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Clinical Indices Predicting Resorption of Pleural Effusion in Tuberculous Pleurisy (결핵성 늑막염에서 삼출액의 흡수에 영향을 미치는 임상적 지표)

  • Lee, Joe-Ho;Chung, Hee-Soon;Lee, Jeong-Sang;Cho, Sang-Rok;Yoon, Hae-Kyung;Song, Chee-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.660-668
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    • 1995
  • Background: It is said that tuberculous pleuritis responds well to anti-tuberculous drug in general, so no further aggressive therapeutic management is unnecesarry except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who need later decortication due to dyspnea caused by pleural loculation or thickening despite several months of anti-tuberculous drug therapy. Therefore, we want to know the clinical difference between a group who received decortication due to complication of tuberculous pleuritis despite of anti-tuberculous drug and a group who improved after 9 months of anti-tuberculous drug only. Methods: We reviewed 20 tuberculous pleuritis patients(group 1) who underwent decortication due to dyspnea caused by pleural loculation or severe pleural thickening despite of anti-tuberculous drug therapy for 9 or more months, and 20 other tuberculous pleuritis patients(group 2) who improved by anti-tuberculous drug only and had similar degrees of initial pleural effusion and similar age, sex distribution. Then we compared between the two groups the duration of symptoms before anti-tuberculous drug treatment and pleural fluid biochemistry like glucose, LDH, protein and pleural fluid cell count and WBC differential count, and we also wanted to know whether there was any difference in preoperative PFT value and postoperative PFT value in the patients who underwent decortication, and obtained following results. Results: 1) Group 1 patients had lower glucose level{$63.3{\pm}30.8$(mg/dl)} than that of the group 2{$98.5{\pm}34.2$(mg/dl), p<0.05}, and higher LDH level{$776.3{\pm}266.0$(IU/L)} than the group 2 patients{$376.3{\pm}123.1$(IU/L), p<0.05}, and also longer duration of symptom before treatment{$2.0{\pm}1.7$(month)} than the group 2{$1.1{\pm}1.2$(month), p<0.05}, respectively. 2) In group 1, FVC changed from preoperative $2.55{\pm}0.80$(L) to postoperative $2.99{\pm}0.78$(L)(p<0.05), and FEV1 changed from preoperative $2.19{\pm}0.70$(L/sec) to postoperative $2.50{\pm}0.69$(L/sec)(p<0.05). 3) There was no difference in pleural fluid protein level($5.05{\pm}1.01$(gm/dL) and $5.15{\pm}0.77$(gm/dl), p>0.05) and WBC differential count between group 1 and group 2. Conclusion: It is probable that in tuberculous pleuritis there is a risk of complication in the case of showing relatively low pleural fluid glucose or high LDH level, or in the case of having long duraton of symptom before treatment. We thought prospective study should be performed to confirm this.

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The Utility of Immunological Markers and Pulmonary Function Test in the Early Diagnosis of Pulmonary Involvement in the Patients with Rheumatoid Arthritis (류마티스 관절염환자에서 폐침범의 진단에 있어서 면역학적 지표와 폐기능 검사의 유용성)

  • Lee, Dong-Suk;Lee, Chang-Beam;Koh, Hee-Kwan;Moon, Doo-Seop;Lee, Jae-Young;Lee, Kyung-Sang;Yang, Suck-Chul;Yoon, Ho-Joo;Bae, Sang-Cheol;Shin, Dong-Ho;Kim, Seong-Yoon;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.878-887
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    • 1995
  • Background: It is reported that frequency of pulmonary involvement in the patients with rheumatoid arthritis reaches 10 to 50% and pulmonary involvement is a principal cause of death. As immunology and radiology has developed, interest for the early diagnosis of pulmonary involvement is increasing. Method: Among the patients at Hanyang University Hospital from March, 1990 to July, 1995, we compared the 29 patients having pulmonary involvement with the 18 patients controls in clinical and chest high resolution computed tomography(HRCT) findings by immunological markers and findings of pulmonary function test. We sought useful markers for early diagnosis of pulmonary involvement with noninvasive investigations. Results: The ratio of males to females was 14 : 15 in the group of pulmonary involvement, and all of the 18 patients were females in the control group. Smoking history was 31%(9/29) in the former group and none in the latter group. Rheumatoid factor(RF) was positive in 95.5%(28/29) of the pulmonary involvement group and in 100%(18/18) of the control group(p=0.12). Antiperinuclear factor(APF) showed a significant difference: 86.9%(20/23, average value: 2.0) was positive in the pulmonary involvement group and 50%(8/16, average value: 1.1) in the control group(p=0.04). Antinuclear antibody(ANA) was positive in 60.7%(17/28) of the pulmonary involvement group and in 72.2%(13/18) of the control group(p=0.33). Cryoglobulin also showed a significant difference: 72%(18/25) in the pulmonary involvement group was positive and 56.2%(9/16) in the control group was positive(p=0.02). Bony erosion was positive in 61.5%(16/26) of the pulmonary involvement group and in 77.7%(14/18) of the control group(p=0.8). On the pulmonary function test, the average value of alveolar volume corrected diffusion capacity and residual volume in the pulmonary involvement group and in the control group were 1.07mmol/rnin/KPa(predicted value: 64.2%), 1.32L(predicted value: 70%) and 1.44mmol/min/KPa, 3.75L(predicted value: 86.6%), respectively(p=0.003, p=0.004), showing a significant difference. Conclusion: APF or cryoglobulin on the serological test, the measurement of residual volume and alveolar volume corrected diffusion capacity may be used as effective markers in the diagnosis of pulmonary involvement of the patients with rheumatoid arthritis.

