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Minimally invasive cardiac surgery with the partial mini-sternotomy in children (소아연령군에서의 부분흉골소절개를 통한 최소침투적심장수술)

  • 이정렬;임홍국;성숙환;김용진;노준량;서경필
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.466-471
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    • 1998
  • Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6${\pm}$41.8 (Range: 1∼148) months and 14.5${\pm}$9.9(Range: 3.0∼40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection(cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I- or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. Result: A mean length of skin incision was 6.1${\pm}$1.0(range: 4.0∼9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0${\pm}$1.1 (range: 2.0∼7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9${\pm}$20.0(range: 28∼147), 29.8${\pm}$12.8(range: 11∼79), and 161.1${\pm}$34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0${\pm}$68.1 (range: 0∼267) cc. All patients were extubated mean 11.3${\pm}$13.8(range: 1∼73) hours after operation. A mean total amount of analgesics used was 0.8${\pm}$1.8(range: 0∼9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0${\pm}$32.2 (range: 10∼194) hours and 6.2${\pm}$2.0(range: 3∼11) days. There were no wound complications and hospital deaths. Conclusion: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.

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Architecture and Depositional Style of Gravelly, Deep-Sea Channels: Lago Sofia Conglomerate, Southeyn Chile (칠레 남부 라고 소피아 (Lago Sofla) 심해저 하도 역암의 층구조와 퇴적 스타일)

  • Choe Moon Young;Jo Hyung Rae;Sohn Young Kwan;Kim Yeadong
    • The Korean Journal of Petroleum Geology
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    • v.10 no.1_2 s.11
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    • pp.23-33
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    • 2004
  • The Lago Sofia conglomerate in southern Chile is a lenticular unit encased within mudstone-dominated, deep-sea successions (Cerro Toro Formation, upper Cretaceous), extending from north to south for more than $120{\cal}km$. The Lago Sofia conglomerate is a unique example of long, gravelly deep-sea channels, which are rare in the modern environments. In the northern part (areas of Lago Pehoe and Laguna Goic), the conglomerate unit consists of 3-5 conglomerate bodies intervened by mudstone sequences. Paleocurrent data from these bodies indicate sediment transport to the east, south, and southeart. The conglomerate bodies in the northern Part are interpreted as the tributary channels that drained down the Paleoslope and converged to form N-S-trending trunk channels. In the southern part (Lago Sofia section), the conglomerate unit comprises a thick (> 300 m) conglomerate body, which probably formed in axial trunk channels of the N-5-trending foredeep trough. The well-exposed Lago Sofia section allowed for detailed investigation of sedimentary facies and large-scale architecture of the deepsea channel conglomerate. The conglomerate in Lago Sofia section comprises stratified conglomerate, massive-to-graded conglomerate, and diamictite, which represent bedload deposition under turbidity currents, deposition by high-density turbidity currents, and muddy debris flows, respectively. Paleocurrent data suggest that the debris flows originated from the failure of nearby channel banks or slopes flanking the channel system, whereas the turbidity currents flowed parallel to the orientation of the overall channel system. Architectural elements produced by turbidity currents represent vertical stacking of gravel sheets, lateral accretion of gravel bars, migration of gravel dunes, and filling of channel thalwegs and scoured hollows, similar to those in terrestrial gravel-bed braided rivers. Observations of large-scale stratal pattern reveal that the channel bodies are offset stacked toward the east, suggestive of an eastward migration of the axial trunk channel. The eastward channel migration is probably due to tectonic tilting related to the uplift of the Andean protocordillera just west of the Lago Sofia deep-sea channel system.

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The Effect of Increase in Length and Volume of Source in Radioactive Iodine Thyroid Uptake Rate (갑상선 섭취율 측정에서 선원의 길이와 부피 증가에 따른 영향)

