• Journal of Chest Surgery
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• v.32 no.3
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• pp.237-248
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• 1999

Background: The late results of repair of tetralogy of Fallot(TOF) are favorable in most patients. Some portion of the patients with tetralogy, however, require reoperation for residual lesions or result in late death. The outcome of patients after tetralogy repair performed during the past 13 years was studied, with an emphasis on postrepair survival and problems including reoperations. Material and Method: A retrospective review of clinical, echocardiographic and catheterization data was performed in 569 of 775 patients with TOF who underwent corrective repair between 1983 and 1995 at Sejong General Hospital, Buchon, Korea. Result: Of 28(4.9%) early deaths(defined as 30 days postrepair), 12 deaths(42.9%) were <1 year of age, with an operative mortality of 15.4%. The surviving 541 patients(age 2.8 months to 43.4 years, median 23 months) have been followed up from 1 month to 12.6 years(median 35 months) postoperatively. Most patients were in good functional class and had normal right ventricular(RV) function. Postrepair results were compared between the transatrial-transpulmonary approach and the conventional right ventriculotomy. The former technique provided a lesser incidence of significant pulmonary regurgitation(P<0.001) and alesser degree of RV dysfunction(P<0.05) compared with those in the latter. There were 10(1.8%) late deaths during the follow-up period and 6 of the deaths were directly related to reoperation or ventricular dysfunction. The 10-year actuarial survival rate was 96.7%. There were 44 reoperations(8.1%) in 39 patients(7.2%), with an operative mortality of 10.3%. The main indications or reoperation included residual ventricular septal defect(VSD) (n=6), pulmonary stenosis(PS) (n=11), VSD with PS(n=17), pulmonary regurgitation(n=7), and tricuspid regurgitation(n=2). The 5- and 10-year freedom from reoperation were 89.4% and 76.1%, respectively. Conclusion: Although the majority of patients with repaired TOF are clinically well, with a high rate of survival, approximately 7% of patients have residual lesions that require surgical therapy. Therefore, the timely and meticulous corrective repair is mandatory to avoid reoperation, and continued close surveillance is also needed for the early detection of residual problems.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.110-115
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• 2005

Background: The aims of this paper were to review the mid term clinical results and to analyze the preoperative risk factors of isolated aortic valve replacement (AVR). Material and Method: Between January 1992 and February 2003, 80 patients underwent isolated AVR. 58 were male and 22 were female patients, raging from 12 to 75 years of age (mean :$46.8{\pm}13.0$ years). 74 patients except one early death and 5 follow-up loss were contacted by OPD or by telephone. The mean duration of follow-up was $44.2{\pm}29.7$ months and the total cumulative period was 272.8 patient-year. Result: The complications in hospital occurred in 35 cases : 12 wound problems (11 superficial, 1 deep), 11 arrhythmias (9 temporary, 2 persistent), 3 low cardiac output, and so forth. The late deaths were 4 cases : the heart-related deaths were 2 cases ($0.7\%$ patient-year). Conclusion: The risk factors that influenced the early mortality and morbidity were older age (> 60 years)(p=0.04), poor preoperative NYHA functional class (> 3) (p=0.048), high preoperative serum creatinin level (> 1.2 mg/100 ml)(p=0.031), long operation time (aortic clamping time>90 min)(p=0.042). The same factors influenced the late mortality and morbidity. Freedom from valve-related complication was $86.4{\pm}5.3\%,$ actuarial survival rate were $96.8{\pm}2.3\%$ at 3 years and $90.8{\pm}4.6\%$ at 10 years.

• Journal of Korean Society of Forest Science
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• v.110 no.4
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• pp.504-515
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• 2021

To examine the relationship between environmental factors influencing the habitat of Aconitum austrokoreense Koidz., this study employed the MexEnt model to evaluate 21 environmental factors. Fourteen environmental factors having an AUC of at least 0.6 were found to be the age of stand, growing stock, altitude, topography, topographic wetness index, solar radiation, soil texture, mean temperature in January, mean temperature in April, mean annual temperature, mean rainfall in January, mean rainfall in August, and mean annual rainfall. Based on the response curves of the 14 descriptive factors, Aconitum austrokoreense Koidz. on the Baekun Mountain were deemed more suitable for sites at an altitude of 600 m or lower, and habitats were not significantly affected by the inclination angle. The preferred conditions were high stand density, sites close to valleys, and distribution in the northwestern direction. Under the five-age class system, the species were more likely to be observed for lower classes. The preferred solar radiation in this study was 1.2 MJ/m². The species were less likely to be observed when the topographic wetness index fell below the reference value of 4.5, and were more likely observed above 7.5 (reference of threshold). Soil analysis showed that Aconitum austrokoreense Koidz. was more likely to thrive in sandy loam than clay. Suitable conditions were a mean January temperature of - 4.4℃ to -2.5℃, mean April temperature of 8.8℃-10.0℃, and mean annual temperature of 9.6℃-11.0℃. Aconitum austrokoreense Koidz. was first observed in sites with a mean annual rainfall of 1,670- 1,720 mm, and a mean August rainfall of at least 350 mm. Therefore, sites with increasing rainfall of up to 390 mm were preferred. The area of potential habitats having distributive significance of 75% or higher was 202 ha, or 1.8% of the area covered in this study.