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Prognostic Value of the Expression of p53 and bcl-2 in Non-Small Cell Lung Cancer (비소세포폐암에서 p53과 bcl-2의 발현이 예후에 미치는 영향)

  • Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Keum, Joo-Seob;Kong, Gu;Lee, Jung-Dal
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.962-974
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    • 1998
  • 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.

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The Royal and Sajik Tree of Joseon Dynasty, the Culturo-social Forestry, and Cultural Sustainability (근세조선의 왕목-사직수, 문화사회적 임업, 그리고 문화적 지속가능성)

  • Yi, Cheong-Ho;Chun, Young Woo
    • Journal of Korean Society of Forest Science
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    • v.98 no.1
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    • pp.66-81
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    • 2009
  • From a new perspective of "humans and the culture of forming and conserving the environment", the sustainable forest management can be reformulated under the concept of "cultural sustainability". Cultural sustainability is based on the emphasis of the high contribution to sustainability of the culture of forming and conserving the environment. This study extracts the implications to cultural sustainability for the modern world by investigating a historical case of the culturo-social pine forestry in the Joseon period of Korea. In the legendary and recorded acts by the first king Taejo, Seonggye Yi, Korean red pine (Pinus densiflora) was the "Royal tree" of Joseon and also the "Sajik tree" related intimately with the Great Sajik Ritual valued as the top rank within the national ritual regime that sustained the Royal Virtue Politics in Confucian political ideology. Into the Neo-Confucian faith and royal rituals of Joseon, elements of geomancy (Feng shui), folk religion, and Buddhism had been amalgamated. The deities worshipped or revered at the Sajik shrine were Earth-god (Sa) and crop-god (Jik). And it is the Earth god and the concrete entity, Sajik tree, that contains the legacy of sylvan religion descended from the ancient times and had been incorporated into the Confucian faith and ritual regime. Korean red pine as the Royal-Sajik tree played a critical role of sustaining the religio-political justification for the rule of the Joseon's Royalty. The religio-political symbolism of Korean red pine was represented in diverse ways. The same pine was used as the timber material of shrine buildings established for the national rituals under Neo-Confucian faith by the royal court of Joseon kingdom before the modern Korea. The symbolic role of pine had also been expressed in the forms of royal tomb forests, the Imposition Forest (Bongsan) for royal coffin timber (Whangjangmok), and the creation, protection, conservation and bureaucratic management of the pine forests in the Inner-four and Outer-four mountains for the capital fortress at Seoul, where the king and his family inhabit. The religio-political management system of pine forests parallels well with the kingdom's economic forest management system, called "Pine Policy", with an array of pine cultivation forests and Prohibition Forests (Geumsan) in the earlier period, and that of Imposition Forests in the later period. The royal pine culture with the economic forest management system had influenced on the public consciousness and the common people seem to have coined Malrimgat, a pure Korean word that is interchangeable with the Chinesecharacter words of prohibition-cultivation land or forest (禁養地, 禁養林) practiced in the royal tomb forests, and Prohibition and Imposition Forests, which contained prohibition landmarks (Geumpyo) made of stone and rock on the boundaries. A culturo-social forestry, in which Sajik altar, royal tomb forests, Whangjang pine Prohibition and Imposition forests and the capital Inner-four and Outer-four mountain forests consist, was being put into practice in Joseon. In Joseon dynastry, the Neo-Confucian faith and royal rituals with geomancy, folk religion, and Buddhism incorporated has also played a critical humanistic role for the culturo-social pine forestry, the one higher in values than that of the economic pine forestry. The implications have been extracted from the historical case study on the Royal-Sajik tree and culturo-social forestry of Joseon : Cultural sustainability, in which the interaction between humans and environment maintains a long-term culturo-natural equilibrium or balance for many generations, emphasizes the importance that the modern humans who form and conserve environment need to rediscover and transform their culturo-natural legacy into conservation for many generations and produce knowledge of sustainability science, the transdisciplinary knowledge for the interaction between environment and humans, which fulfills the cultural, social and spiritual needs.

