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Modified Fontan Operation: Physio-anatomic Causes of Low Cardiac Output and Persistent Pleural Effusion (Fontan 수술후 저심장박출증 및 지속성 흉막 삼출액이 발생되는 해부생리학적 원인)

  • Han, Jae-Jin;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.213-221
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    • 1990
  • We have experienced 62 cases of modified Fontan operations in Seoul Nat’l University Hospital from Apr. 1986 to Jul. 1989, They were 38 males and 24 females, and their age was ranged from 16 months to 15.5 years of age. [mean age : 5.73$\pm$2.99 years] There were 16 operative deaths and 2 late deaths, therefore 29% of overall mortality. Their diagnoses were as follows; 28 single ventricle, 11 tricuspid atresia, 6 DORV with LV hypoplasia, 3 pulmonary atresia with hypoplastic RV, 3 TGA with hypoplastic RV, 3 cor\ulcornerGA with hypoplastic LV and PA, 6 AV canal defects with PA, and 2 others. Low cardiac output and pleural effusion were developed frequently, so we divide 40 patients into some groups to analyze the physiologic and anatomic causes of them. By the degree of the LCO, group A was no LCO[mean amount of inotropics used: 0-5 \ulcornerg/kg/min] with 17 cases, B mild LCO [5-10] with 11, C moderate to severe LCO but alive[>10] with 8, D severe LCO to death with 4 cases. For the pleural effusion, group 1 was to be removed the chest tube within 1 week with 8 cases, group II within 3 weeks with 21 cases, group III beyond 3 weeks with 12 cases. We considered their age, diagnosis, pulmonary artery size[PA index], pulmonary artery abnormality, palliative shunt, systemic ventricular type, pulmonary artery wedge pressure, as preoperative factors, and operative methods, and as postoperative factors, CVP, LAP, arrhythmia, thrombosis, atrioventricular valvular insufficiency, etc. In the view of LCO, pulmonary artery size and PCWP were statistically significant [P<0.05], and arrhythmia, A-V valve insufficiency were inclined to the group C and D Pleural effusion was influenced by the pulmonary artery size, pulmonary artery resistance, PCWP, and CVP significantly. [P<0.05] And arrhythmia, residual shunt, and A-V valvular insufficiency were inclined to group II and III, too. As a results, the followings are to be reminded as the important factors at the care of post-Fontan LCO, and persistent pleural effusion [1] pulmonary artery size, [2] pulmonary artery resistance, [3] PCWP, [4] CVP, [5] arrhythmia, [6] residual shunt, [7]A-V valvular insufficiency.

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The Study on living Art and Costumes Culture of the Middle-Age Europe (중세유럽의 생활미술과 복식문화에 관한 연구)

  • 이순홍
    • Journal of the Korean Society of Costume
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    • v.35
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    • pp.17-44
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    • 1997
  • Medieval European practical art and style of costume is studied through referring to the literatures. The type of clothing that was seen on tapestries arts and crafts paintings and wall paintings and appeared in the architecture such as church. There were symbolic aspects of color motifs at this period and some restraints for clothing according to the social class, It was a period that draped garments due to the War of Crusades is appeared. Be-cause the medieval taste and decorative character is not only 'formative art' but also the taste beyoud 'mode' and atomsphere of that times it could be seen the strong reflec-tion of customs in the clothing of that times which is shown in works of art. 1) The purpose of Christian art which was found in mosaics stained glasses wall pain-tings and statues of architecture was not just the revival of natural phenomena but visuali-zation of sacred and invisible things. It was valuable to understandin of the spiritual through the sense organ It was a monumental art that was combined with decorative func-tion and role of the Bible. It revealed what was about the religious spiritual miracle, 2) In the medieval European painting characteristic and beautiful creativity was the basis of an argument. Both "Worship of East-ern" that is painted ion a parchment and "Cor-onation of Charles VI" were described decor-ation motifs on the edge of buildings geo-metric patterns and others with outstanding skill. there were precise technologic skill of architect and glassmen and lots of patience of craftsmen. " The Labour of the Months" and the scene of"A Trial at the Court" is also de-scribed elaborately. 3) Tapestry was developed in France Ger-many Swiss at the 14th century. Religionary and historical themes unicorn lady bird flowering plants and others were major motifs. It was very important as decorative wall coverings and as practical door arch and bed hangings. It was made through patient hard work with simple technique and it was con-sidered as an art for practical use. Tapestry was what everyone wish to have. It is reckoned for the item of the best gift. The royalty and nobility ordered and used custom-made tapestries. Sometimes the subject of motifs consisted of series which were deeply related to living 4) Decorative arts and crafts was the art that used materials such as precious metals jewels and others and that accorded with the luxurious and gorgeous taste of the royalty and nobility. Christian considered splendid and beautiful color of light as a symbol of glory. They used also for church appliances, There were metal crafts wood crafts textile crafts and others, As was stated above the costume appeared on the arts and crafts for living revealed the process of changes saw how the politic econ-omic and social organizations were developed.and social organizations were developed.

