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Sinus Node Function after Extended Transseptal Approach for Mitral Valve Surgery: 164 Clinical Cases (경중격 절개방식을 좌심방 상부까지 연장시킨 방법을 통한 승모판막 수술 후 동방 결절 기능부전에 대한 164예 임상분석)

  • Ryu Se Min;Kim Hyun Koo;Cho Yang Hyun;Sim Jae Hoon;Sohn Young-sang;Choi Young Ho;Kim Hark Jei
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.214-220
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    • 2005
  • Extended transseptal approach can provide an excellent view of the mitral valve but the safety of this approach is controversial because this incision requires transaction of the sinus node artery, which in most cases and can result postoperative arrhythmia. The purpose of this study was to evaluate perioperative and longterm conduction disturbances and the cardiac rhythms of patients who underwent an extended transseptal approach for mitral valve surgery. Material and Method: Postoperative cardiac rhythms were analyzed in the 164 consecutive patients who received mitral valve replacements with a extended transseptal approach between March 1992 and July 2003. Result: Of the 84 patients in normal sinus rhythm, 34 ($39\%$) had developed transient junctional rhythm and atrial fibrillation after operation, lasting less than 72 hours in most of cases. No intractable arrhythmias occurred. Most of these arrhythmia were not detected at the time of discharge and only 8 patients ($9\%$) had atrial fibrillation at discharge. Postoperative PR intervals increased for 1 week, then decreased within 2 weeks postoperatively, and returned to normal range by 6 months postoperatively. During the postoperative period, 4 of the 78 patients with preoperative atrial fibrillation developed normal sinus thythm. Conclusion: The post-operative arrhythmias were temporary and showed no significant complications after extended transseptal approach for the mitral valve surgery.

Clinical features of vaccination-associated thrombocytopenic purpura in children (예방접종과 관련된 소아 혈소판 감소 자반병의 임상적 특성)

  • Lee, Wan Soo;Yu, Seung Taek;Shin, Sae Ron;Young Du
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.610-615
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    • 2008
  • Purpose : Idiopathic thrombocytopenic purpura (ITP) is a relatively common hematological disease in children. It generally occurs after exposure to a common viral infection episode; however, it may occasionally follow immunization with measles, measles-mumps-rubella (MMR), hepatitis B (HBV), influenza, diphtheria-tetanus-pertussis (DTP), or chickenpox vaccines. In this study, the incidence, clinical characteristics, and treatment outcome of vaccination-associated ITP were investigated and compared with non-vaccination-associated ITP. Methods : The admission records of 105 pediatric ITP patients between 0-14 years of age admitted to Department of Pediatrics, Wonkwang University Hospital from January 1994 to July 2007 were retrospecitively reviewed. Patients were grouped into a vaccination-associated group and a non-vaccination-associated group according to vaccination history within the previous 1 month, and various clinical features between the two groups were statistically analyzed. Results : Thirteen patients (12%) had a preceding vaccination. Eight had received DTP vaccination, 2 had received hepatitis B, and 1 each had received influenza, MMR, and Japanese B encephalitis vaccination. However, none of the patients had a recurrent thrombocytopenia after subsequent vaccinations. In the vaccination-associated group, the age was significantly lower, anemia was more common, and the risk period with blood platelet count $<20{\times}10^9/L$ was significantly shorter than for the in non-vaccination-associated group. Also, wet purpura was less prominent and the remission within 1month was more frequently achieved in the vaccination-associated ITP group. Conclusion : Vaccination-associated ITP patients showed mild symptoms with a more benign and shorter lasting course than non-vaccination-associated ITP patients. Moreover, platelet count assessment at the time of the next immunization may not be necessary.

