• Journal of Chest Surgery
• /
• v.31 no.5
• /
• pp.472-480
• /
• 1998

We reviewed the surgical results of intracardiac lateral tunnel Fontan procedure for the repair of functional single ventricles. Between 1990 and 1996, 104 patients underwent total cavopulmonary anastomosis. Patients' age and body weight averaged 35.9(range 10 to 173) months and 12.8(range 6.5 to 37.8) kg. Preoperative diagnoses included 18 tricuspid atresias and 53 double inlet ventricles with univentricular atrioventricular connection and 33 other complex lesions. Previous palliative operations were performed in 50 of these patients, including 37 systemic to pulmonary artery shunts, 13 pulmonary artery bandings, 15 surgical atrial septectomies, 2 arterial switch procedures, 2 resections of subaortic conus, 2 repairs of total anomalous pulmonary venous connection and 1 Damus-Stansel-Kaye procedure. In 19 patients bidirectional cavopulmonary shunt operation was performed before the Fontan procedure and in 1 patient a Kawashima procedure was required. Preoperative hemodynamics revealed a mean pulmonary artery pressure of 14.6(range 5 to 28) mmHg, a mean pulmonary vascular resistance of 2.2(range 0.4 to 6.9) wood-unit, a mean pulmonary to systemic flow ratio of 0.9(range 0.3 to 3.0), a mean ventricular end-diastolic pressure of 9.0 (range 3.0 to 21.0) mmHg, and a mean arterial oxygen saturation of 76.0(range 45.6 to 88.0)%. The operative procedure consisted of a longitudinal right atriotomy 2cm lateral to the terminal crest up to the right atrial auricle, followed by the creation of a lateral tunnel connecting the orifices of either the superior caval vein or the right atrial auricle to the inferior caval vein, using a Gore-Tex vascular graft with or without a fenestration. Concomitant procedures at the time of Fontan procedure included 22 pulmonary artery angioplasties, 21 atrial septectomies, 4 atrioventricular valve replacements or repairs, 4 corrections of anomalous pulmonary venous connection, and 3 permanent pacemaker implantations. In 31, a fenestration was created, and in 1 an adjustable communication was made in the lateral tunnel pathway. One lateral tunnel conversion was performed in a patient with recurrent intractable tachyarrhythmia 4 years after the initial atriopulmonary connection. Post-extubation hemodynamic data revealed a mean pulmonary artery pressure of 12.7(range 8 to 21) mmHg, a mean ventricular end-diastolic pressure of 7.6(range 4 to 12) mmHg, and a mean room-air arterial oxygen saturation of 89.9(range 68 to 100) %. The follow-up duration was, on average, 27(range 1 to 85) months. Post-Fontan complications included 11 prolonged pleural effusions, 8 arrhythmias, 9 chylothoraces, 5 of damage to the central nervous system, 5 infectious complications, and 4 of acute renal failure. Seven early(6.7%) and 5 late(4.8%) deaths occured. These results proved that the lateral tunnel Fontan procedure provided excellent hemodynamic improvements with acceptable mortality and morbidity for hearts with various types of functional single ventricle.

• Radiation Oncology Journal
• /
• v.16 no.4
• /
• pp.485-495
• /
• 1998

Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 50 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patients with median follow up duration 50 months (range 6-162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58$\%$) was the most frequent site of occurrence followed by trunk (20$\%$) and head and neck (12$\%$). Histologically malignant fibrous histiocytoma (23$\%$), liposarcoma (17$\%$), malignant schwannoma (12$\%$) constitute 52$\%$ of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42$\%$) received chemotherapy with various regimen in the postoperative period. Results : Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48$\%$) of local recurrence. Four patients (7$\%$) developed simultaneous local recurrence and distant metastasis and 8 patients (13$\%$) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck Primary This feature is likely explanation for the decreased local control rate. Five of 29 Patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 $\%$, 30.6$\%$ respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.9 no.2
• /
• pp.138-147
• /
• 1998

