• Journal of Chest Surgery
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• v.37 no.9
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• pp.735-741
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• 2004

Blood cardioplegia is known as an established cardioplegic solution during open heart surgery. Recently, the Histidine-Tryptophan-Ketoglutarate (HTK) solution has been introduced as a cardioplegia in Korea. This study was designed to compare the myocardial protective effect between the cold blood cardioplegia (CBC) and HTK solution. Material and Method: Forty patients who underwent valve surgery or coronary artery bypass surgery were randomly divided into CBC group (n=20) and HTK group (n=20). The perioperative hemodynamic and clinical data were analyzed. The concentration of CK-MB, Troponin 1 and Lactate from coronary sinus and radial arterial blood were compared for the evaluation of the myocardial damage. The postoperative serial CK-MB levels were measured. Result: The characteristics of preoperative patients were similar in two groups. The hemodynamic parameters and postoperative clinical data were also similar between the two groups. There were no statistical significances between the CBC and HTK group in the difference of biochemical markers: Δ CK-MB (15.3$\pm$26.0 vs 19.3$\pm$14.3), ΔTro-1 (2.4$\pm$4.9 vs 2.0$\pm$2.20), ΔLac (1.6$\pm$1.0 vs 1.9$\pm$2.5). The serial CK-MB levels were not significantly different between the two groups. Conclusion: These results suggested that the myocardial protective effect of HTK solution was similar to cold blood cardioplegia during open heart surgery.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.749-754
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• 2004

Off-pump coronary artery bypass grafting (Off-Pump CABG) has been proven to have less morbidity and to facilitate early recovery. High-risk surgical patients may have benefitted by avoiding the adverse effects of the cardiopulmonary bypass. We compared the effectiveness of Off-Pump CABG with that of coronary artery bypass using cardiopulmonary bypass (On-Pump CABG) in high-risk patients. Material and Method: 682 patients (424 Off-Pump CABG and 258 On-Pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Patients who were considered high risk were selected High risk is defined as the presence of one or more of nine adverse prognostic factors. Data were collected from 492 patients in Off-Pump CABG and 100 in On-Pump CABG for risk factors, extent of coronary disease, and in-hospital outcomes. Result： Off-Pump CABG group and On-Pump CABG group did not show differences in their preoperative risk factors. We used more arterial grafts in Off-Pump CABG group (p < 0.05). Postoperative results showed that operative mortality (0.5% in Off-Pump CABG versus 2.0% in On-Pump CABG), renal failure (2.6% in Off-Pump CABG versus 7.0% in On-Pump CABG), and perioperative myocardial infarction (1.5% in Off-Pump CABG versus 1.0% in On-Pump CABG) did not differ significantly. However, Off-Pump CABG had shorter mean operation time (p<0.05), lower mean CK-MB level (p <0.05), lower rate of usage of inotropics (p < 0.05), shorter mean ventilation time (p <0.05), lower perioperative stroke (0% versus 2.0%), and shorter length of stay (p < 0.05) than On-Pump CABG. On-Pump CABG had more distal grafts (p<0.05) than Off-Pump CABG. Although Off-Pump CABG and On-Pump CABG did not show statistical differences in mortality and morbidity was more frequent in CABG. Conclusion: Off-Pump CABG reduces morbidity and favors hospital outcomes. Therefore, Off-Pump CABG is safe, reasonable and may be a preferable operative strategy for high-risk patients.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.413-421
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• 1999