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Combination of an Enzymatically Hydrolyzed Yeast and Yeast Culture with a Direct-fed Microbial in the Feeds of Broiler Chickens

  • Gomez, S.;Angeles, M.L.;Mojica, M.C.;Jalukar, S.
    • Asian-Australasian Journal of Animal Sciences
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    • v.25 no.5
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    • pp.665-673
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    • 2012
  • A balance trial experiment was carried out to evaluate the potential relationship between an enzymatically hydrolyzed yeast (EHY) and yeast culture combined with a live Bacillus subtilis (Bs) on the productive parameters, ileal digestibility, retention of nutrient and energy and villus morphology in broilers. Seventy two 28 d old, Ross B308 male broilers were assigned to a factorial combination of 2 levels of EHY (0 and 1 kg/ton of feed) and 2 levels of Bs (0 and 125 g/ton of feed). The experiment lasted 2 weeks. Several treatment interactions were observed. EHY-fed broilers showed the lowest feed intake and feed conversion ratio whereas Bs-fed broilers showed the highest feed intake and intermediate feed conversion ratio (EHY and BS interaction, p<0.05). Also, EHY-fed broilers had greater ileal digestibility of dry matter (EHY and BS interaction, p<0.01) and energy (EHY and BS interaction, p<0.05) but these responses were counterbalanced by the combination of EHY and Bs. The thickness of the mucosa was similar between the control and EHY-fed broilers, but was lowest when Bs was added alone (EHY and BS interaction, p<0.01). The thickness of the villus was greater in EHY plus Bs-fed broilers, intermediate for the control and lower for Bs or EHY-fed broilers (EHY and BS interaction, p<0.05). The area of the villus was greater in the control and EHY plus Bs-fed broilers (EHY and BS interaction, p<0.05). In addition, EHY-fed broilers showed greater breast yield and nitrogen retention (p<0.01) and ashes digestibility (p<0.05). On the other hand, Bs-fed broilers had greater carcass and breast weight, nitrogen retention, energy excretion and villus height (p<0.05). In summary, EHY and Bs enhanced some growth, carcass and nutrient retention responses, but did not show any synergic relationship in these responses. Opposite to this, the results suggest that the positive effect of EHY on the feed conversion and digestibility of nutrients were counterbalanced by the addition of Bs.

Fungal flora of Ullung Island (V) -on additional agaric fungi- (울릉도의 균류상 (V) -기타 주름버섯류에 대하여-)

  • Jung, Hack-Sung
    • The Korean Journal of Mycology
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    • v.22 no.2
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    • pp.196-208
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    • 1994
  • Some additional fungi were collected during two field trips to Ullung Island in July and September of 1992. Through the observation of agaric fungi, 36 mushrooms were identified to the species or subspecies and are listed below. Among them, three species and one subspecies, Mycena luteopallens, Mycena macrocystidiata, Amanita hemibapha ssp. similis, and Pluteus petasatus, were confirmed new to Korea and are registered here with descriptions.