Authors surveyed intrafamilial child sexual abuse in the children under 15years old in clinical. We sent the semi-structured child sexual abuse questionnaires to 7055 board certified pediatrics, obstetrics and gynecology, family medicine and emergency medicine. Total respondents were 1205. The results from these respondents were as follows. 1) The numbers of respondents who have had the experience of treating victims of intrafamilial child sexual abuses were 157(13.0% of total respondents). 2) Among the perpetrators, 58(36.9%) were siblings and 32(20.4%) 26(16.6%) were step-fathers, and respectively. The most common age bracket was 10s(39.5%), and the next was 40s and 50s (33.7%) Almost all(98.7%) of the perpetrators were male. 3) The mean age of victims was $12.1{\pm}3.3$ years old, and all of the victims were female, and the number of victims who had previous mental or physical handicaps and behavior problems were 5(3.2%) and 8(5.1%) respectively. 4) The ways by which intrafamilial child sexual abuses were found were abnormal behaviors 45(28.7%), victim's own report 40(25.5%), pregnancy 18(11.5%), pain complaint 13(8.3%), other person's report 13(8.3%), and detection during examination 12(7.6%). 5) Time lags between intrafamilial child sexual abuses and hospital visits were after 1 month 97(61.8%), from 1 day to 1 week 29(18.5%), within 1 day 21(13.4%), and from 1 week to 1 month 10(6.4%). 6) Physical complications were perineal wound 93(59.2%), hymen rupture 90(57.3%), pregnancy 68(43.3%), wound of other part of body 11(7.0%), and sexually transmitted disease 4(4.5%). 7) Treatment for victims were discharge 92(58.6%), admission, operation or transfer to a bigger hospital 25(15.9%), psychiatry consult 19(12.1%), report to police(10.9%) and social work consult 3(1.9%). These results suggest that considerable numbers of physicians have had the experience of treating victims of intrafamilial child sexual abuses, and intrafamilial child sexual abuses are the major medical as well as social issue in children in Korea.

• Korean Journal of Ecology and Environment
• /
• v.44 no.3
• /
• pp.264-271
• /
• 2011

At the Jangheung multipurpose dam, which is on the Tamjin River, a trapping and trucking operation was established to maintain continuous upstream migration of fish,. To facilitate fish gathering, installation of an effective fishing trap was required. In this study, we evaluated the fish trap, established at the Jangheung dam, using PIT (Passive Integrated Transponder) telemetry. A total of 254 individuals from 15 species were monitored. Among these tagged species, 36 individuals from 6 species (Carassius auratus, C. cuvieri, Zacco temminckii, Z. platypus, Pungtungia herzi, and Pseudobagrus koreanus) were detected; a 14.2% detection rate. C. auratus recorded the highest detection rate of 44.2% while P. herzi was 14.3%. Z. temminckii and Z. platypus showed relatively low detection, 5% and 7.7% respectively. Some of individuals from C. auratus and Z. platypus did not pass through the antenna at the first attempt but were continuously detected on multiple days. There were no statistical differences in body size (total length, standard length and body weight) of individuals that did or did not swim into the trap (Mann-Whitney U test, p>0.05). Fish mainly swam into the trap during outflow of water from the dam (Mann-Whitney U test, p<0.001) and showed a higher detection frequency in daytime than nighttime (Mann-Whitney U test, p<0.001). Thus, for fish movement into the trap, external factors such as outflow from dam and time of day have important roles. Based on detection rate, not all fishes showed upstream migration but represented selective migration. Consequently, the establishment of flexible outflow strategies that take into consideration ecological characteristics of fishes should required for improving the efficiency of fishway.

• Clinical and Experimental Pediatrics
• /
• v.52 no.7
• /
• pp.824-831
• /
• 2009

Purpose : We aimed to investigate the efficacy of and functional recovery after intracerebral transplantation of different doses of mouse mesenchymal stem cells (mMSCs) in immature rat brain with hypoxic-ischemic encephalopathy (HIE). Methods : Postnatal 7-days-old Sprague-Dawley rats, which had undergone unilateral HI operation, were given stereotaxic intracerebral injections of either vehicle or mMSCs and then tested for locomotory activity in the 2nd, 4th, 6th, and 8th week of the stem cell injection. In the 8th week, Morris water maze test was performed to evaluate the learning and memory dysfunction for a week. Results : In the open field test, no differences were observed in the total distance/the total duration (F=0.412, P=0.745) among the 4 study groups. In the invisible-platform Morris water maze test, significant differences were observed in escape latency (F=380.319, P<0.01) among the 4 groups. The escape latency in the control group significantly differed from that in the high-dose mMSC and/or sham group on training days 2-5 (Scheffe's test, P<0.05) and became prominent with time progression (F=6.034, P<0.01). In spatial probe trial and visible-platform Morris water maze test, no significant improvement was observed in the rats that had undergone transplantation. Conclusion : Although the rats that received a high dose of mMSCs showed significant recovery in the learning-related behavioral test only, our data support that mMSCs may be used as a valuable source to improve outcome in HIE. Further study is necessary to identify the optimal dose that shows maximal efficacy for HIE treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.6
• /
• pp.644-651
• /
• 2000

