• Journal of Chest Surgery
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• v.36 no.7
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• pp.463-471
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• 2003

The long-term results of combined mitral valve repair and aortic valve replacement (AVR) have not been well evaluated. This study was performed to investigate the early and long-term results of mitral valve repair with AVR. Material and Method: We retrospectively reviewed 45 patients who underwent mitral valve repair and AVR between September 1990 and April 2002. The average age was 47 years: 28 were men and 17 women. Twelve patients had atrial fibrillation and three had a previous cardiac operation. The mitral valve disease consisted of pure insufficiency (MR) in 34 patients, mitral stenosis (MS) in 3, and mixed lesion in 8. Mitral valve disease was due to rheumatic origin in 24 patients, degenerative in 11, annular dilatation in 8, and ischemia or endocarditis in 2. The functional anatomy of mitral valve was annular dilatation in 31 patients, chordal elongation in 19, leaflet thickening in 19, commissural fusion in 13, chordal fusion in 10, chordal rupture in 6, and so on. Aortic prostheses used included mechanical valve in 32 patients, tissue valve in 12, and pulmonary autograft in one. The techniques of mitral valve repair included annuloplasty in 32 patients and various valvuloplasty of 54 techniques in 29 patients. Total cardiopulmonary bypass and aortic cross clamp time were 204$\pm$62 minute and 153$\pm$57 minutes, respectively. Result: Early death was in one patient due to low output syndrome (2.2%). After follow up of 57$\pm$37 months, late death was in one patient and the actuarial survival at 10 years was 96$\pm$4%. Recurrent MR developed grade II or III in 11 patients and moderate MS in 3. Three patients required reoperation for valve-related complications. The actuarial freedom from recurrent MR, MS, and reoperation were 64$\pm$11%, 86$\pm$8%, and 89$\pm$7% respectively. Conclusion: Combined mitral valve repair with AVR offers good early and long-term survival, and adequate techniques and selection of indication of mitral valve repair, especially in rheumatic disease, are prerequisites for better long-term results.

• Journal of Society of Preventive Korean Medicine
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• v.5 no.2
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• pp.40-68
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• 2001