A Study on Salt Removal in Controlled Cultivation Soil Using Electrokinetic Technology (전기동력학 기술을 이용한 시설재배지 토양의 염류제거 효과연구)

  • Kim, Lee Yul;Choi, Jeong Hee;Lee, You Jin;Hong, Soon Dal;Bae, Jeong Hyo;Baek, Ki Tae
    • Korean Journal of Soil Science and Fertilizer
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    • v.45 no.6
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    • pp.1230-1236
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    • 2012
  • To verify that the electrokinetic remediation is effective for decreasing salinity of fields of the plastic-film house, field tests for physical property, chemical property, and crop productivity of soils have been conducted. The abridged result of those tests is as follows. In the EK treatment, the electrokinetic remediation has been treated at the constant voltage (about 0.8 V $cm^{-1}$) for fields of the farm household. At this time, an alternating current (AC) 220 V of the farm household was transformed a direct current. The HSCI (High Silicon Cast Iron) that the length of the stick for a cation is 20cm, and the Fe Plate for an anion have been spread out on the ground. As the PVC pipe that is 10 cm in diameter was laid in the bottom of soils, cations descend on the cathode were discharged together. For soil physical properties according to the EK treatment, the destruction effect of soil aggregate was large, and the infiltration rate of water was increased. However, variations of bulk density and porosity were not considerable. Meanwhile, in chemical properties of soils, principal ions of such as EC, $NO_3{^-}$-N, $K^+$, and $Na^+$ were better rapidly reduced in the EK treated control plot than in the untreated control plot. And properties such as pH, $P_2O_5$ and $Ca^{2+}$ had a small impact on the EK. For cropping season of crop cultivation according to the EK treatment, decreasing rates of chemical properties of soils were as follows; $NO_3{^-}$-N 78.3% > $K^+$ 72.3% > EC 71.6% $$\geq_-$$ $Na^+$ 71.5% > $Mg^{2+}$ 36.8%. As results of comparing the experimental plot that EK was treated before crop cultivation with it that EK was treated during crop cultivation, the decreasing effect of chemical properties was higher in the case that EK was treated during crop cultivation. After the EK treatment, treatment effects were distinct for $NO_3{^-}$-N and EC that a decrease of nutrients is clear. However, because the lasting effect of decreasing salinity were not distinct for the single EK treatment, fertilization for soil testing was desirable carrying on testing for chemical properties of soils after EK treatments more than two times. In the growth of cabbages according to the EK treatment, the rate of yield increase was 225.5% for the primary treatment, 181.0% for the secondary treatment, and 124.2% for third treatment compared with the untreated control plot. The yield was increased by a factor of 130.0% for the hot pepper at the primary treatment (Apr. 2011), 248.1% for the lettuce at the secondary treatment (Nov.2011), and 125.4% for the young radish at the third treatment (Jul. 2012). In conclusion, the effect of yield increase was accepted officially for all announced crops.

Effect of Reperfusion after 20 min Ligation of the Left Coronary Artery in Open-chest Bovine Heart: An Ultrastructural Study (재관류가 허혈 심근세포의 미세구조에 미치는 영향 : 재관류 손상에 관한 연구)

  • 이종욱;조대윤;손동섭;양기민;라봉진;김호덕
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.739-748
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    • 1998
  • Background: It has been well documented that transient occlusion of the coronary artery causes myocardial ischemia and finally cell death when ischemia is sustained for more than 20 minutes. Extensive studies have revealed that ischemic myocardium cannot recover without reperfusion by adequate restoration of blood flow, however, reperfusion can cause long-lasting cardiac dysfunction and aggravation of structural damage. The author therefore attempted to examine the effect of postischemic reperfusion on myocardial ultrastructure and to determine the rationales for recanalization therapy to salvage ischemic myocardium. Materials and methods: Young Holstein-Friesian cows(130∼140 Kg body weight; n=40) of both sexes, maintained with nutritionally balanced diet and under constant conditions, were used. The left anterior descending coronary artery(LAD) was occluded by ligation with 4-0 silk snare for 20 minutes and recanalized by release of the ligation under continuous intravenous drip anesthesia with sodium pentobarbital(0.15 mg/Kg/min). Drill biopsies of the risk area (antero-lateral wall) were performed at just on reperfusion(5 minutes), 1-, 2-, 3-, 6-, 12-hours after recanalization, and at 1-hour assist(only with mechanical respiration and fluid replacement) after 12-hour recanalization. The materials were subdivided into subepicardial and subendocardial tissues. Tissue samples were examined with a transmission electron microscope (Philips EM 300) at the accelerating voltage of 60 KeV. Results: After a 20-minute ligation of the LAD, myocytes showed slight to moderate degree of ultrastructural changes including subsarcolemmal bleb formation, loss of nuclear matrix, clumping of chromatin and margination, mitochondrial destruction, and contracture of sarcomeres. However, microvascular structures were relatively well preserved. After 1-hour reperfusion, nuclear and mitochondrial matrices reappeared and intravascular plugging by polymorphonuclear leukocytes or platelets was observed. However, nucleoli and intramitochondrial granules reappeared within 3 hours of reperfusion and a large number of myocytes were recovered progressively within 6 hours of reperfusion. Recovery was apparent in the subepicardial myocytes and there were no distinct changes in the ultrastructure except narrowed lumen of the microvessels in the later period of reperfusion. Conclusions: It is likely that the ischemic myocardium could not be salvaged without adequate restoration of coronary flow and that the microvasculature is more resistant to reversible period of ischemia than subendocardium and subepicardium. Therefore, thrombolysis and/or angioplasty may be a rational method of therapy for coronarogenic myocardial ischemia. However, it may take a relatively longer period of time to recover from ischemic insult and reperfusion injury should be considered.