  • Hwang, Dong Hun;Oh, Shin Hyun;Kim, Jung Yul;Kang, Chun Koo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.70-75
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    • 2017
  • Purpose Radioactive iodine thyroid uptake (RAIU) rate is an examination which determines and seeks about general functions of thyroid gland. The size of thyroid gland is normally different between each person, also patients having thyroid diseases have had a variety of size of thyroid gland compared with others. The purpose of this study will investigate about the counting rate which is effected by the geometric factors through the length and volume changes of the source in RAIU rate. Materials and Methods I-131 185 kBq ($5{\mu}Ci$) were placed in a cylindrical phantom of 0.5 cm, 1 cm, 1.5 cm, and 3 cm in diameter, respectively, and saline was added to gradually increase the length by 1 cm in the horizontal and vertical directions to give a change in volume. The source was measured 20 times for 20 seconds from a distance of 25 cm to $364.4keV{\pm}20%$ energy ROI with Captus 3000 thyroid uptake system (Capintec, NJ, USA). Results When the source was located in the transverse direction of the detector, the consequence of one-way ANOVA is that even though the length of source is increased each diameter, there is mostly no significant difference. When the source was located in the longitudinal direction and the counting rate of length 1 cm at all diameter is set to 100%, the average is 92.57% for length 2 cm, 86.1% for 3 cm, 80.69% for 4 cm, 74.82% for 5 cm, and 69.68% at 6 cm. Conclusion According to this study, it is expected that the gap of RAIU rate has been depended on the thickness of thyroid gland as well as the diameter of the beaker. We know that the change of the volume with the increase of the length of the source had less effect on the change of the counting rate. Thus, in order to reduce the error in the measurement of the counting rate with the thyroid uptake rate equipment, an accurate counting rate can be relatively measured if the counting rate which is measured is corrected by thickness or the distance between the thyroid and the thyroid uptake rate equipment is changed.

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The Subject of Jeongganbo Invention from the Viewpoint of Music Education (음악교육의 관점에서 바라본 정간보 창안의 주체)

  • Yim, Hyun-taek
    • (The) Research of the performance art and culture
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    • no.36
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    • pp.415-440
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    • 2018
  • On September 23, 2015, the Ministry of Education announced the 2015 revision of educational curriculum which aimed at 'cultivating creative talents' based on the Article 23, Section 2 of the Elementary and Secondary Education Law. As a result, music curriculum have also been partially revised, which seems to maintain the 2009 revision of music curriculum. Although Jeongganbo 井間譜 is already exposed in the music curriculum for the third and forth grades of elementary school, the learning content about how to read Jeongganbo and how to express the pitch and length of sound including the origin of its name and the background of its invention are dealt with specifically in the fifth and sixth grades. Jeongganbo is known as the oldest mensural notation in the Orient created by King Sejong of the Joseon Dynasty in the middle of the $15^{th}$ century, and it was used for the first time in Sejong sillok akbo 世宗實錄樂譜 (Scores in the Annals of King Sejong), the oldest musical score still in existence. However, in the music textbooks as well as the most of specialized books related to the Korean traditional music, it is uncritically accepted without providing clear grounds that Sejong invented Jeongganbo himself. If so, it is necessary to investigate on which grounds it is claimed that Sejong invented Jeongganbo. This paper first examined the grounds of the proposition that "Sejong invented Jeongganbo," which is introduced in the music textbooks for the fifth and sixth grades of elementary school, by separating it into Sejong's creation of Sinak 新樂 (new music), Sejo's invention of Jeongganbo and Sejong's invention of Hangeul. Next, this paper examined how the subject of the invention of Jeongganbo has been described in the textbooks for the fifth and sixth grades in elementary school based on the 2009 revision of music curriculum, and suggested the direction of a desirable music education by pointing out the related problems. According to historical records and circumstances such as Sejong's creation of Sinak, Sejo's invention of Jeongganbo with 16 Jeonggan (square) in one vertical line, Sejong's invention of Hangeul and so on, it seems to be the most reasonable that Sejong is the subject of the invention of Jeongganbo as of now. However, the attitude of the musical academy to accept and educate the unclear thing as if it is a fact does not seem desirable. Therefore, I suggest that it should be described "Jeongganbo was invented in the period of Sejong" or "it is supposed that Jeongganbo was invented by Sejong" rather than presenting "Sejong made Jeongganbo" or "created" until revealing the clear evidence about the subject of Jeongganbo.