In this study, grade of subjective symptom appealed by laborer of Jeollabuk-do was evaluated using questionary regarding factor made effect on musculoskeletal disease and in addition, studied relationship with health promotion life style of them. Based on the result, relationship of general characteristics of musculoskeletal subjective symptom and life-style of the subjects was concluded as below. 1. General characteristics of study subjects were as following. Ratio of male was higher as 57.7% of male and 42.2% female and age distribution was 5.1% of 20s, 34.99% of 30s, 36.3% of 40s and 23.7% of 50s and therefore, $30{\sim}40$ aged groups showed highest ratio. Most subjects (74.9%) was married status and in case of education level, high-school graduate and dropout (23.3%) and over-college graduate (46.8%) showed highest distribution. $1{\sim}2$ Mil. KRW (29.5%) and $2{\sim}2.99$ Mil. KRW (21.2%) is the main income distribution and however there was high ratio of non-reply (29.0%). In case of employment period, $10{\sim}14$ years (15.3%) and over 15 years (29.6%) showed highest ratio and there were many non-reply (39.4%) and in addition, 67.6% replied as own house and 14.3% as lease on deposit base in question of residence type. 2. Subjects showed high ratio of subjective symptom appeal of 62.79% and many cases (50.23%) appealed 1 or 2 symptoms. Symptom by body region was 29.8% (waist), 27% (shoulder), 21.2% (knee), 15.5% (neck), 9.5% (ankle), 8.1% (wrist) and 5.0% (elbow) in order. In case of relationship with general characteristics, female comparing with male, non-residence of own house, subjects with lower education level and employment period of $10{\sim}14$ years showed higher appeal rate and kind of symptoms than others. Therefore, it was concluded that rate of musculoskeletal symptom appeal have close relationship with gender, level of living, education level, age and employment period. 3. In case of severe pain of upper body except waist and ankle, it was appealed in both or right side and it means that upper body pain is originated from right side and right region pain is transited to both region pain. In addition, there was 39.41% of non-reply to existence of right-left region pain and therefore, it was evaluated that, in may cases, there was no awareness of their own symptom condition even on subjective symptom. 4. Degree of pain was, as pain over middle level, evaluated as 2.79 on full mark of 4.0 and in order of waist (2.97), ankle (2.83), knee (2.82), wrist (2.82), neck (2.79), shoulder (2.70) and elbow (2.62). In addition, 71.97% appealed $2{\sim}3$ cases for the latest 1 week. Owing to subjective symptom, 54.95% drop into hospital or pharmacy, 10.32% made temporary retirement or absence, 7.99% transferred into more comfortable duty and $39.4{\sim}54%$ experienced one or more managing mentioned above. 5. Fulfillment of health promotion life style of subjects was evaluated on full mark of 4.0 and total score was 2.63. Average mark of each area was personal relationship (3.05), self-realization (2.92), stress management (2.63), health control (2.48), physical exercise (2.19) and nutrition management (2.19) and personal relationship was highest and physical exercise and nutrition management were lowest. As general characteristics influencing health promotion life style, gender, residence style and employment period showed significant difference. Male showed higher mark than female and showed higher mark in order of own house, others, lease on deposit base, monthly rent. Subjects with longer employment period showed higher mark with significant difference. 6. Accounting of factor influencing each area of health promotion life style, self-realization showed significance in marriage status, income, residence style and education level and health control in age, residence style and employment period. Physical exercise showed significant difference in gender, age, residence style and employment period and nutrition in gender, age, residence style and employment period. Stress management showed significant difference in residence style and employment period and however not in personal relationship. 7. Health promotion life style relating with existence and kind of pain showed significant difference in all area except personal relationship area. In absence of pain, there was statistically significant high score in all area even in total health promotion life style and all area. Accounting of kind of pain, cases of $1{\sim}2$ kinds of pain and $5{\sim}6$ kinds of pain showed relatively high score and it was lower than mark of subject stated absence of pain. 8. Subjects appeal symptom were classified by symptom region and difference of total and each areas were evaluated. General area (p=0.002), self-realization (p=0.012), health management (p=0.023), physical exercise (p=0.028), nutrition management (p=0.028) and stress control (p=0.001) showed statistically significant difference and not in personal relationship area. Especially, elbow, shoulder and neck area marked high and group appealed pain of knee, arm and elbow, foot and ankle marked low. Based on those results, subjective symptom should be accounted seriously in diagnosis of occupational musculoskeletal disease of laborer and among subjective symptom, general characteristics of gender, age, condition of living, education level and employment period make effect. Generally subject appeal symptom marked lower than subject without symptom appeal and it means that life management of subject appealing musculoskeletal pain make important role in management and treatment of occupational musculoskeletal disease.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.67 no.1
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• pp.1-8
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• 2022

In order to manufacture feed suitable for consumer use and provide feed value information, we analyzed the feed components of the four main forage rice varieties by plant parts harvested 30 days after heading. The contents of the six feed ingredients were significantly different (p<0.05) among harvested parts. In the panicle, the crude protein (CP) (6.97%) and lignin (3.11%) were the highest, while the crude ash (CA) and neutral detergent fiber (NDF) contents were significantly lower, resulting in a total digestible nutrient (TDN) content of 77.29%, which is higher than that of the stem (64.82%) and leaf blade and sheath (LBS) (63.57%) (p<0.05). In contrast, the content of crude fat (CF) did not differ significantly among parts (p<0.05). In panicles from 'Jonong', 'Nokyang' and 'Yeongwoo', the TDN content of each cultivar was 78.48-79.07%, with no significant difference among the varieties. In 'Mogwoo' (Mw), the CP content was 8.70%, which was much higher than that of other varieties (p<0.05). In particular, the Mw TDN content was slightly lower in the panicle (72.95%) but higher in the stem (75.37%) and LBS (66.49%) than in the other varieties. The CA, NDF, acid detergent fiber (ADF), and lignin contents were also very low compared to other varieties; therefore, the feed value of the stem and LBS was excellent. In addition, the total dry matter weight (DMW) was 123 g per hill, which was much higher than 82-105 g per hill for other varieties. The distribution of DMW by part was LBS (56.9 g), stem (36.8 g), and panicle (29.3 g), and because the parts, except the panicles, were much higher than the 43-57% of other varieties (grain straw ratio: 76%), rice straw is advantageous in terms of quantity and feed value when used as forage on farms. The relative feed value (RFV) of the four cultivars ranged from 86.79-403.74 across all parts, and hay of grade 3 or higher with an RFV of 100 or more increased with delayed heading in both stems and LBS. This is due to the accumulation of starch into grains during ripening, which supports the observation that the RFV of the early flowering 'Jonong' and 'Nokyang' panicles increased.