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The Effects of Past Success on Performance: The Mediating Role of Self-Efficacy, Burnout, and Engagement (과거성공이 성과에 미치는 영향 : 자아효능감, 소진, 몰입의 매개역할을 중심으로)

  • Im, Chang-Hee
    • Management & Information Systems Review
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    • v.29 no.1
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    • pp.49-78
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    • 2010
  • Traditionally, self-efficacy, burnout and engagement are defined as work related states of mind, and formally speaking, students are not employees. But, we assume that from a psychological perspective, student core activities can be considered work. Therefore, based on SCT(social cognitive theory), we examine the mediating role of self-efficacy in the prediction of student burnout and engagement, and also the mediation of burnout and engagement between self-efficacy and performance(GPA). There is no research to date wether there would be mediating role of these variables between past success and performance. These effects were analysed in the context of mediating role of the variables in a university in a sample of 438 students. This study utilized a convenience sample drawn from various major scholar area. Results of structural equation modeling analyses were consist with a full mediation model in which academic past success predicts self-efficacy, which in turn, predicts student burnout and engagement. Also our proposed model showed that burnout and engagement are partial or full mediating variables between self-efficacy and performance. Our study's findings provide evidence that engagement fully accounted for the relationship between self-efficacy and performance, and burnout partially explained the relationships. These findings aligns with the general theorizing supported by JD-R model and SCT(social cognitive theory). More specifically, it builds on the JD-R literature as it tests one of the proposed mechanisms in the relationship between job resources and work engagement. Implications of study are discussed, together with limitations and suggestions for future research.

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Developmental Changes in Digestive Enzymes Activity of Black Rockfish Sebastes inermis (볼락, Sebastes inermis 자.치어의 성장에 따른 소화효소 활성 변화)

  • Gwak Woo-Seok;Park Dae-Won
    • Journal of Aquaculture
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    • v.19 no.2
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    • pp.125-132
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    • 2006
  • Black rockfish larvae and juveniles were reared for 95 days after parturition (DAP) in order to determine four enzyme activities (trypsin, pepsine-like enzyme, lipase, amylase) during ontogeny. Larvae were fed rotifers Brachionus plicatilis from 1 to 25 DAP, Artemia nauplii from 10 to 78 DAP and then gradually changed to pelleted feed from 30 DAP. Temperature was kept between $13.5{\sim}14.9^{\circ}C$. Trypsin and lipase activities were found in 2 DAP larvae ($7.0{\pm}1.5$ unit and $4.5{\pm}1.4$ unit, $mean{\pm}SD$, respectively). The evolution of both enzymes activities showed a profile marked by drastic increases between postflexion and juvenile stage. There is an increment on specific trypsin activity at 10 DAP, corresponding with the beginning of Artemia feeding. Pepsin-like enzyme activity was found at 11 DAP and increased drastically from 56 DAP, cor-responding with the initiation of juvenile stage. Amylase activity was also found at 11 DAP and maintained at a low level up to 38 DAP followed by a drastic increase from 39 DAP to 50 DAP. Considering our results of both trypsin and pepsin-like enzyme activities, it might be concluded that higher somatic growth of Sebastes inermis could be possible with the initiation juvenile of stage and the early juvenile stage is a suit-able period for feeding an artificial diet for fish.

Sleep-Related Respiratory Disturbances (수면과 관련된 호흡장애)

  • Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.2 no.1
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    • pp.55-64
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    • 1995
  • During sleep, relatively major respiratory physiological changes occur in healthy subjects. The contributions and interactions of voluntary and metabolic breathing control systems during waking and sleep are quite different Alterations of ventilatory control occur in chemosensitivity, response to mechanical loads, and stability of ventilation. The activities of intercostal muscles and muscles involved in regulating upper airway size are decreased during sleep. These respiratory physiological changes during sleep compromise the nocturnal ventilatory function, and sleep is an important physiological cause of the nocturnal alveolar hypoventilation. There are several causes of chronic alveolar hypoventilation including cardiopulmonary, neuromuscular diseases. Obstructive sleep apnea syndrome (OSAS) is an important cause of nocturnal hypoventilation and hypoxia. Coexistent cardiopulmonary or neuromuscular disease in patients with OSAS contributes to the development of diurnal alveolar hypoventilation, diurnal hypoxia and hypercapnia. The existing data indicates that nocturnal recurrent hypoxia and fragmentation of sleep in patients with OSAS contributes to the development of systemic hypertension and cardiac bradytachyarrhythmia, and diurnal pulmonary hypertension and cor pulmonale in patients with OSAS is usually present in patients with coexisting cardiac or pulmonary disease. Recent studies reported that untreated patients with OSAS had high long-term mortality rates, cardiovascular complications of OSAS had a major effect on mortality, and effective management of OSAS significantly decreased mortality.

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Effects of Bedding Material Composition in Deep Litter Systems on Bedding Characteristics and Growth Performance of Limousin Calves

  • Meng, J.;Shi, F.H.;Meng, Qingxiang;Ren, L.P.;Zhou, Z.M.;Wu, H.;Zhao, L.P.
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.1
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    • pp.143-150
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    • 2015
  • The objective of this study was to evaluate the effects of different litter mixture compositions on bedding system temperature, pH and volatile fatty acid and ammonia-N ($NH_3$-N) content, and the serum physico-chemical parameters and growth indices of calves. Thirty-two Limousin calves ($280{\pm}20kg$) were randomly assigned to four groups (n = 8 for each group) according to the bedding system used: i) control with soil only (CTR); ii) mixture with 50% paddy hulls (PH), 30% saw dusts (SD), 10% peat moss (PM) and 10% corn cobs (CC) (TRT1); iii) mixture with 15% PH, 15% SD, 10% PM, 40% CC, and 20% corn stover (CS) (TRT2); iv) mixture with 30% PH, 10% PM, 40% CC, and 20% CS (TRT3). The litter material combinations of different treatments were based on the cost of bedding system materials in China. The cost of four treatments from low to high: Control$NH_3$-N level (271.83 to 894.72 mg/kg) was lowest for TRT1 (p<0.0001) and highest for TRT2 (p<0.0001). The acetate, propionate and butyrate levels were highest for the control group (p<0.0001). In all the groups, the pH value (6.90 to 9.09) increased at the beginning and later remained stable at below 9.09. The temperature of deep litter increased at the first week and reached the maximum ($42.1^{\circ}C$) on day 38. 3,5,3'-Triiodothyronine ($T_3$) levels in the TRT1 group animals (p<0.0001) were lower than those in the control and TRT2 animals. 3,5,3',5'-Tetraiodothyronine ($T_4$) in the TRT1 group (p = 0.006) was lower than that in the other treatment groups. Cortisol (COR) in the control and TRT1 group was lower (p<0.0001) than that in the TRT2 and TRT3 groups. Corticosterone (CORt) in the control group was higher (p<0.0001) than that in the treatment groups. The findings indicate that the deep litter bedding systems provided better conditions for animal health and growth performance compared with the control system. Furthermore, the litter composition of TRT1 was found to be optimal among the three treatment groups.

Effects of Chronic Inflammation on Energy Metabolism and Growth Performance in Weanling Piglets

