitude of 10m above sea level) from 1969 through 1972. Heterosis, combining ability, dominance and recessive gene action, genetic variance, and phenotypic and genotypic correlation were investigated by $F_1'S$ from an 11-parent partial diallel cross and the segregating $F_2$ and $F_3$ populations of the cross Paymaster times Heujueusseo Trice. The following points resulted from this study, 1. Heteroses for number of bolls per plant and lint yield were significant at 27, 84% and 37.26%, respectively. No other character had significant heteroses. 2. The GCA estimates for all studied characteristics were higher than the SCA estimates. Varieties with high GCA effects were Suwon 1 for earliness, Paymaster and Arijona for high lint percent, and Arijona for long fiber, etc, 3. SCA estimates for lint yield varied widely in crosses with Mokpo 4, Mokpo 6 and Heujueusseo Trice. Those crosses with the highest SCA effects were combinations with large characteristics differences, Example of these crosses are Mokpo 4 times Acala 1517W, Mokpo 4 times D. P. L. and Heujueusseo Trice aud Paymaster. 4. Early-maturing varieties were completely dominant to late-maturing varieties in some combinations while other crosses gave intermediate phenotypes. These results suggest additive genetic action by multi-genes. Heujueusseo Trice, Mokpo 6, and Suwon 1 showed highest degree of dominance for earliness. 5. There were no significant trends for inheritance of weight of boll and 100 seeds weight. 6. Long staple was partially to completely dominant to short staple. Though there were single gene ratios the rate of dominance decreased in the $F_2$ and $F_3$ populations in the cross between the long staple variety Paymaster and the short staple variety Heujueusseo Trice. Diallel cross $F_1$ hybrids showed complicated allelic gene action for staple length. Various dominance degree were shown by varieties. 7. Number of bolls per plant indicated strong over-dominance and small non-allelic additive gene action. 8. Lint Yield was characterized by over-dominance and by multiple non-allelic-gene action. High-yielding varieties were dominant to low-yielding ones. However, the low-yielding variety Heujueusseo Trice showed over-dominance, indicating different reactions according to the varieties and combinations. 9. Broad sense heritability for days to flowering was 34-39% while narrow sense heritability was 11%. Large variations of individual plants caused by Korean climatic conditions cause this situation. Heritability estimates for weight of boll was 30% for broad sense and 22% for narrow sense. 10. Heritability estimates for staple length and lint percent were very high suggesting strong selection effects. 11. Narrow sense heritability estimates for number of bolls per plant was 30% in the diallel cross $F_1$ hybrids and 36% in the $F_2$ population of the special cross. Broad sense heritability was estimated at 67% suggesting that. 12. Heritability estimates for lint yield was low due to high over-dominance in the diallel cross $F_1$ hybrids. Heritability estimates for yield was low in the $F_1$ hybrids but high in the $F_2$ and $F_3$ populations. 13. Phenotypic and genotypic correlations between lint percent and days to flowering and between staple length and days to flowering were high in the $F_1, $$F_2$ and $F_3$ populations. Late-maturing varieties and individuals had long staple and high lint percent in general. As the correlation between days to flowering and lint yield was extremely low, the two traits were considered independent of each other. Days to flowering and number of bolls per plant were negatively correlated in the $F_3$ population, indicating early-maturing individual plants with many bolls may be readily selected. 14. Phenotypic and genotypic correlations between lint percent and staple length were high in $F_1, $$F_2$ and $F_3$ populations. Accordingly, long staple varieties were high in lint percent. It was recognized that lint yield and lint percent were positively correlated in the diallel cross $F_1$ hybrids, and lint percent and staple length were positively correlated in the $F_2$ population, indicating that lint percent and staple length affect lint yield. 15. Lint yield was significantly and positively phenotypically correlated with number of bolls per plant in $F_1, $$F_2$ and $F_3$ populations. A high genotypic correlation was also noted indicating a close genetic relationship. The selection efficiencies for a high-yielding variety can be increased when individual plants with many bolls are selected in later generations. The selection efficiencies for good fiber quality can be enhanced when individuals with long staple and high lint percent are selected in early generations.