• Journal of the Korean Society of Marine Environment & Safety
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• v.23 no.7
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• pp.834-846
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• 2017

An increase in the number of retiring experienced pilots as well as drastic graying of new pilots will raise the problems on deepening imbalance of supply and demand of pilots over the next 7 years, which could entail fatal problems for the safety of harbour pilotage. In this study, the improvement plan of legal system to ease imbalance between supply and demand of pilots and help secure more experienced pilots has been proposed. A current state survey and analysis, statistical analysis, questionnaire survey on foreign countries, in-depth consultation with experts, etc., were all carried out to support this research. The conclusions of this study are, firstly, to propose an amendment that the minimum requirement of 5 years of seagoing service as a master to sit for the pilot exam should be relaxed to 2 years(which must include at least 1 year of master's seagoing service within the most recent 5 years) but the minimum requirement of 1 year of pilotage service should be reinforced to 1 year and 6 months to obtain a higher class of pilot certificate. Secondly, it is proposed that an amendment offering an additional 1 point per year over the minimum period of 2 years of seagoing service as a master should be added, with a maximum of 10 points in order to rationalize the additional incentive point system. In order to secure experienced pilots and resolve the legal conflict between the certificate revalidation system and the retirement system, it is also proposed that an amendment be passed revoking the retirement system and limiting the validity of any new certificates only to 68 years of age when issuing or revalidating a certificate, if an applicant is over a certain age. Promotional work, such as collecting opinions from interested parties and generating positive public awareness, should be carried out in the future. It will also be necessary to conduct a study on the training pilot exam system.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.57 no.4
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• pp.316-333
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• 2021

In order to understand basic data for improving the fishing system and fishing vessel structure in coastal improved stow net fishery, a questionnaire survey and on-site hearing were conducted from May 10 to June 11, 2019 to analyze opinions on the improvement of operation status and fishing vessel structure. The questionnaire survey consisted of ten questions on the operation status of coastal improved stow net fishery and six questions on the improvement of fishing vessel structure, and the results of each question were analyzed by the region, the captain's age, the captain's career and the age of fishing vessel. As a result of analyzing opinions on the operation status of the coastal improved stow net fishery, it was found that the average time required for casting net was 32.8 to 33.0 minutes and that the average time required for hauling net was 41.0 to 42.2 minutes which took 10 to 12 minutes more than for casting net. The most important work requiring improvement during fishing operation (the first priority) were 'hauling net operation,' 'readjustment and storage of fishing gear,' and 'fish handling' and the hardest factor in fishing management were in the order of 'reduction of catch,' 'labor shortage' and 'rising labor costs.' The most institutional improvement that is most needed in coastal improved stow net fishery was an 'using fine mesh nets.' Most of the respondent to the questions on the experience in hiring foreign crews was 'either hiring or willing to hire foreign crews,' and the average number of foreign crews employed was found to be 2.3 to 2.4 persons. The most important reason for hiring (or considering employment) foreign crews was 'high labor costs.' The degree of communication with foreign crews during fishing operation were 'moderate' or 'difficult to direct work.' The most important problem in hiring foreign crews (the first priority) was an 'illegal departure.' As the survey results on the opinion of structural improvement of coastal improved stow net fishing vessel, the degree of satisfaction with fishing vessel structure related to fishing operation was found to be somewhat unsatisfactory, with an average of 3.3 points on a five-point scale. The inconvenient structure of fishing vessel in possession (the first priority), the space needed most for the construction of new fishing vessel (the first priority) and the space considered important for the construction of new fishing vessel (the first prioprity) was a 'fish warehouse.' The most preferred equipment for the construction of new fishing vessel were 'engine operation monitoring' and 'navigation safety devices.' The average size (tonnage class), the average horse power and the average total length of fishing vessel for proper profit and safety fishing operation was between 13.8 and 14.0 tonnes, 808.3 to 819.5 H.P. and 23.4 to 23.5 meters, respectively. The results of the operation status of coastal improved stow net fishery and the requirement for improving the fishing vessel structure are expected to be provided as basic data for reference when we build or improve the fishing vessel.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.651-658
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• 2003

Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52％ of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5％) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1％. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6％; bleeding events, 90.2$\pm$4％; paravalvular leakage 92.3$\pm$4％; and overall valve-related morbidity at 1 year was 76.6$\pm$3％. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8％) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9％, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.