The Tool to Design Sustainable Business Models: A Case Study for the Social Ventures (지속가능한 비즈니스모델 설계 도구: 소셜벤처 사례를 중심으로)

  • Park, JaeWhan;Jeon, Hyejin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.1
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    • pp.187-198
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    • 2019
  • The purpose of this study is to seek ways of utilizing TLBMC by understanding business model of social ventures that are accompanied by social and environmental as well as economic missions. In order to achieve this, business models from economic, environmental and social perspectives will be analyzed, and we seek to enhance sustainability of social venture entrepreneurs. As the analysis tool, TLBMC(Triple Layered Business Model Canvas) expands upon the business model canvas that is widely utilized and recognizes economical terms. The TLBMC is proposed by Joyce, A., & Paquin, R. L.(2016) to help achieve a holistic view with horizontal and vertical associations. The study tries to overcome limitations of previous studies and observe a variety of economic, environmental, and social perspectives that social ventures should have with the TLBMC. As a result, it has the following implications; Firstly, creating separate social, environmental and economic business model canvas helps a business to have a holistic approach. Secondly, it was found that social venture characteristics of environmental and social perspectives were applied in practice. Lastly, we have established experience data on social venture business model. This study focuses on the opinions, the meanings and the subjective views of the participants. As a result, conclusions are drawn by the researchers ' assertions and has limitations as a research on case studies. However, this study will help people who are preparing or studying social ventures to have economic, environmental, and social perspectives. Also, redefinition of the direction and value of entrepreneurs operating social ventures, such as vision and mission, will help clarify the roles and responsibility of organizations. As a fundamental step for future empirical studies, this study could be the base for social venture business model studies.

The Emergence of Wooden Chamber Tombs with Stone Mound and the Changing Nature of Tombs at the Wolseong North Burial Ground of Gyeongju in the Early Silla Phase (신라 전기 적석목곽분의 출현과 경주 월성북고분군의 묘제 전개)

  • Choi, Byung Hyun
    • Korean Journal of Heritage: History & Science
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    • v.49 no.3
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    • pp.154-201
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    • 2016
  • During the Incipient and Early Silla phases, which witnessed the establishment and development of the ancient Silla state, the Wolseong North Burial Ground functioned as not only the central burial ground in the Gyeongju region of the capital of Silla but also as the central burial ground of the whole Silla state. Wolseong North Burial Ground is where transformations in Silla funerary architecture first occurred. As such, an empirical study of the tombs constructed at this burial ground can be regarded as a starting point from which an understanding of the development of the tomb culture of the Silla state may be achieved. This paper therefore aims to examine the changing nature of the tomb culture of the Early Silla phase through the burial data of Wolseong North Burial Ground and the Gyeongju region. Wooden chamber tombs were constructed from the late phase of Saroguk. At Wolseong North Burial Ground, which eventually developed into the central burial ground of the Gyeongju region, wooden chamber tombs embellished with stone packing emerged during the Incipient Silla phase; wooden chamber tombs with stone mounds, on the other hand, first appeared in the Early Silla phase and eventually became established as the central tomb type. A key difference between the wooden chamber tomb embellished with stone packing and the wooden chamber tomb with stone mound is that, in the case of the latter, stones were packed not only around sides of the wooden structure that acted as the burial chamber but also on top of this structure. The addition of a high earthen mound surrounded by protective ring of stones is another distinctive feature of the latter, presenting a contrast to the low mound of the former. During the Early Silla phase, two types of wooden chamber tombs with stone mounds were constructed at Wolseong North Burial Ground: those with burial chambers located above ground and those with subterranean burial chambers. Also constructed during this phase were the wooden chamber tomb embellished with packed stones, the wooden chamber tomb embellished with packed clay, simple earth cut burials, which had been used since the Incipient Silla phase, as well as the stone-lined burials with vertical entrance which first appeared in the Early Silla phase. However, of these different types of burials, it was only the wooden chamber tomb with stone mound that was covered with a 'high mound.' Differentiation between the different tomb types can also be observed in terms of location, type of burial chamber used, construction method, and tomb size. It is therefore possible to surmise that stratification between the different tomb types, which first emerged in the Incipient Silla phase, became intensified during the Early Silla phase.