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A Study on Improvement of Test Method of Nuclear Power Plant ESF ACS by applying Regulatory Guide 1.52 (Rev.3) (Reg. Guide 1.52(Rev.3)를 적용한 원전 ESF 공기정화계통 성능시험법 개선 연구)

  • Lee, Sook-Kyung;Kim, Kwang-Sin;Sohn, Soon-Hwan;Song, Kyu-Min;Lee, Kae-Woo;Park, Jeong-Seo;Cho, Byoung-Ho;Yoo, Byeang-Jea;Hong, Soon-Joon;Kang, Sun-Haeng
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.8 no.4
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    • pp.311-318
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    • 2010
  • U. S. NRC Regulation Guide 1.52 regulating ESF ACS in nuclear power plants has been revised to revision 3. To apply reduction of operability test time, allowance of alternative challenge agents for in-place leak test of HEPA filters, and upgrade of Methyl Iodide penetration acceptance criterion in activated carbon performance test suggested in Reg. Guide 1.52(Rev.3) on Yonggwang units 5 and 6 ESF ACSes, technical feasibility study was carried out with on-site experiments as well as experiments with a lab-scale model. It was confirmed that the moisture in the system returned to the level before the test in 1 or 4 days even though the moisture was removed during the operability test lasting more than 10 hours. Therefore, it is appropriate to perform monthly operability test in 15 minutes just long enough to check the operability of equipment. To change challenge material for in-place HEPA filter leak test, size of aerosol, production rate, and leak detection capability were compared for DOP and PAO. It was concluded that PAO can be substituted for DOP in nuclear power plants. The upgrade of Methyl Iodide penetration acceptance criterion from 0.175 % to 0.5 % in active carbon filter bed deeper than 4 inches was to conform to the change of activated carbon performance test method to ASTM D3803(1989). It was confirmed that Methyl Iodide penetration acceptance criterion of 0.5 % under $30^{\circ}C$, relative humidity 95 % condition was conservatively good enough for testing performance of active carbon insitu. The licence change of Yonggwang units 5 and 6 has been completed based on this study.

Multiplification of the Reality in Contemporary Sculpture (현대조각에 있어서 실재의 다중화)