• Journal of Preventive Medicine and Public Health
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• v.5 no.1
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• pp.115-123
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• 1972

As a link of chain study program of school health, a survey was made up by the screening test with audiometry for hearing disturbance on 18,675 high school students who are mainly aged in 15-19 years from November 5.1969 to October 30. 1970. The results obtained were summerized as follows. According to our criteria as table 3, the rates of the profound, the severe and the moderate who required the appropriate hearing aids were 0.02%, 0.03% and 0.14% respectively:-the cumulative percentage was 0.197. When the marginal, 0.23% should be included the cumulative rate was 0.41%. But there was no-significance by sex and school classes. If we will make the special classes for them one class would be estimated out of 10,000 persons when a class is formed with about 15 persons. Otherwise when we examined that according to each ear of persons, the rates of the profound, the severe and the moderate were 0.17%, 0.22% and 0.33% respectively and their cumulative percentage wag 0.72. There was no significance also by sex and age. By the way, the rate of hearing disturbance in urban high school students tended to lower than rural. And the perceptive disturbance was higher than rural in rate. The conductive disturbance tended to oppose in comparison with the above.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.32 no.1
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• pp.93-106
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• 2014

In this study, Analyze environment of location, investigation into vegetation resources, survey management status and establish to classify the management area for Natural monument No.374 Pyengdae-ri Torreya nucifera forest. The results were as follows: First, Torreya nucifera forest is concerned about influence of development caused by utilization of land changes to agricultural region. Thus, establish to preservation management plan for preservation of prototypical and should be excluded development activity to cause the change of terrain that Gotjawal in the Torreya nucifera forest is factor of base for generating species diversity. Secondly, Torreya nucifera forest summarized as 402 taxa composed 91 familly 263 genus, 353 species, 41 varieties and 8 forms. The distribution of plants for the first grade & second grade appear of endangered plant to Ministry of Environment specify. But, critically endangered in forest by changes in habitat, diseases and illegal overcatching. Therefore, when establishing forest management plan should be considered for put priority on protection. Thirdly, Torreya nucifera representing the upper layer of the vegetation structure. But, old tree oriented management and conservation strategy result in poor age structure. Furthermore, desiccation of forest on artificial management and decline in Torreya nucifera habitat on ecological succession can indicate a problem in forest. Therefore, establish plan such as regulation of population density and sapling tree proliferation for sustainable characteristics of the Torreya nucifera forest. Fourth, Appear to damaged of trails caused by use. Especially, Scoria way occurs a lot of damaged and higher than the share ratio of each section. Therefore, share ratio reduction Plan should be considered through the additional development of tourism routes rather than the replacement of Scoria. Fifth, Representing high preference of the Torreya nucifera forest tourist factor confirmed the plant elements. It is sensitive to usage pressure. And requires continuous monitoring by characteristic of Non-permanent. In addition, need an additional plan such as additional development of tourism elements and active utilizing an element of high preference. Sixth, Strength of protected should be differently accordance with importance. First grade area have to maintenance of plant population and natural habitats. Set the direction of the management. Second grade areas focus on annual regeneration of the forest. Third grade area should be utilized demonstration forest or set to the area for proliferate sapling. Fourth grade areas require the introduced of partial rest system that disturbance are often found in proper vegetation. Fifth grade area appropriate to the service area for promoting tourism by utilizing natural resources in Torreya nucifera forest. Furthermore, installation of a buffer zone in relatively low ratings area and periodic monitoring to the improvement of edge effect that adjacent areas of different class.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.230-238
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• 1998