• Korea Science and Art Forum
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• v.32
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• pp.319-334
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• 2018

This research is a case study to make sure the enhancement of students' imagination and creativity through developing and applying the Literature-Art-Science Integrated Education Program. Its research object was totally 25 persons of 29 students of the 1st to the 4 th Grades from Gunsan Sulsan Elementary School. Its research period lasted for 4 months from September to December, 2017, and I, as the research place, used the art room at Gunsan Sulsan Elementary School. The programs were totally 10 sessions with a unit of 1 session per each grade for 2 hours from 1:00 to 3:00 in the afternoon from Monday through Friday. I fixed ten themes of this program-eight plane modeling, and two solid modeling, and finished the work of storytelling during summer vacation. And I arranged their levels as low:middle:high(3:5:2) ones. The former was 'A Film of Monster Gorilla'(L), 'Learning the Spirit of Gyeongju Choi's Family'(M), 'A Tale of My Friend Made of Natural Materials'(L), 'The Reading of My Dream'(M), 'Gathering the Objects in My Mobile'(M), 'A Mock Trial of Marrying Off'(M), 'Painting My Favorite Children's Poem'(H), and 'Painting My Favorite Children's Song'(H), and the latter was 'Seeking for a Bluebird in My Mind'(L), and 'Making My Cherished Object' (M). Then I used the unique art expression technique per each theme, which were in sequence marbling, Korean paper art, combine painting, collage, imaginary painting, imaginary painting, play dough art, imaginary painting techniques. And I delivered to the students the scientific knowledge in terms of growing or manufacturing processes of materials used for making artworks. Prior to and after the processing this program, I surveyed about the students' ability of integrated thinking and emotional experience by 'Figure B Type' and 'Figure A Type' of The Torrance Tests of Creative Thinking, and took statistics with the resultant data. And I executed a paired t-test in order to verify the significance of mean difference in the result of investigation with those data. From the analyzed result according to the elements of creativity and the mean quotients of creativity, there showed a significant difference (t=3.47, p<.01) in 'fluency', and also a significant difference(t=3.59, p<.01) in 'creativity.' Judging from the statistic values of two fields such as the student's ability of integrated thinking and emotional experience, I estimate that over the majority of the students showed the enhancement in self-confident creative expression as well as higher interest and concern through this program. The result that I arranged and analyzed the making process of artworks, the photos of the resultant, etc. as such is as follows : Firstly, from this program being proceeded as art-centered STEAM class, the student's systematic problem-solving ability was improved in his ability of integrated thinking to transform the literary contents into artistic one. Secondly, the student obtained the emotional experience such as interest in the class, self-confidence, intellectual satisfaction, self-fulfillment, etc. through art-centered STEAM class using ten art expression techniques. Thirdly, the student's mind willing to cooperate, communicate with his friends, and care for them was ripened in the process of problem-solving. Fourth, the student's self-confidence was further instilled when presenting famous artists and their artworks in the introduction and finale of ten art expression techniques. Likewise, the statistic values on the fields of student's ability of integrated thinking and emotional experience illustrate that over the majority of the students showed improvement in the ability of creative expression with confidence as well as higher interest and concern upon this program.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.247-256
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• 2008