  • You, Jae-Heung
    • Journal of Science of Art and Design
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    • v.12
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    • pp.65-96
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    • 2007
  • Today, the modern art is extremely diverse. It is denying its own boundary through chaos, extreme, abjection. In fact the diversity of the modern art can be best described as questioning and challenging to the essence of the reality, rather than the artistic pursuit of the beauties. The pursuit of the reality has been a long lasting discourse since the ancient. Through the history, the reality (referent) and representation (image) has been complementing and disposing each other in a relationship of a meaningful construction until the modern times. The limit of modernistic self-reference and the emergence of the figure leads to the emergence of Post-modernism in a trend of experimenting new visual arts. The return to the figure is clearly distinguished from existing representation's system and it brought new meanings to approaches and interpretations of the reality. In the case of Pop arts of 1960's and the following the modern sculptures, which is covered by this thesis, I put an emphasis on the diversification of those via changed strategies on the reality. In a situation where the reality is dictated by signified, the modern arts can no longer stay on a classic concept of representation, rather it pursuits new system and diverse strategies. I provide three types of strategic characters of the reality and the diversification of reality: the transition of the reality. These three types can be used as a frame work, which is supporting new aspects of the modern arts in reflecting on existing system. Therefore, the reason of categorizing is to distinguish modernistic arts and post modernistic arts, and to propose new post-modernistic discourses. Adapting J.F, Lyotard's view, absence is used to trace down the diversification of the reality thorough the sublime on the deconstruction of the mega discourses and the relationship of representation. Based on H. Faster's theory of the appropriation, the appropriation is used to exemplify the strategies of visual arts are in variations and being delayed. Lastly, in the transition, J. Baudrilliard's simulacre is used in terms of the concept of post modernistic representation. Based on the core of his theories, the deconstruction of existing concepts and simulation as the post modernistic representation, and the world of hyperreality based on simulacre are explained. These allows us to deny that representation is the expression of reality through mimesis. My aim is to work on the definition of the arts and representation in the modern era, and go further from there in order to clarify meaning and extension of the modern sculptures. Now two artists are reviewed based on their own art works: George Seagal; Jeff Koons. They are selected among numerous artists from the Post Modern era. Epic contents and emphasis on daily life of Seagal's works show good examples to artists from Pop Arts and following time period and may have served as a start point for Postmodernism. Indeed, he tried to show a newly defined relationship between art works and daily life experience. On the other hand, J.Koons used the strategies of fabrication and appropriation, which shows characteristics of the postmodernism. Through his four individual exhibitions, he shows the diversification of the reality based on art works as fetishistic merchandises, and newly defined concept of Ready-made since M Duchamp. Lastly, the diversification of the reality is analyzed again in context of my art works. I focused on the return to the figure among a variety of trends of late 20 th century modern sculpture. It showed the post modernistic point of view on the reality. Post modernistic diversified strategies are adopted as a method of distinguishing each art works via the diversification of the reality. This is the result of contemporary social and cultural situations.

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Clinical Characteristics of Neonatal Status Epilepticus (신생아 간질 중첩증의 임상 특성)

  • Jung, Kyeong Hun;Kim, Yun Hee;Kwon, Young Se;Jun, Yong Hoon;Kim, Soon Ki;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1342-1347
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    • 2005
  • Purpose : Among perinatal risk factors, neonatal seizures are one of the strongest independent discriminators of adverse outcome, representing high risks of mortality and neurologic morbidity. This study was undertaken to evaluate the neurologic outcome of neonatal status epilepticus according to underlying etiology, seizure pattern, onset time, and duration. Methods : We reviewed retrospectively 36 neonates(19 males, 17 females) with status epilepticus who were admitted to the neonatal intensive care unit, Inha Hospital between July, 1988 and June, 2003. They were evaluated with neurologic examination, laboratory data, EEG findings, and neuroimaging studies etc. Results : The mean gestational period of the patients was $37.0{\pm}3.6$ weeks and birth weight was $2.70{\pm}0.82$ kilogram. Fifty two point eight percent of the neonates were male and 66.7 percent were born at term. The most common cause of neonatal status epilepticus was hypoxic-ischemic encephalopathy. In preterm babies, intracranial hemorrhages showed an especially high frequency(P=0.034). Gestational age and birth weight did not show a correlation with neurologic complications. The incidence of neurological sequelae were significantly related to prolonged seizures lasting more than 1 hour(P=0.002). Neonates with seizures within the first 72 hours tended to be more frequent among those who developed adverse outcomes(P=0.016). Generalized tonic seizures had the worst prognosis, whereas those children who had subtle seizures had better outcomes than any other type(P<0.05). Generalized tonic seizures were primarily represented on EEG by abnormal background, whereas subtle seizure showed a significantly more normal EEG than any other seizures(P<0.05). Conclusion : Our results indicate that neonatal status epilepticus with early onsets, prolonged durations. And generalized tonic types can predict an increased risk for neurologic sequelae. So, those seizures must be perceived as medical emergencies and treated aggressively with antiepileptic drugs.