We reviewed the surgical results of intracardiac lateral tunnel Fontan procedure for the repair of functional single ventricles. Between 1990 and 1996, 104 patients underwent total cavopulmonary anastomosis. Patients' age and body weight averaged 35.9(range 10 to 173) months and 12.8(range 6.5 to 37.8) kg. Preoperative diagnoses included 18 tricuspid atresias and 53 double inlet ventricles with univentricular atrioventricular connection and 33 other complex lesions. Previous palliative operations were performed in 50 of these patients, including 37 systemic to pulmonary artery shunts, 13 pulmonary artery bandings, 15 surgical atrial septectomies, 2 arterial switch procedures, 2 resections of subaortic conus, 2 repairs of total anomalous pulmonary venous connection and 1 Damus-Stansel-Kaye procedure. In 19 patients bidirectional cavopulmonary shunt operation was performed before the Fontan procedure and in 1 patient a Kawashima procedure was required. Preoperative hemodynamics revealed a mean pulmonary artery pressure of 14.6(range 5 to 28) mmHg, a mean pulmonary vascular resistance of 2.2(range 0.4 to 6.9) wood-unit, a mean pulmonary to systemic flow ratio of 0.9(range 0.3 to 3.0), a mean ventricular end-diastolic pressure of 9.0 (range 3.0 to 21.0) mmHg, and a mean arterial oxygen saturation of 76.0(range 45.6 to 88.0)%. The operative procedure consisted of a longitudinal right atriotomy 2cm lateral to the terminal crest up to the right atrial auricle, followed by the creation of a lateral tunnel connecting the orifices of either the superior caval vein or the right atrial auricle to the inferior caval vein, using a Gore-Tex vascular graft with or without a fenestration. Concomitant procedures at the time of Fontan procedure included 22 pulmonary artery angioplasties, 21 atrial septectomies, 4 atrioventricular valve replacements or repairs, 4 corrections of anomalous pulmonary venous connection, and 3 permanent pacemaker implantations. In 31, a fenestration was created, and in 1 an adjustable communication was made in the lateral tunnel pathway. One lateral tunnel conversion was performed in a patient with recurrent intractable tachyarrhythmia 4 years after the initial atriopulmonary connection. Post-extubation hemodynamic data revealed a mean pulmonary artery pressure of 12.7(range 8 to 21) mmHg, a mean ventricular end-diastolic pressure of 7.6(range 4 to 12) mmHg, and a mean room-air arterial oxygen saturation of 89.9(range 68 to 100) %. The follow-up duration was, on average, 27(range 1 to 85) months. Post-Fontan complications included 11 prolonged pleural effusions, 8 arrhythmias, 9 chylothoraces, 5 of damage to the central nervous system, 5 infectious complications, and 4 of acute renal failure. Seven early(6.7%) and 5 late(4.8%) deaths occured. These results proved that the lateral tunnel Fontan procedure provided excellent hemodynamic improvements with acceptable mortality and morbidity for hearts with various types of functional single ventricle.
Background: Alteration of p53 tumor suppressor genes is most frequently identified in human neoplasms, including lung carcinoma. It is well known that bcl-2 oncoprotein protects cells from apoptosis. Recent studies have demonstrated that bcl-2 expression is associated with favorable prognosis for patients with non-small cell lung carcinoma. However, the precise biologic role of bcl-2 in the development of these tumors is still obscure. p53 and bcl-2 have important regulatory influence in the apoptotic pathway and thus their relationship is of interest in tumorigenesis, especially lung cancer. Purpose: The author investigated to know the prognostic significance of the expression of p53 and bcl-2 in radically resected non-small cell lung cancer. Method: 84 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from 1980 to 1994 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for p53 and bcl-2. Results : The histologic classification of the tumor was based on WHO criteria., and the specimens included 45 squamous cell carcinomas(53.6%), 28 adeonocarcinomas(33.3%) and 11 large cell carcinomas(13.1 %). p53 immunoreactivity was noted in 47 cases of 84 cases(56.0%). bcl-2 immunoreactivity was noted in 15 cases of 84 cases(17.9%). The mean survival duration was $64.23{\pm}10.73$ months in bcl-2 positive group and $35.28{\pm}4$. 39 months in bcl-2 negative group. The bcl-2 expression was significantly correlated with survival in radically resected non-small cell lung cancer patients(p=0.03). The mean survival duration was $34.71{\pm}6.12$ months in p53 positive group and $45.35{\pm}6.30$ months in p53 negative group(p=0.21). The p53 expression was not predictive for survival. There was no correlation between combination of the different status of p53 and bcl-2 expression in our study. Conclusions : The interaction and the regulation of new biologic markers, such as those involved in the apoptotic pathway, are complex. bcl-2 overexpression is a good prognostic factor in non-small cell lung cancer and p53 expression is not significantly associated with the prognostic factor in non-small cell lung cancer.