  • Moon, H.K.;Han, In K.;Gentry, J.L.;Parmentier, H.K.;Schrama, J.W.
    • Asian-Australasian Journal of Animal Sciences
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    • v.12 no.2
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    • pp.174-179
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    • 1999
  • The effect of a chronic inflammation (cell-mediated immune response) on energy metabolism and growth performance was assessed in weanling piglets. Twenty four barrows of 4 wk of age were assigned to one of two immunization treatments : Control group [CON: immunized with Incomplete Freund's Adjuvant (lFA)] or Immunization group [IMMU: immunized with Complete Freund's Adjuvant (CFA)]. On d0, piglets were weaned and subcutaneously immunized at the medial side of the femur with 2 ml of IFA or CFA, respectively. Energy and nitrogen balances were measured per group during 13-d balance period, and total $(HP_{tot})$, activity-related ($(HP_{act})$) and non-activity-related $(HP_{cor})$ heat production were determined every 9-min by indirect calorimetry. Ig total titers to Mycobacterium butyricum, which is present in CFA, were higher (p<0.01) in IMMU than in CON on d13 (2.5 vs 1.8) and d20 (2.9 vs 1.8) after immunization. There were no differences (p>0.10) between treatments in rectal temperature, performance, feed intake, and availability and partitioning of energy during the balance period. Average daily feed intake was numerically higher in IMMU than in CON (0.34 vs 0.32 kg/d), but there was no difference (p>0.10) in metabolizability of the dietary energy between treatments. $HP_{act}/HP_{tot}$ was 16.24 and 16.89%, and retained energy was 251 and 268 $268\;kJ{\cdot}kg^{0.75}{\cdot}d^{-1}$ for CON and IMMU, respectively. Numerically, maintenance requirement of IMMU was even lower than that of CON $(419\;vs\;427\;kJ{\cdot}kg^{0.75}{\cdot}d^{-1})$. The present study suggests that a chronic inflammation has no effect on energy metabolism and growth performance, in spite of the difference in systemic antibody responses. The reason was considered to be due to locally induced immune response, resulting from the possible encapsulation at the site of injection, and/or to a low systemic immune stress which is within a functionally acceptable physiological range for the piglets.

The Effect of Frontline Employees' Experienced Customer Incivility on Service Performance (고객접점직원의 고객무례경험이 서비스 성과에 미치는 효과: 감정소진과 정서조절역량의 역할을 중심으로)

  • KIM, Minsung;HUR, Won-Moo;KIM, Byung-Soo
    • Journal of Distribution Science
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    • v.17 no.8
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    • pp.107-118
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    • 2019
  • Purpose - The present study examines the effect of service employees' experienced customer incivility through their emotional exhaustion. We identified service employees' emotion regulation ability as a boundary condition (i.e., moderating variable) that decreased the positive relationship between service employees' experienced customer incivility and their emotional exhaustion. Furthermore, we also investigated the negative relationship between service employees' experienced customer incivility and their service performance via emotional exhaustion. Research design, data, and methodology - Drawing on AET (affective event theory) and COR (conservation of resources) theory, we developed three research hypotheses (i.e., mediation, moderation, and moderated mediation). Online panel survey data from 552 frontline employees at several service organizations (e.g., department stores, retail stores, hotels, restaurants, airlines, banking, insurance company, and etc) in South Korea were examined. To assess two types of validity (i.e., convergent and discriminant validity) and reliability of measurement model, we employed the CFA (confirmatory factor analysis) using M-plus 8.2 software. Internal consistency also was tested by Cronbach' α. In addition, we employed the SPSS PROCESS MACRO 2.16, which was recommended by Hayes (2013, 2015), to estimate mediation, moderation, and moderated mediation effects. Results - As predicted, the negative relationship between service employees' experienced customer incivility and their service performance was mediated by emotional exhaustion. Furthermore, service employees' emotion regulation ability also played a significant moderating role of the relationship between service employees' experienced customer incivility and emotional exhaustion, such that this relationship was less pronounced when service employees had a high level of their emotion regulation ability than when thir emotion regulation ability was low. Service employees' emotion regulation ability further moderated this mediation effect of service employees' experienced customer incivility on service performance through emotional exhaustion. These findings have theoretical implications for employees' experienced customer incivility and emotion regulation ability research and provide managerial implications for practitioners. Conclusions - This study empirically elaborated the previous model of service employees' experienced customer incivility and personal resource (e.g., emotion regulation ability) literature by presenting the findings that service employees' experienced customer incivility influences their service performance via emotional exhaustion and that emotion regulation ability effectively reduces this negative effect.