Evaluation of Future Turbidity Water and Eutrophication in Chungju Lake by Climate Change Using CE-QUAL-W2 (CE-QUAL-W2를 이용한 충주호의 기후변화에 따른 탁수 및 부영양화 영향평가)

  • Ahn, So Ra;Ha, Rim;Yoon, Sung Wan;Kim, Seong Joon
    • Journal of Korea Water Resources Association
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    • v.47 no.2
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    • pp.145-159
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    • 2014
  • This study is to evaluate the future climate change impact on turbidity water and eutrophication for Chungju Lake by using CE-QUAL-W2 reservoir water quality model coupled with SWAT watershed model. The SWAT was calibrated and validated using 11 years (2000~2010) daily streamflow data at three locations and monthly stream water quality data at two locations. The CE-QUAL-W2 was calibrated and validated for 2 years (2008 and 2010) water temperature, suspended solid, total nitrogen, total phosphorus, and Chl-a. For the future assessment, the SWAT results were used as boundary conditions for CE-QUAL-W2 model run. To evaluate the future water quality variation in reservoir, the climate data predicted by MM5 RCM(Regional Climate Model) of Special Report on Emissions Scenarios (SRES) A1B for three periods (2013~2040, 2041~2070 and 2071~2100) were downscaled by Artificial Neural Networks method to consider Typhoon effect. The RCM temperature and precipitation outputs and historical records were used to generate pollutants loading from the watershed. By the future temperature increase, the lake water temperature showed $0.5^{\circ}C$ increase in shallow depth while $-0.9^{\circ}C$ in deep depth. The future annual maximum sediment concentration into the lake from the watershed showed 17% increase in wet years. The future lake residence time above 10 mg/L suspended solids (SS) showed increases of 6 and 17 days in wet and dry years respectively comparing with normal year. The SS occupying rate of the lake also showed increases of 24% and 26% in both wet and dry year respectively. In summary, the future lake turbidity showed longer lasting with high concentration comparing with present behavior. Under the future lake environment by the watershed and within lake, the future maximum Chl-a concentration showed increases of 19 % in wet year and 3% in dry year respectively.

Ecological Characteristics of Bombus ignitus Smith in Korea (한국산 호박벌(Bombus ignitus Smith)의 생태적 특성)

  • ;;;;M. Bilinski
    • Korean journal of applied entomology
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    • v.38 no.2
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    • pp.101-107
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    • 1999
  • Queens of Korean native bumblebee species, Bombus ignitus were collected from the field in the spring of 1998 to investigate their ecological characteristics and reared under the laboratory conditions; 3 0 f 1$^{\circ}$C, 55 25% of relative humidity and darkness. As a result, 94.4% of the queens laid eggs in 6.00f 2.41 days after the field collection. The first worker and the first drone from the egg cell of the collected queens appeared in 18.90 f 1.16 and 68.96 f 3.94 days, respectively. In the colony foundation, 86.1% of the collected queens founded their colony, and 96.8% of them produced new queens in 71.14f 6.88 days. The life span of the colony-founded queen covered for 86.90f24.35 days, whereas that of non-colonized queen for 15.67 f 7.37 days. One colony sized as big as 987.82f 145.84 in number, composing of workers (188.79f 18.23), drones (691.10f 159.24) and queens (107.93 f47.48). Copulation lasting time of queen and drone took 23.00f 7.33 minutes in average. In a new queen emergence, there were two patterns; single peak type of new queen emergence in 12.31 k6.95 days and two peaks type of it in 74.00f 17.61 days. The number of eggs per egg cell of new queen averaged as 8.86f 4.00 grains and an egg period covered 3 days after oviposition. An egg cell sized as 7.15 f0.88 mm in a width, 7.79 f 1 .l 1 mm in a length and 3.33 f 0.23 mm in a height. An egg shaped as banana and sized as 1.22 f 0.09 mm in a width and as 3.5 1 f 0.21 mm in a length, weighing as 2.70 + 0.30 mg.