Background: Ischemia reperfusion injury is known to contribute to the major causes of the early graft failure in lung transplantation. Triiodothyronine (T3) has been suggested to ameliorate ischemia reperfusion injury from both in vivo and in vitro experiments of various organs. Prospecting its beneficial effect for pulmonary allograft preservation, we made a new solution by adding T3 into the extracellular type dextran solution. Material and Method: Twelve adult mongrel dogs underwent left lung allotransplantation. Six donor dogs were flushed with the new solution(Group 1, n=6), and the remaining six were flushed with Euro-Collins solution to serve as controls(Group 2, n=6). Allografts were stored in each preservation solution for 20 hours at 4$^{\circ}C$. Left single lung transplantations were performed. The right pulmonary artery and the right main bronchus were clamped at 15 minutes after the reperfusion and maintained throughout the experiment to evaluate the transplanted left lung function. Result: Arterial carbon dioxide tension was better in group 1 than in group 2 throughout the experiment period and the difference was statistically significant at 2 hours after reperfusion(28.0${\pm}$3.0 mmHg and 53.1${\pm}$17.4 mmHg, p<0.05). The differences of arterial oxygen partial pressure, peak airway pressure and pulmonary vascular resistance showed no statistical significance. The malondialdehyde(MDA) level, measured from tissue obtained at 120 minutes after reperfusion showed no statistically significant difference. The tissue wet/dry ratio of group 1(649${\pm}$27 %) was significantly lower than that of group 2(686${\pm}$71 %, p<0.05). The microscopic examination revealed varying degrees of injury represented mainly by findings such as perivascular neutrophil infiltration, capillary hemorrhage and interstitial congestion. These findings were less severe in group 1 than those in group 2. Conclusion: The new solution demonstrated superior allograft preservation after 20 hour ischemia compared to Euro-Collins solution in canine single left lung transplantation model, these results suggest that T3 might be a promising agent for pulmonary allograft preservation.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.136-141
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• 2003

We assessed the intermediate-term result of tricuspid annuloplasty (TAP) for tricuspid valve regurgitation (TR) associated with congenital heart disease in adults. Risk factors for residual TR were also analysed. Material and Method: From August 1989 to June 2001, seventy three adult patients, 51 females and 22 males, underwent TAP for TR associated with various congenital heart disease. Their age ranged from 46 years to 73 years (mean:43). Associated heart anomalies were atrial septal defect (55), ventricular septal defect (6), partial anomalous pulmonary venous return (4) and others (8). Preoperative and post-operative TR velocities were 3.25 m/sec and 2.56 m/sec respectively, and the types of TAP were De Vega in 43, Kay in 18 and Ring annuloplasty in 12. Postoperative follow-up duration was 2,347 patient-month (mean: 32.6 months), and 134 two-dimensional echocardiographic examinations were done during this period. Residual TR greater than III/IV was considered as TAP failure. Result: TAP failure was observed in 7 patients (9.6%), and one patient among them underwent tricuspid valve replacement. Risk factors for TAP failure were diagnosis other than atrial septal defect (p=0.001), preoperative (p=0.038) and postoperative (p=0.028) high TR velocity. There was no statistical significance in terms of TAP methods. Conclusion: Careful evaluation of valve morphology and aggressive surgical intervention are mandatory for the repair of TR with preoperative or residual RV pressure overload.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.317-323
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• 2009

Background: Although high efficiency of conversion into sinus rhythm has been demonstrated after performing the Cox-Maze procedure in patients with atrial fibrillation associated with mitral valve disease, the changes in the mechanical function and size of the left atrium have not been determined. The aim of the study was to evaluate the effect of the Maze procedure on the left atrial size and contractile transport function. Material and Method: From July 1997 to July 2008, 647 consecutive patients were operated on for chronic atrial fibrillation associated with mitral valve disease. Among these, 211 patients that (1) were able to be followed up for 2 years after surgery, (2) had sustained normal sinus rhythm, regardless of whether they were taking anti-arrhythmic medications and (3) did not have valvular regurgitation greater than grade III or they did not have moderate grade valvular stenosis were selected for evaluation. The left atrial size and contractile transport function were assessed by transthoracic echocardiography at the postoperative base line (1 year) and at regular follow-up periods (2 years, 3 years, 4 years and 6 year). Result: The left atrial dimension was increased and the contractile transport function was decreased during the follow-up period. The longer the follow-up period, the greater was the statistical significance of the left atrial size increase and contractile transport function decrease. Conclusion: In patients who sustain normal sinus rhythm conversion after a Maze III procedure with a mitral valve operation, there is a gradual increase of the left atrial dimensions and a decrease of contractile transport function during the follow-up period. Therefore, scrupulous follow-up is needed for these patients.