Structural and Functional Changes of The Brain in The Patient with Schizophrenia, Paranoid type : Correlation among Brain MRI Findings, Neurocognitive Function and Psychiatric Symptoms (편집형 정신분열병 환자에서 뇌의 구조적 변화와 기능적 변화 : 뇌자기공명영상소견, 신경인지기능 및 정신증상간의 상관관계)

  • Kang, Cheol-Min;Lee, Young-Ho;Jung, Young-Jo;Lee, Jung-Heum;Kim, Su-Ji;Park, Hyun-Jin
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.54-70
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    • 1998
  • Objectives : The purpose of this study is to evaluate the role of structural and functional changes of the brain in the pathophysiology of schizophrenia. Methods : The authors measured the regions of interest on the magnetic resonance imaging of the brain in 20 patients with paranoid schizophrenia(15 men and 5 women) and 23 control subjects(15 men and 8 women). We also assessed the neurocognitive functions with the Wisconsin Card Sorting Test, the Benton Neuropsychological Assessment, and the Weschler IQ test-Korean version, soft neurologic signs, and psychiatric symptoms in the patient group. Results : In the patient group, all ventricles and basal ganglia including caudate nucleus and globus pallidus were significantly enlarged. Although there were no significant differences between the two groups in the values of right frontal lobe and left temporal lobe, there was a tendency of decrease in the values of right frontal lobe and left temporal lobe. There were significant positive correlations between the values of ventricles and the frequency of previous hospitalization. However, there were no significant correlations between other values of regions of interest and clinical data. The value of the right frontal lobe was significantly correlated with the score of soft neurologic signs, which is suggestive of the neurodevelopmental abnormalities. There were significant correlations between the value of frontal lobe and the scores of the various subscales of Benton Neuropsychiatric Inventory. In contrast, the value of left amygdala and putamen showed significant correlation with the score of verbal IQ on the Weschler IQ test. Structural changes of the temporal lobe areas were related with the positive and general symptom scores on PANSS, while those of the basal ganglia were related with the negative symptom scores. Conclusions : These results suggest that the structural changes of the brain in the patients with schizophrenia show the dual process, which is suggestive that the enlarged ventricle show the neurodegenerative process, while enlarged basal ganglia, and shrinked right frontal and left temporal lobe show the neurodevelopmental abnormalities. Among these changes, structural changes of the frontal lobe related with various neuropsychological deficits, while those of left temporal lobe related with language abnormality. Relative to the relation between structural changes and psychiatric symptoms, structural changes of the temporal lobe areas were related with the positive and general symptoms, while those of the basal ganglia were related with the negative symptoms.

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Measuring the Public Service Quality Using Process Mining: Focusing on N City's Building Licensing Complaint Service (프로세스 마이닝을 이용한 공공서비스의 품질 측정: N시의 건축 인허가 민원 서비스를 중심으로)