The First Discovery of Quaternary Fault in the Western Part of the South Yangsan Fault - Sinwoo Site (양산단층 남부 이서 지역에서 최초로 발견된 제4기 단층 - 신우지점)

  • Choi, Sung-Ja;Ghim, Yong Sik;Cheon, Youngbeom;Ko, Kyoungtae
    • Economic and Environmental Geology
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    • v.52 no.3
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    • pp.251-258
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    • 2019
  • During the detailed geological survey around the southern Yangsan Fault, we newly found a Quaternary fault outcrop, which cuts unconsolidated sediments. The fault named the Sinwoo site, located in the Sinwoo pasture, Miho-ri, Duseo-myeon, Ulsan metropolitan city, is the first discovered Quaternary fault near the western part of the south Yangsan Fault. In this study, we provide information on characteristics of fault geometry and unconsolidated sediment at Sinwoo site based on the analysis data of topography, drainage, and lineament around the study site. The fault site is situated at pediment slope, but fan-shaped middle terrace, as well as thick sediment exposed at low terrace, indicates that the unconsolidated sediments have been deposited in the alluvial fan environment. The drainage develops to the third-order drainage system, and the first and the second drainage system meet at right angles to each other and form a radial drainage pattern. In addition, the NE-SW direction lineaments can be identified on the basis of the curvature of the river and the step of the topographic relief, running over the Sinwoo site. The fault of $N30-35^{\circ}E/79-82^{\circ}SE$ shows ~ 5.8 m apparent vertical offset and dominantly reverse-slip sense based on slickenline, rotation of pebbles, and drag folding at footwall. However, some discontinuous sediments observed in the footwall are interpreted as fissure-filling materials due to the strike-slip movement. Now, we are under multidisciplinary investigations of additional field survey and age dating in order to determine the evolution of Sinwoo site fault during the Quaternary.

Storyboard of Immortal Land in Gugok-Wonlim - A Special Reference to Goisan - (구곡원림(九曲園林)에서 찾는 신선경(神仙境)의 경관 스토리보드 - 괴산 갈은구곡(葛隱九曲)을 대상으로 -)

  • Rho, Jae-Hyun;Park, Joo-Sung;Sim, Woo-Kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.29 no.1
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    • pp.90-104
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    • 2011
  • This study identified the scenic characteristics in Gugok and symbolism reflected in titles of the scenery of the season in Gugok from a perspective of Sundoism concentrated on Galeun Gugok in Goisan which is influenced most greatly by Sundoism hermit ideas in Korea, along with Seonyudong-Gugok. In addition, it suggested a measure for arrangement and narrative Storyboard of Galeun Gugok structure corresponding with promotion and propagation of Gugok cultural scenes and educational goals. According to analysis and interpretation of the various Gugoks forming Galeun Gugok in terms of their titles, names engraved in surrounding elements and the coherent symbolic meanings of its scenery and place through comparison with secenery of near Seonyudong-Gugok, the result shows that Galeun Gugok comprises wishes for eternal life in the forms of Taoist hermit-related scenery of the season within the range of stream and old stories based on environmental affordance. In figurative way, it ultimately presents the Wonyung(圓融) idea which seeks a harmonious combination of God and humankind. In particular, consciousness of longevity without problems is deeply inherent in the background of eternalness of plants, divinity of animals and natural homeostasis. Also, 9 Gok Seongukam set up at visual terminal reflect noticeably that a game Go is the amusement of the immortals, which describe 9 ranks of GO figuratively. Galeun Gugok is formed in a unity structure, which is hermit-oriented Sundoism and motif, such as longevity and immortality, divinity and enjoyment of Sundoism hermit rather than used as a method to achieve taste for the arts or ethics. Given the fact, it presents eternal longevity and atmosphere of seclusion in very strong way. Development of spatial Storyboard structure based on this is interpreted as 'Entering the world of hermits(Introduction)'-'Looking the world(Development)'-'Living with hermits(Turn)'-'Becoming hermit(Conclusion).' Finally, the scenery image of Galeun Gugok presented in surface structure is based on beauty of the immortal land scenery as well as beauty of pre-achieved space in Gugokdongcheon and arranged the vertical narrative structure as divine space of 9 ranks of GO. Taking those into account, scenery story board of Galeun Gugok was suggested in accordance with a theme of 6 cuts; Gnagsun(降仙)-Sungyeong(仙境)- Sunyak(仙藥)-Sunhak(仙鶴)-Sunyu(仙遊)-Eunsun(隱仙). It is obvious that hermit which live an eternal life as a representative of Sundoism, should be the main motif of scenery planning in a filed of modem landscaping. Therefore, the most valuable component in designing Korean landscape must be the homeostasis of surrounding landscape which supports the characteristics of invariability and divinity of nature.