• Korean Journal of Food Science and Technology
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• v.30 no.2
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• pp.324-332
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• 1998

In order to standardize the chinese cabbage kimchi, the preparation method, kinds of ingredients and levels of the ingredients were determined by the statistical survey of literatures obtained from cooking books, scientific papers and kimchi manufacturing factory. The standardized ingredient kinds and ratio of chinese cabbage kimchi were $13.0{\pm}7.0$ of radish, $2.0{\pm}0.5$ of green onion, $3.5{\pm}0.8\;or\;2.5{\m}0.3$ of red pepper powder, $1.4{\pm}0.4$ of garlic, $0.6{\pm}0.3$ of ginger, $2.2{\pm}1.6$ of anchovy juice, and $1.0{\pm}0.3$ of sugar in the proportion of 100 salted chinese cabbage, and the final salt concentration was adjusted to 2.7% using salt. Red pepper powder level was quite different from the literature sources, so sensory evaluation, chemical properties and antimutagenic effect and growth inhibitory effect on human cancer cells of the kimchi samples were studied to decide the proper ratio of the red pepper powder as an ingredient. Red pepper powder 3.5% (average level for kimchi manufacturing factory) added kimchi was better in quality than red pepper powder 2.5% (average level for cooking books and scientific papers) added kimchi in sensory evaluation and chemical properties. The juice of red pepper powder 3.5% added kimchi showed not only the stronger antimutagenicity against aflatoxin $B_1$ in Salmonella typhimurium TA100 but also the higher inhibitory effect on the growth of AGS human gastric adenocarcinoma cells in SRB assay than that of red pepper powder 2.5% added kimchi. In conclusion, the standardized ratio of the ingredients was 13.0 radish, 2.0 green onion, 3.5 red pepper powder, 1.4 garlic, 0.6 ginger, 2.2 anchovy juice, 1.0 sugar, and 2.7 final salt concentration in the proportion of 100 salted chinese cabbage.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.3
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• pp.197-205
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• 2011

Purpose: This study was to evaluate the accuracy of the implant torque controller used in dental clinics and to investigate whether it was applied appropriately. Materials and methods: Fifty dentists who work in dental clinics were enrolled in this study. Dental (implant) practice career, experience frequency of implant screw loosening and fracture, education of implant torque controller application and infection control methods were included in the survey. 25 Ncm and 30 Ncm of the tightening torque applied to the implant screw were measured by 50 clinicians. After measuring the torque value by using the torque controller, the torque mean according to where education about the implant torque controller was received was analyzed with independent t-test at the significance level of 0.05. Results: The torque controller used in private dental clinics showed 4.78% error ratio. When 50 dentists applied 25 Ncm to the implant screw was $29.0{\pm}8.4$ Ncm, and that in 30 Ncm was $34.3{\pm}9.1$ Ncm. Statistical significance was found between the group that was educated about implant torque application and the group that was not educated. Conclusion: During the prosthodontic treatment with implant, there was difference between actual applied torsion force and the amount torque controller indicated. Clinicians have to not only be well-informed about the accurate usage method of the torque controller, but also keep and manage the torque controller so as to maintain continuous and accurate torque values. Through this, it is considered to achieve clinical results to minimize problems of screw loosening or fracture.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.121-131
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• 2004

Objectives: This study was conducted to understand the status of influenza vaccination in some rural communities and to apply the results to formulate a counterplan for influenza prevention. Methods: The authors conducted a questionnaire survey from May 26 to May 29, 2003 among the residents in two rural communities: 602 people at the village Gigye-myeon and 965 at the village Cheongsong-gun. For statistical analysis the chi-square test and chi-square for trend method were used. Significance was set a p<0.05. Results: The study group contained 722 (46.1%) males and 845 (53.9%) females. In response to the question 'Influenza vaccination must be taken every year', 845 people (86.0%) replied 'Yes'. In response to the question 'Influenza vaccination can prevent cold', 224 people (20.8%) replied 'No'. The rate of influenza vaccination increased every year from 2000 to 2002 (p<0.05) and was lower for those under sixty-four than for those over sixty-five. In response to the question 'Plan to receive influenza vaccination in 2003', 531 people (52.8%) responded they will have influenza vaccination. Conclusions: Many people had a wrong perception about influenza vaccination. Therefore, their wrong perception must be corrected by a publicity campaign. The rate of influenza vaccination for those from over fifty to under sixty-four should be increased by public policy because they are as susceptible to influenza as those over sixty-five. This study produced meaningful results from the investigation into the status of influenza vaccination for the residents in rural communities and these findings can be utilized in the formulation of future influenza vaccination policy.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.181-190
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• 2005