In cases of severe alveolar bony resorption in the edentulous posterior maxillae, implant placement is limited anatomically due to maxillary sinus. If the ridge is atrophic, the various bone grafting methods are required for the ridge augmentation. But the result of the onlay grafting procedure is not always promising. On the posterior maxilla, maxillary sinus mucosa lifting and bone grafting into the sinus floor, subantral augmentation(SA) technique are recommended. Various SA procedures have been developed for implant installation. We perfer to simultaneous block bone graft and implant installation through the residual alveolar ridge into the grafted block bone to fix the grafted bone and to gain the primary stability of the installed fixture. When a sagittal skeletal discrepancy in present due to the severe alveolar bony resorption of the maxilla, the advancement of the maxilla by Le Fort I osteotomy simultaneously with installation of implant fixtures combined with sinus lifting and interpositional bone graft procedure can be indicated. We applied various SA techniques for implant installtion to the 46 edentulous posterior maxillae, and total 154 implants were installed at our department from 1992 to 1999. Various SA techniques were classified in detail and the indications of each techniques were discussed. The changes of residual bony height following SA procedure were studied. The results were as follows. 1. The SA procedure combined with bone graft and simultaneous fixture installation were performed in 41 cases, 126 fixtures were installed and 5 fixtures were removed out of them. Le Fort I osteotomy procedure combined with sinus lifting and interpositional bone graft simultaneous with fixture installation were performed in 5 cases. Total 28 fixtures were installed and 2 fixtures were removed so far. 2. Autogenous block bone graft into sinus floor were performed in 35 cases, autogenous particulated marrow cancellous bone(PMCB) graft in 9 cases, and demineralized human bone powder in 2 cases. The donor site for bone graft were anterior iliac bone in 39 cases, posterior iliac bone in 3 cases and mandibular symphysis in 1 case and mandibular ramus in 1 case. 3. In 9 cases with which SA procedure had been performed with the block bone graft, the change of pre- and postoperative residual bony height were measured using MPR(multiplanar reformatted)-CT. The mean residual bony height was 8.0mm preoperatively, 20.2mm at 6 months following up operation and we gained average 12.2mm alveolar bony height. So, we can recommend this one-stage subantral augmentation and fixture installation technique as a time conserving, safe and useful method for compromised posterior edentulous maxilla.

• The Korean Journal of Nuclear Medicine
• /
• v.36 no.1
• /
• pp.1-7
• /
• 2002

Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

• Journal of Food Hygiene and Safety
• /
• v.13 no.4
• /
• pp.319-331
• /
• 1998

The purposes of this study were to develop Hazard Analysis Critical Control Point plan applicable to cook/chilled Pork Bulkogi (broiled sliced pork with sauces) in school foodservice operations and to establish reasonable shelf-life limits by assessing food quality during chilled storage period of 5 days. During the product flow, time-temperature profile was recorded and microbiological analyses including mesophilic and psychrotrophic total plate counts, coliform, and fecal coliform and qualitative analyses of Salmonella and Listeria monocytogenes were done. Chemical analyses (pH, acid value, total volatile basic nitrogen), sensory evaluation, and quantitative analysis of thiamin were conducted for 5 days of chilled storage. The number of mesophiles in raw pork ($4.26{\pm}0.11\;Log\;CFU/g$), seasoning mixture ($5.97{\pm}O.04\;Log\;CFU/g$) and marinated pork ($5.56{\pm}0.21\;Log\;CFU/g$) were below the microbial standards for "requires further cooking" food items. Listeria monocytogenes was detected in seasoning mixture. After heating, the number of mesophiles ($5.17{\pm}0.04\;Log\;CFU/g$) were slightly reduced but it did not meet the microbial guidelines of $5\;Log\;CFU/g$ for "ready-to-eat" foods. No other microbes including pathogens were detected. By reheating the menu item after chilled storage, the number of mesophiles were reduced in every phase of 1st day ($4.62{\pm}0.22\;Log\;CFU/g$), 3rd day ($4.55{\pm}0.20\;Log\;CFU/g$) and 5th day ($4.25{\pm}0.16\;Log\;CFU/g$) of chilled storage, and the number of microbes was below the standard limits for "ready-to-eat" foods. At the fifth day of chilled storage, pH (p<0.05), acid value (p<0.01) and TVBN (p<0.05) showed significant increases. Sensory evaluation results did not show any significant change for 5 days of chilled storage. Thiamin content showed a decrease for 5 days of chilled storage. Consequently, the ideal shelflife recommended for Pork Bulkogi was within 3 days of chilled storage. CCPs for Pork Bulkogi were purchasing and receiving of raw meat and some seasoning ingredients, heating, chilling, chilled storage, reheating, and distribution.