Purpose : Worldwidely, the incidence of the hepatitis A has been markedly decreased in the past years. Also in Korea, there has been only a few sporadic cases without evidence of epidemics since the mid 1980s. However, the incidence of the hepatitis A in young adults and childen has been in trends of increasing since 1996. So, we retrospectively performed the study on the epidemiolgical changes and the clinical feature of hepatitis A in childen, living in Kyung-gi province, since 1988 to 1998. Methods : The four affiliated hospitals of the Catholic University of Korea, Our lady of Mercy's hospital, Holy family hospital, Eui-Jung-bu St. Mary's hospital, and St. Vincent hospital, were enrolled in this study. We conducted statistical analysis on the incidence of hepatitis A since 1988 to 1998, concerning with the period (monthly, annually), age, sex and related epidemiological property, by reviewing the hospital records of the patients with hepatitis A. We simultaneously performed the study concerning with the clinical characteristics of hepatitis A. Results : 1) During the study period, 46 children was diagnosed as hepatitis A, and among them 28 children (60.1%) developed sporadically in the 1998. And sex ratio was 1.2(male):1(female). 2) Most of the patients developed between March and July, and hepatitits A were mainly developed in the patients above the 10 year old ages(37 patients; 80.4%). 3) The socioeconomic and educational status of the patient's parents was almostly below the middle and low class. Although, we could not find the etiological factors in most cases, but we found the evidence of interfamilial transmission in one family. 4) The patients complained the symptoms of nausea and vomiting, jaundice, poor appetite, mild fever, fatigueness, abdominal pain, URI symptom, dyspepsia, dark urine, headache and diarrhea in order, and findings of jaundice, hepatomegaly, RUQ tenderness, splenomegaly and LLQ tenderness in order were seen. 5) All patients showed abnormal findings of the liver function tests, and the pattern of cholestatic hepatitis were seen in most cases, but these findings were normalized within the 2~4 weeks. The findings of the gall bladder wall thickening, hepatomegaly, splenomegaly and ascites were seen on abodominal sonogram. 6) The prognosis of all patients were good without complications, except in one case who had the episode of transient recuurence. And the mean hospitalization dates were 11.1 days. Conclusion : We found that the incidence of hepatitis A showed the increasing trend, and peaked in the 1998 in Kyung-gi province children. And hepatitis A mainly developed in children above the 10 year old ages. The scioeconomic and educational status of patient's family was almostly below the middle class. All of them showed abnormal liver function, and clinically cholestatic hepatitis features were seen in most cases. But, the prognosis was excellent without complication in all cases.

• Journal of Chest Surgery
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• v.40 no.4 s.273
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• pp.280-287
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• 2007

Background: We retrospectively evaluated the clinical results of surgically managing patients with Ebstein's anomaly. Material and Method: Between Feb. f 984 and June 2006, 50 patients who underwent surgical treatment for Ebstein's anomaly at Yonsei Cardiovascular Center were retrospectively reviewed. The mean age of the patients was 26.9 years and 19 patients were male, Associated anomalies included atrial septal defect (33), patent ductus arteriosus (2), ventricular septal defect (1), and pulmonary stenosis (4), and 90%, (45/50) of the patients had more than a moderate degree of tricuspid regurgitation. Carpentier type A was present in 6 patients, type B in 26, type C in 14 and type D in 4. Ten patients were associated with WPW syndrome. Conservative surgery was possible in 31 patients (tricuspid annuloplasty, plication of the atrialized RV), Fontan's operation was peformed in 4 patients, tricuspid valve replacement was done in 12 and palliative surgery was done in 2 patients. Thirteen patients were associated with hi-directional cavopulmonary shunt (BCPS: one and a half ventricular repairs): 10 patients with WPW syndrome and 4 patients with atrial fibrillation underwent concomitant ablation. Result: The postoperative median NYHA functional class $(3{\rightarrow}1)$ and the mean cardio-thoracic ratio $(0.65{\rightarrow}0.59)$ were decreased significantly (p<0.001, p=0.014). The mean oxygen saturation $(86.6{\rightarrow}94.1%)$, and median TR grade $(4{\rightarrow}1)$ were also significantly improved (p=0.004, p<0.001). For comparison of BCPS and conservative surgery, the preoperative right ventricular pressure (33.0 vs. 41.3 mmHg), the ICU stay (2.80 vs. 1.89 days), the hospital say (10.6 vs. 16.8 days), and the left ventricular ejection fraction (64.3 vs. 72.8%) were statistically different. Postoperative mortality occurred in 3 patients (6%) due to biventricular failure in 2 patients and sepsis in the other patient. The mean follow up duration was 101.5 months, and one patient died of Fontan failure and 6 patients required reoperation (bioprosthetic degenerative change (2) and Fontan conversion (4)). The overall survival rate at 10 years was 90.2%, the freedom from reoperation rate and rate of cardiac related events were 78.9% and 49.2%, respectively. Conclusion: Surgical management of Ebstein's anomaly can be performed safely, and the associated BCPS may be helpful for high-risk patients. Adequate application of surgical management may increase the long-term survival with a reduced rate of reoperation.