Purpose: The purpose of this study is to evaluate anal sphincter preservation rates, survival rates, and prognostic factors in patients with rectal cancer treated with preoperative chemoradiotherapy. Materials and Methods: One hundred fifty patients with pathologic confirmed rectal cancer and treated by preoperative chemoradiotherapy between January 1999 and June 2007. Of the 150 patients, the 82 who completed the scheduled chemoradiotherapy, received definitive surgery at our hospital, and did not have distant metastasis upon initial diagnosis were enrolled in this study. The radiation dose delivered to the whole pelvis ranged from 41.4 to 46.0 Gy (median 44.0 Gy) using daily fractions of $1.8{\sim}2.0\;Gy$ at 5 days per week and a boost dose to the primary tumor and high risk area up to a total of $43.2{\sim}54\;Gy$ (median 50.4 Gy). Sixty patients (80.5%) received 5-fluorouracil, leucovorin, and cisplatin, while 16 patients (19.5%) were administered 5-fluorouracil and leucovorin every 4 weeks concurrently during radiotherapy. Surgery was performed for 3 to 45 weeks (median 7 weeks) after completion of chemoradiotherapy. Results: The sphincter preservation rates for all patients were 73.2% (60/82). Of the 48 patients whose tumor was located at less than 5 cm away from the anal verge, 31 (64.6%) underwent sphincter-saving surgery. Moreover, of the 34 patients whose tumor was located at greater than or equal to 5 cm away from the anal verge, 29 (85.3%) were able to preserve their anal sphincter. A pathologic complete response was achieved in 14.6% (12/82) of all patients. The downstaging rates were 42.7% (35/82) for the T stage, 75.5% (37/49) for the N stage, and 67.1% (55/82) for the overall stages. The median follow-up period was 38 months (range $11{\sim}107$ months). The overall 5-year survival, disease-free survival, and locoregional control rates were 67.4%, 58.9% and 84.4%, respectively. The 5-year overall survival rates based on the pathologic stage were 100% for stage 0 (n=12), 59.1% for stage I (n=16), 78.6% for stage II (n=30), 36.9% for stage III (n=23), and one patient with pathologic stage IV was alive for 43 months (p=0.02). The 5-year disease-free survival rates were 77.8% for stage 0, 63.6% for stage I, 58.9% for stage II, 51.1% for stage III, and 0% for stage IV (p<0.001). The 5-year locoregional control rates were 88.9% for stage 0, 93.8% for stage I, 91.1% for stage II, 68.2% for stage III, and one patient with pathologic stage IV was alive without local recurrence (p=0.01). The results of a multivariate analysis with age (${\leq}55$ vs. >55), clinical stage (I+II vs. III), radiotherapy to surgery interval (${\leq}6$ weeks vs. >6 weeks), operation type (sphincter preservation vs. no preservation), pathologic T stage, pathologic N stage, pathologic overall stage (0 vs. I+II vs. III+IV), and pathologic response (complete vs. non-CR), only age and pathologic N stage were significant predictors of overall survival, pathologic overall stage for disease-free survival, and pathologic N stage for locoregional control rates, respectively. Recurrence was observed in 25 patients (local recurrence in 10 patients, distant metastasis in 13 patients, and both in 2 patients). Acute hematologic toxicity ($\geq$grade 3) during chemoradiotherapy was observed in 2 patients, while skin toxicity was observed in 1 patient. Complications developing within 60 days after surgery and required admission or surgical intervention, were observed in 11 patients: anastomotic leakage in 5 patients, pelvic abscess in 2 patients, and others in 4 patients. Conclusion: Preoperative chemoradiotherapy was an effective modality to achieve downstaging and sphincter preservation in rectal cancer cases with a relatively low toxicity. Pathologic N stage was a statistically significant prognostic factor for survival and locoregional control and so, more intensified postoperative adjuvant chemotherapy should be considered in these patients.