• Korean Journal of Ecology and Environment
• /
• v.48 no.4
• /
• pp.212-218
• /
• 2015

In South Korea, various nature-like fishways recently been installed for use by a wide variety of fish species. However, limited attempts have been made to monitor the fish utilization. The present study was conducted to ascertain the frequencies and patterns of utilization of the fishway installed at Beakjae Weir. We collected fish species that use the fishway by installing a fyke net at the exit of the fishway at least once a month from April 2013 to October 2013. Additionally, in order to identify all fish species that can potentially use the fishway, we investigated the fish fauna downstream to Beakjae Weir (mainstream of the Geum River). We found that 10 species belonging to 2 families used the fishway; this accounted for 64% of the total species inhabiting the mainstream. The species that used the fishway most frequently were Microphysogobio jeoni, followed by Squaliobarbus curriculus and Opsariichthys uncirostris amurensis. The highest number of fish using the fishway was observed in August, which was positively correlated with the water temperature (Spearman rank correlation, $r_s$=0.743, P=0.035). The sizes of the fish using the fishway varied widely, with the total body length ranging from 39 mm to 550 mm. Analysis of the time-dependent utilization frequency revealed that most fish used the fishway during the night (20:00~08:00). Compared to other fishways installed along the Geum River, the fishway installed at Beakjae Weir was used by fewer species and fish. This may be attributed to the structural inadequacy of the fishway, thereby resulting in a low attraction efficiency. Therefore, measures should be adopted to enhance the fishway attraction and passage efficiency. The results of this study can be used to ensure efficient operation and management of the Beakjae Weir fishway as well as serve as basic data for developing and building nature-like fishways tailored to Korean situations.

• Applied Biological Chemistry
• /
• v.37 no.2
• /
• pp.130-141
• /
• 1994

A continuous two-stage membrane (1st-SCMR, MWCO 10,000; 2nd-SCMR, MWCO 5,000) reactor was developed and optimized for the production of fish skin gelatin hydrolysate with different molecular size distribution profiles using trypsin and pronase E. The optimum operating conditions in the 1st-step membrane reactor using trypsin were: temperature, $55^{\circ}C$ ; pH 9.0; enzyme concentration, 0.1 mg/ml; flux, 6.14 ml/min; reaction volume, 600 ml; and the ratio of substrate to trypsin, 100 (w/w). After operating for 1 hr under the above conditions, 79% of total amount of initial gelatin was hydrolysed. In the 2nd-step using pronase E under optimum operating conditions[temperature, $50^{\circ}C$ ; pH 8.0; enzyme concentration, 0.3 mg/ml; flux, 6.14 ml/min; reaction volume, 600 ml; and the ratio of substrate to pronase E, 33 (w/w)], the 1st-step hydrolysate was hydrolysed above 80%. Total enzyme leakages in the 1st-step and 2nd-step membrane reactors were about 11.5% at $55^{\circ}C$ for 5hrs and 9.0% at $50^{\circ}C$ for 4 hrs, respectively. However, there was no apparent correlation between enzyme leakage and substrate hydrolysis. The membrane has a significant effect on activity lose of trypsin and pronase E activity for 1 hr of the membrane reactors operation. The loss of initial activity of enzymes were 34% and 18% in the 1st-step and 2nd-step membrane reactor, whereas were 23% and 10% after operating time 3 hr in the 1st-step and 2nd-step membrane reactor lacking the membrane, respectively. The productivities of 1st-step and 2nd-step membrane reactor for 8 times of volume replacement were 334 mg and 250 mg per mg enzyme, respectively.