  • Lee, Jung Seung
    • Journal of Intelligence and Information Systems
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    • v.25 no.4
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    • pp.35-52
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    • 2019
  • As public services are provided in various forms, including e-government, the level of public demand for public service quality is increasing. Although continuous measurement and improvement of the quality of public services is needed to improve the quality of public services, traditional surveys are costly and time-consuming and have limitations. Therefore, there is a need for an analytical technique that can measure the quality of public services quickly and accurately at any time based on the data generated from public services. In this study, we analyzed the quality of public services based on data using process mining techniques for civil licensing services in N city. It is because the N city's building license complaint service can secure data necessary for analysis and can be spread to other institutions through public service quality management. This study conducted process mining on a total of 3678 building license complaint services in N city for two years from January 2014, and identified process maps and departments with high frequency and long processing time. According to the analysis results, there was a case where a department was crowded or relatively few at a certain point in time. In addition, there was a reasonable doubt that the increase in the number of complaints would increase the time required to complete the complaints. According to the analysis results, the time required to complete the complaint was varied from the same day to a year and 146 days. The cumulative frequency of the top four departments of the Sewage Treatment Division, the Waterworks Division, the Urban Design Division, and the Green Growth Division exceeded 50% and the cumulative frequency of the top nine departments exceeded 70%. Higher departments were limited and there was a great deal of unbalanced load among departments. Most complaint services have a variety of different patterns of processes. Research shows that the number of 'complementary' decisions has the greatest impact on the length of a complaint. This is interpreted as a lengthy period until the completion of the entire complaint is required because the 'complement' decision requires a physical period in which the complainant supplements and submits the documents again. In order to solve these problems, it is possible to drastically reduce the overall processing time of the complaints by preparing thoroughly before the filing of the complaints or in the preparation of the complaints, or the 'complementary' decision of other complaints. By clarifying and disclosing the cause and solution of one of the important data in the system, it helps the complainant to prepare in advance and convinces that the documents prepared by the public information will be passed. The transparency of complaints can be sufficiently predictable. Documents prepared by pre-disclosed information are likely to be processed without problems, which not only shortens the processing period but also improves work efficiency by eliminating the need for renegotiation or multiple tasks from the point of view of the processor. The results of this study can be used to find departments with high burdens of civil complaints at certain points of time and to flexibly manage the workforce allocation between departments. In addition, as a result of analyzing the pattern of the departments participating in the consultation by the characteristics of the complaints, it is possible to use it for automation or recommendation when requesting the consultation department. In addition, by using various data generated during the complaint process and using machine learning techniques, the pattern of the complaint process can be found. It can be used for automation / intelligence of civil complaint processing by making this algorithm and applying it to the system. This study is expected to be used to suggest future public service quality improvement through process mining analysis on civil service.

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.

A Study on People Counting in Public Metro Service using Hybrid CNN-LSTM Algorithm (Hybrid CNN-LSTM 알고리즘을 활용한 도시철도 내 피플 카운팅 연구)

  • Choi, Ji-Hye;Kim, Min-Seung;Lee, Chan-Ho;Choi, Jung-Hwan;Lee, Jeong-Hee;Sung, Tae-Eung
    • Journal of Intelligence and Information Systems
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    • v.26 no.2
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    • pp.131-145
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    • 2020
  • In line with the trend of industrial innovation, IoT technology utilized in a variety of fields is emerging as a key element in creation of new business models and the provision of user-friendly services through the combination of big data. The accumulated data from devices with the Internet-of-Things (IoT) is being used in many ways to build a convenience-based smart system as it can provide customized intelligent systems through user environment and pattern analysis. Recently, it has been applied to innovation in the public domain and has been using it for smart city and smart transportation, such as solving traffic and crime problems using CCTV. In particular, it is necessary to comprehensively consider the easiness of securing real-time service data and the stability of security when planning underground services or establishing movement amount control information system to enhance citizens' or commuters' convenience in circumstances with the congestion of public transportation such as subways, urban railways, etc. However, previous studies that utilize image data have limitations in reducing the performance of object detection under private issue and abnormal conditions. The IoT device-based sensor data used in this study is free from private issue because it does not require identification for individuals, and can be effectively utilized to build intelligent public services for unspecified people. Especially, sensor data stored by the IoT device need not be identified to an individual, and can be effectively utilized for constructing intelligent public services for many and unspecified people as data free form private issue. We utilize the IoT-based infrared sensor devices for an intelligent pedestrian tracking system in metro service which many people use on a daily basis and temperature data measured by sensors are therein transmitted in real time. The experimental environment for collecting data detected in real time from sensors was established for the equally-spaced midpoints of 4×4 upper parts in the ceiling of subway entrances where the actual movement amount of passengers is high, and it measured the temperature change for objects entering and leaving the detection spots. The measured data have gone through a preprocessing in which the reference values for 16 different areas are set and the difference values between the temperatures in 16 distinct areas and their reference values per unit of time are calculated. This corresponds to the methodology that maximizes movement within the detection area. In addition, the size of the data was increased by 10 times in order to more sensitively reflect the difference in temperature by area. For example, if the temperature data collected from the sensor at a given time were 28.5℃, the data analysis was conducted by changing the value to 285. As above, the data collected from sensors have the characteristics of time series data and image data with 4×4 resolution. Reflecting the characteristics of the measured, preprocessed data, we finally propose a hybrid algorithm that combines CNN in superior performance for image classification and LSTM, especially suitable for analyzing time series data, as referred to CNN-LSTM (Convolutional Neural Network-Long Short Term Memory). In the study, the CNN-LSTM algorithm is used to predict the number of passing persons in one of 4×4 detection areas. We verified the validation of the proposed model by taking performance comparison with other artificial intelligence algorithms such as Multi-Layer Perceptron (MLP), Long Short Term Memory (LSTM) and RNN-LSTM (Recurrent Neural Network-Long Short Term Memory). As a result of the experiment, proposed CNN-LSTM hybrid model compared to MLP, LSTM and RNN-LSTM has the best predictive performance. By utilizing the proposed devices and models, it is expected various metro services will be provided with no illegal issue about the personal information such as real-time monitoring of public transport facilities and emergency situation response services on the basis of congestion. However, the data have been collected by selecting one side of the entrances as the subject of analysis, and the data collected for a short period of time have been applied to the prediction. There exists the limitation that the verification of application in other environments needs to be carried out. In the future, it is expected that more reliability will be provided for the proposed model if experimental data is sufficiently collected in various environments or if learning data is further configured by measuring data in other sensors.