Kim, Soo-Ock;Kim, Dae-Jun;Kim, Jin-Hee;Yun, Jin I.
Korean Journal of Agricultural and Forest Meteorology
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v.15
no.2
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pp.76-84
/
2013
An adequate downscaling of the official forecasts of Korea Meteorological Administration (KMA) is a prerequisite to improving the value and utility of agrometeorological information in rural areas, where complex terrain and small farms constitute major features of the landscape. In this study, we suggest a simple correction scheme for scaling down the KMA temperature forecasts from mesoscale (5 km by 5 km) to the local scale (30 m by 30 m) across a rural catchment, especially under temperature inversion conditions. The study area is a rural catchment of $50km^2$ area with complex terrain and located on a southern slope of Mountain Jiri National Park. Temperature forecasts for 0600 LST on 62 days with temperature inversion were selected from the fall 2011-spring 2012 KMA data archive. A geospatial correction scheme which can simulate both cold air drainage and the so-called 'thermal belt' was used to derive the site-specific temperature deviation across the study area at a 30 m by 30 m resolution from the original 5 km by 5 km forecast grids. The observed temperature data at 12 validation sites within the study area showed a substantial reduction in forecast error: from ${\pm}2^{\circ}C$ to ${\pm}1^{\circ}C$ in the mean error range and from $1.9^{\circ}C$ to $1.6^{\circ}C$ in the root mean square error. Improvement was most remarkable at low lying locations showing frequent cold pooling events. Temperature prediction error was less than $2^{\circ}C$ for more than 80% of the observed inversion cases and less than $1^{\circ}C$ for half of the cases. Temperature forecasts corrected by this scheme may accelerate implementation of the freeze and frost early warning service for major fruits growing regions in Korea.
PARK, Jeong-Woo;YIM, Du-Hyun;NAM, Kwang-Woo;KIM, Jin-Young
Journal of the Korean Association of Geographic Information Studies
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v.19
no.4
/
pp.52-62
/
2016
Smart City is urban development for complex problem solving that provides convenience and safety for citizens, and it is a blueprint for future cities. In 2008, the Korean government defined the construction, management, and government support of U-Cities in the legislation, Act on the Construction, Etc. of Ubiquitous Cities (Ubiquitous City Act), which included definitions of terms used in the act. In addition, the Minister of Land, Infrastructure and Transport has established a "ubiquitous city master plan" considering this legislation. The concept of U-Cities is complex, due to the mix of informatization and urban planning. Because of this complexity, the foundation of relevant regulations is inadequate, which is impeding the establishment and implementation of practical plans. Smart City intelligent service facilities are not easy to define and classify, because technology is rapidly changing and includes various devices for gathering and expressing information. The purpose of this study is to complement the legal definition of the intelligent service facility, which is necessary for integrated management and operation. The related laws and regulations on U-City were analyzed using text-mining techniques to identify insufficient legal definitions of intelligent service facilities. Using data gathered from interviews with officials responsible for constructing U-Cities, this study identified problems generated by implementing intelligent service facilities at the field level. This strategy should contribute to improved efficiency management, the foundation for building integrated utilization between departments. Efficiencies include providing a clear concept for establishing five-year renewable plans for U-Cities.
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