The results of biventricular repair for double outlet right ventricle have been improved in recent series. We studied the surgical and long term results for total correction of double outlet right ventricle by the type of ventricular septal defect. Material and Method: Between November 1979 and December 2003, 126 patients had biventricular repair for double outlet right ventricle. The mean age was 1.8 years (range 1$\~$44) and 86 patients ($68.3\%$) were male. We classified and studied this disease by the type of VSD. Result: The locations of VSD were subaortic in 79 ($62.7\%$), subpulmonary in 17 ($13.5\%$), doubly committed in 16 ($12.7\%$) and noncommitted in 14 ($11.1\%$). 28 patients had palliative operation before total correction and the mean interval to total correction was 41.0$\pm$45.1 months. The methods of total correction were intraventricular baffling in 37 ($29.4\%$), intraventricular baffling with patch enlargement of right ventricular outflow tract in 49 ($38.9\%$), intraventricular baffling with Rastelli procedure in 15 ($11.9\%$), arterial switch operation in 8 ($6.3\%$) and REV procedure in 4 ($3.2\%$), etc. Hospital mortality rate was $10.3\%$ (13 patients) and 25 reoperations were performed in 24 patients ($19.0\%$). The risk factors for hospital mortality and reoperation were cardiopulmonary bypass time (p=0.020) and previous palliative operation (p=0.013), respectively. Follow up was possible in 98 patients and mean follow up period was 118.9$\pm$70.7 months. The percent survival and survival for freedom from reoperation at 15 years were $82.5\%$ and $66.7\%$, respectively. The survival rate was significantly lower (p=0.003) in transposition of great artery type and remote type than in simple ventricular septal defect type and tetralogy of Fallot type, but there was no statistical differences in survival rate for freedom from reoperation. Conclusion: It is thought to be that acceptible surgical and long term results can be obtained with application of appropriate methods of repair for double outlet right ventricle.

• Journal of Environmental Policy
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• v.9 no.2
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• pp.185-205
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• 2010

Climate change vulnerability assessment based on local conditions is a prerequisite for establishment of climate change adaptation policies. While some studies have developed a methodology for vulnerability assessment at the national level using statistical data, few attempts, whether domestic or overseas, have been made to develop methods for local vulnerability assessments that are easily applicable to a single city. Accordingly, the objective of this study was to develop a conceptual framework for climate change vulnerability, and then develop a general methodology for assessment at the regional level applied to a single coastal city, Mokpo, in Jeolla province, Korea. We followed the conceptual framework of climate change vulnerability proposed by the IPCC (1996) which consists of "climate exposure," "systemic sensitivity," and "systemic adaptive capacity." "Climate exposure" was designated as sea level rises of 1, 2, 3, 4, and 5 meter(s), allowing for a simple scenario for sea level rises. Should more complex forecasts of sea level rises be required later, the methodology developed herein can be easily scaled and transferred to other projects. Mokpo was chosen as a seaside city on the southwest coast of Korea, where all cities have experienced rising sea levels. Mokpo has experienced the largest sea level increases of all, and is a region where abnormal high tide events have become a significant threat; especially subsequent to the construction of an estuary dam and breakwaters. Sensitivity to sea level rises was measured by the percentage of flooded area for each administrative region within Mokpo evaluated via simulations using GIS techniques. Population density, particularly that of senior citizens, was also factored in. Adaptive capacity was considered from both the "hardware" and "software" aspects. "Hardware" adaptive capacity was incorporated by considering the presence (or lack thereof) of breakwaters and seawalls, as well as their height. "Software" adaptive capacity was measured using a survey method. The survey questionnaire included economic status, awareness of climate change impact and adaptation, governance, and policy, and was distributed to 75 governmental officials working for Mokpo. Vulnerability to sea level rises was assessed by subtracting adaptive capacity from the sensitivity index. Application of the methodology to Mokpo indicated vulnerability was high for seven out of 20 administrative districts. The results of our methodology provides significant policy implications for the development of climate change adaptation policy as follows: 1) regions with high priority for climate change adaptation measures can be selected through a correlation diagram between vulnerabilities and records of previous flood damage, and 2) after review of existing short, mid, and long-term plans or projects in high priority areas, appropriate adaptation measures can be taken as per this study. Future studies should focus on expanding analysis of climate change exposure from sea level rises to other adverse climate related events, including heat waves, torrential rain, and drought etc.