A Study on the Yousang-Dae Goksuro(Curve-Waterway) in Gangneung, Yungok-Myun, Yoodung Ri (강릉 연곡면 유등리 '유상대(流觴臺)' 곡수로(曲水路)의 조명(照明))

  • Rho, Jae-Hyun;Shin, Sang-Sup;Lee, Jung-Han;Huh, Jun;Park, Joo-Sung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.1
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    • pp.14-21
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    • 2012
  • The object of the study, Yousang-Dae(流觴臺) and engraved Go broad text on the flat rock in Gangneung-si Yungok-myun Yoodung-ri Baemgol, reveals that the place was for appreciating arts like Yusang Goksu and Taoist hermit's games. three times of detail reconnaissance survey brought about the results as follows. There is a the text, Manwolsan(滿月山) Baegundongcheon(白雲洞天), engraved on the rock in Baegunsa(白雲寺) that had been built by Doun at the first year of King Hungang(in 875) of the United Shilla, became in ruins in the middle of Joseon, and then was rebuilt in 1954. The text is an invaluable evidence indicating that the tradition of Taoist hermit and Sunbee(classical scholars) culture has been generated in Baemgol Valley. According to the 2nd vol. of Donghoseungram(東湖勝覽), the chronicle of Gangneung published by Choi Baeksoon in 1934, there is a record saying that 'Baegunsa in Namjeonhyeon is the classroom where famous teachers like Yulgok Lee Yi or Seongje Choi Ok were teaching' that verifies the historic property of the place. In addition, the management of Nujeong(樓亭) and Dongcheon can be traced through Baegunjeong(白雲亭) constructed by Kim Yoonkyung(金潤卿) in Muo year, the 9th year of Cheoljong(1858) according to Donghoseungram and the completed version of Jeungboyimyoungji(增補臨瀛誌). Also, Baegundongdongcheon(白雲亭洞天), the text engraved on the standing stone across the stream from Yousang-Dae stone, was created 3 years after the Baegunjeong construction in the 12th year of Cheoljong(1861), which refers a symbolic sign closely related with Yousang-Dae. Based on this premise and circumstance, with careful studying the remains of 'Yusang-dae' Goksuro, we discovered that the Sebun-seok(細分石) controling the amount and the speed of moving water and the remains of furrows of Keumbae-soek(擒盃石) and Yubae-gong(留盃孔) containing water stream with cups through the mountain stream and rocks around Yusang-Dae. In addition, as 21 people's names engraved under the statement of 'Oh-Seong(午星)' were discovered on the bottom of the rock, this clearly confirms that the place was one of the main cultural footholds of tasting the arts which have characteristics of Yu-Sang-Gok-Su-Yeon(流觴曲水宴) until the middle of the 20th century. It implies that the arts tasting culture of Sunbees had been inherited centering on Yusang-dae in this particular place until the middle of the 20th century. It is necessary to be studied in depth because the place is a historic and unique cultural place where 'Confucianism, Buddhism, and Zen'were combined together. Based on the result of the study, the identification of 23 people as well as the writer of Yusang-Dae text should be carefully studied in depth in terms of the characteristics of the place through gathering data about appreciation of arts like Yusanggoksu. Likewise, we should make efforts to discover the chess board engraved on the rock described on the documents, thus we should consider to establish plans to recover the original shape of the place, for example, breaking the cement pavement of the road, additional excavation, changing the existing route, and so fourth.

Mid-term results of IntracardiacLateral Tunnel Fontan Procedure in the Treatment of Patients with a Functional Single Ventricle (기능적 단심실 환자에 대한 심장내 외측통로 폰탄술식의 중기 수술성적)

  • 이정렬;김용진;노준량
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.472-480
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    • 1998
  • 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.

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