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Clinical Study of Acute and Chronic Pain by the Application of Magnetic Resonance Analyser $I_{TM}$ (자기공명분석기를 이용한 통증관리)

  • Park, Wook;Jin, Hee-Cheol;Cho, Myun-Hyun;Yoon, Suk-Jun;Lee, Jin-Seung;Lee, Jeong-Seok;Choi, Surk-Hwan;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.192-198
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    • 1993
  • In 1984, a magnetic resonance spectrometer(magnetic resonance analyser, MRA $I_{TM}$) was developed by Sigrid Lipsett and Ronald J. Weinstock in the USA, Biomedical applications of the spectrometer have been examined by Dr. Hoang Van Duc(pathologist, USC), and Nakamura, et al(Japan). From their theoretical views, the biophysical functions of this machine are to analyse and synthesize a healthy tissue and organ resonance pattern, and to detect and correct an abnormal tissue and organ resonance pattern. All of the above functions are based on Quantum physics. The healthy tissue and organ resonance patterns are predetermined as standard magnetic resonance patterns by digitizing values based on peak resonance emissions(response levels or high pitched echo-sounds amplified via human body). In clinical practice, a counter or neutralizing resonance pattern calculated by the spectrometer can correct a phase-shifted resonance pattern(response levels or low pitched echo-sounds) of a diseased tissue and organ. By administering the counter resonance pattern into the site of pain and trigger point, it is possible to readjust the phase-shifted resonance pattern and then to alleviate pain through regulation of the neurotransmitter function of the nervous system. For assessing clinical effectiveness of pain relief with MRA $I_{TM}$ this study was designed to estimate pain intensity by the patient's subjective verbal rating scale(VRS such as graded to no pain, mild, moderate and severe) before application of it, to evaluate an amount of pain relief as applied the spectrometer by the patients subjective pain relief scale(visual analogue scale, VAS, 0~100%), and then to observe a continuation of pain relief following its application for managing acute and chronic pain in the 102 patients during an 8 months period beginning March, 1993. An application time of the spectrometer ranged from 15 to 30 minutes daily in each patient at or near the site of pain and trigger point when the patient wanted to be treated. The subjects consisted of 54 males and 48 females, with the age distribution between 23~40 years in 29 cases, 41~60 years in 48 cases and 61~76 years in 25 cases respectively(Table 1). The kinds of diagnosis and the main site of pain, the duration of pain before the application, and the frequency of it's application were recorded on the Table 2, 3 and 4. A distinction between acute and chronic pain was defined according to both of the pain intervals lasting within and over 3 months. The results of application of the spectrometer were noted as follows; In 51 cases of acute pain before the application, the pain intensities were rated mild in 10 cases, moderate in 15 cases and severe in 26 cases. The amounts of pain relief were noted as between 30~50% in 9 cases, 51~70% in 13 cases and 71~95% in 29 cases. The continuation of pain relief appeared between 6~24 hours in two cases, 2~5 days in 10 cases, 6~14 days in 4 cases, 15 days in one case, and completely relived of pain in 34 cases(Table 5~7). In 51 cases of chronic pain before the application, the pain intensities were rated mild in 12 cases, moderate in l8 cases and severe in 21 cases. The amounts of pain relief were noted as between 0~50% in 10 cases, 51~70% in 27 cases and 71~90% in 14 cases. The continuation of pain relief appeared to have no effect in two cases. The level of effective duration was between 6~12 hours in two cases, 2~5 days in 11 cases, 6~14 days in 14 cases, 15~60 days in 9 cases and in 13 cases the patient was completely relieved of pain(Table 5~7). There were no complications in the patients except a mild reddening and tingling sensation of skin while applying the spectrometer. Total amounts of pain relief in all of the subjects were accounted as poor and fair in 19(18.6%) cases, good in 40(39.2%) cases and excellent in 43(42.2%) cases. The clinical effectiveness of MRA $I_{TM}$ showed variable distributions from no improvements to complete relief of pain by the patient's assessment. In conclusion, we suggest that MRA $I_{TM}$ may be successful in immediate and continued pain relief but still requires several treatments for continued relief and may be gradually effective in pain relief while being applied repeatedly.

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