Development of Electret to Improve Output and Stability of Triboelectric Nanogenerator (마찰대전 나노발전기의 출력 및 안정성 향상을 위한 일렉트렛 개발)

  • Kam, Dongik;Jang, Sunmin;Yun, Yeongcheol;Bae, Hongeun;Lee, Youngjin;Ra, Yoonsang;Cho, Sumin;Seo, Kyoung Duck;Cha, Kyoung Je;Choi, Dongwhi
    • Korean Chemical Engineering Research
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    • v.60 no.1
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    • pp.93-99
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    • 2022
  • With the rapid development of ultra-small and wearable device technology, continuous electricity supply without spatiotemporal limitations for driving electronic devices is required. Accordingly, Triboelectric nanogenerator (TENG), which utilizes static electricity generated by the contact and separation of two different materials, is being used as a means of effectively harvesting various types of energy dispersed without complex processes and designs due to its simple principle. However, to apply the TENG to real life, it is necessary to increase the electrical output. In addition, stable generation of electrical output, as well as increase in electrical output, is a task to be solved for the commercialization of TENG. In this study, we proposed a method to not only improve the output of TENG but also to stably represent the improved output. This was solved by using the contact layer, which is one of the components of TENG, as an electret for improved output and stability. The utilized electret was manufactured by sequentially performing corona charging-thermal annealing-corona charging on the Fluorinated ethylene propylene (FEP) film. Electric charges artificially injected due to corona charging enter a deep trap through the thermal annealing, so an electret that minimizes charge escape was fabricated and used in TENG. The output performance of the manufactured electret was verified by measuring the voltage output of the TENG in vertical contact separation mode, and the electret treated to the corona charging showed an output voltage 12 times higher than that of the pristine FEP film. The time and humidity stability of the electret was confirmed by measuring the output voltage of the TENG after exposing the electret to a general external environment and extreme humidity environment. In addition, it was shown that it can be applied to real-life by operating the LED by applying an electret to the clap-TENG with the motif of clap.

Experimental Study on Modular Community Planting for Natural Forest Restoration (자연림 복원을 위한 모듈군락식재 실험연구)

  • Han, Yong-Hee;Park, Seok-Gon
    • Korean Journal of Environment and Ecology
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    • v.36 no.3
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    • pp.338-349
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    • 2022
  • This study aims to investigate whether modular community planting, which entailed planting a variety of species of seedlings at high density, was more effective in restoring natural forests than the existing mature tree planting. We also investigated whether the planting density of the modular community planting facilitates growth or improves the tree layer coverage. We conducted outdoor experiments in which the samples were divided into a mature tree planting plot (control plot), where mature trees were planted at wide intervals, and a modular community planting (MCP) plot (treatment plot), where multiple seedlings were planted in high density. The MCP plot was further divided into the plot in which 3 seedlings were planted per m2 and the plot of 1 seedling per m2. We measured the specimens' survival rate, growth rate (tree height, crown width, and root collar diameter), and cover rate for 26 months from May 2019 and the predicted future tree height growth using the measured tree height. The survival rate and relative growth rate of the MCP were higher than those of the mature tree planting plot. The vertical coverage rate of the tree crown in the MCP exhibited complete coverage of the ground before 23 months, while the coverage rate of the mature tree planting decreased due to transplantation stress. The seedlings in the MCP, which were planted at high density, grew well and were predicted to grow higher than the mature trees in the large tree planting plot within 5 to 6.5 years after planting. It was due to multiple species, seedlings, high-density planting, and planting foundation improvements, such as soil enhancement and mulching. In other words, the seedlings planted in the MCP had a higher survival rate as their environmental adaptation after planting was better, and their early growth was also larger than the trees in the mature planting plot. The high-density mixed planting of various native species not only mitigated the inter-complementary environmental pressures but also facilitated growth by inducing competition between species. Moreover, the planting foundation improvement effectively increased the seedlings' viability and growth rate. A reduction in follow-up management costs is expected as the tree layer coverage sharply increases due to the higher planting density. In the MCP (3 seedlings per m2 and 1 seedling per m2), the tree height growth was promoted with the higher planting density, and the crown width and root collar diameter tended to be larger with the lower planting density, but these differences were not statistically significant.