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Development of Cotton Farming and Transformation of Rural Area in Sanliurfa Prefecture, Turkey (터키 샹르울파주 목화농업의 전개와 지역사회의 변화)

  • Kang, Sukkyeong
    • Journal of the Korean Geographical Society
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    • v.48 no.1
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    • pp.87-111
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    • 2013
  • Regional disparities between eastern and western regions is the most of serious problem for balanced regional development in Turkey. The Southeastern Anatolia Project (GAP) is being implemented to eliminate these regional development disparities. The work that was initially planned as predominantly for hydraulic energy production to utilize water resources of the Tigris and Euphrates rivers more effectively was later transformed into an integrated multi-sector regional development project. This study noted that this region had very limited cash crop production because of the constraints of semi-arid climate of the southeastern region, however, later, it has changed Turkey's major cotton producing region since Southeastern Anatolia Project carried out. Therefore, this study investigated background, process, and content of the Southeastern Anatolia Project with respect to high cotton productivity in this region and examined the dynamic changes of cotton productivity in this region. In addition, Sanliurfa prefecture is one of the main development axes of the Southeastern Anatolia Project, because government investments are concentrated on this prefecture. Therefore, this study examined the background and process of cotton farming growth in this prefecture. In 2011, Sanliurfa prefecture produced 37.6% of Turkey's total cotton production. This is mainly due to agricultural infrastructure expansion such as land consolidation, irrigation, roads and farm roads. Also, it is one of the main factor that subsidies paid to farmers for cotton cultivation. The introduction of irrigation has dramatically changed the direction of seasonal migration of this area. Prior to irrigation, this area had a serious social issue about out-migration for seasonal labor to other areas. However, the introduction of irrigation made this area that changed to in-migration and intramigration for cotton cultivation. Irrigation water is supplied to farmers through the WUAs (Water User Associations) that handed over irrigation water management, operation from DSI (General Directorate of State of Hydraulic Works). However, the WUAs are under the influence of Ashiret, a traditional feudal social structure. Because of this reason, it does not have an efficient management for farmers. Also, it is one of the reasons that this area does not have autonomous farmer organization.

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Research on the Legal Composition and Institutional Systems of The Dao Constitution: Focusing on The Constitution of the Republic of Korea (『도헌』의 법률적 구성과 제도적 장치 연구 - 대한민국헌법을 중심으로 -)

  • Kim, Young-jin
    • Journal of the Daesoon Academy of Sciences
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    • v.40
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    • pp.77-114
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    • 2022
  • The purpose of this study is to analyze the ideological background, legal composition, and separation of powers contained within the institutional devices of The Dao Constitution based on the basic principles of the legal system, which would be embodied in The Constitution of the Republic of Korea. The ideological background of The Dao Constitution is that of the religion, Daesoon Jinrihoe. In Daesoon Jinrihoe, it is held that the Supreme God, Sangje, determined that Mutual Contention, the ruling pattern of the Former World, ran contrary to His divine will and this endangered the world as nature and humans had also fallen into Mutual Contention. As an act of divine intervention, Sangje established Mutual Beneficence so that nature and humanity could follow Mutual Beneficence as a paradigm shift culminating in a Great Opening of the universe. Sangje, the agent behind the paradigm shift, revealed His divine will that humans transform into mutually beneficent humans. Therefore, The Dao Constitution was written to be a set of fundamental norms based on the 'rights and obligations of the members of Daesoon Jinrihoe' to accept and implement the will of Sangje as it applies to each member's mission. The legal composition of The Dao Constitution consists of the body and supplementary provisions. The text consists of general rules, moral rights and obligations, origins, and institutional devices. Institutional devices include the Central Council, the Institute of Propagation and Edition, the Institute of Religious Services, Works, Financial Management, and the Institute of Audit and Inspection. The legal composition of The Dao Constitution is similar to that of the Constitution. The difference is that while the Constitution applies a 'principle of maximum rights and minimum obligations,' The Dao Constitution stipulates more obligations than rights in order to complete the mission of the members. The principle of separation of powers is applied to the institutional devices in The Dao Constitution. In The Dao Constitution, the organizational form of the central headquarters has been divided into a 'before and after' scheme surrounding the death of Dojeon. The organizational form of the central headquarters prior to Dojeon's death was similar to a Constitutional Monarchy. After the death of Dojeon, the central headquarters' organizational form became similar to a parliamentary cabinet system. The separation of powers at central headquarters is divided among a legislative power (the Central Council), an executive power (the Institute of Religious Services), and a judicial power (the Institute of Audit and Inspection). The separation of powers within the functions of the central government first occurs between the Central Council and its employees, then between the Central Council and the Institute of Auditing and Inspection, and also between the Legislative Government and the Institute of Religious Services. Furthermore, the principle of a vertical separation of powers exists between the central headquarters and the local organization.

Diagnostic Approach to the Solitary Pulmonary Nodule : Reappraisal of the Traditional Clinical Parameters for Differentiating Malignant Nodule from Benign Nodule (고립성 폐결절에 대한 진단적 접근 : 악성결절과 양성결절의 감별 지표에 대한 재검토)

  • Kho, Won Jung;Kim, Cheol Hyeon;Jang, Seung Hun;Lee, Jae Ho;Yoo, Chul Gyu;Chung, Hee Soon;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.500-518
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    • 1996
  • Background : The solitary pulmonary nodule(SPN) presents a diagnostic dilemma to the physician and the patient. Many clinical characteristics(i.e. age, smoking history, prior history of malignancy) and radiological characteristics( i.e. size, calcification, growth rate, several findings of computed tomography) have been proposed to help to determine whether the SPN was benign or malignant. However, most of these diagnostic guidelines are based on the data collected before computed tomography(CT) has been introduced and lung cancer was not as common as these days. Moreover, it is not well established whether these guidelines from western populations could be applicable to Korean patients. Methods : We had a retrospective analysis of the case records and radiographic findings in 114 patients presenting with SPN from Jan. 1994 to Feb. 1995 in Seoul National University Hospital, a tertiary referral hospital. Results : We observed the following results ; (1) Out of 113 SPNs, the etiology was documented in 94 SP IS. There were 34 benign SP s and 60 malignant SPNs. Among which, 49 SPNs were primary lung cancers and the most common hi stologic type was adenocarcinoma. (2) The average age of patients with benign and malignant SPNs was $49.7{\pm}12.0$ and $58.1{\pm}10.0$ years, respectively( p=0.0004), and the malignant SPNs had a striking linear propensity to increase with age. (3) No significant difference in the hi story of smoking was noted between the patients with benign SPNs($13.0{\pm}17.6$ pack- year) and those with malignant SPNs($18.6{\pm}25.1$ pack-year) (p=0.2108). (4) 9 out of 10 patients with prior history of malignancy had malignant SPNs. 5 were new primary lung cancers with no relation to prior malignancy. (5) The average size of benign SPNs($3.01{\pm}1.20cm$) and malignant SPNs($2.98{\pm}0.97cm$) was not significantly different(p=0.8937). (6) The volume doubling time could be calculated in 22 SPNs. 9 SPNs had the volume doubling time longer than 400 days. Out of these, 6 were malignant SPNs. (7) The CT findings suggesting malignancy included the lobulated or spiculated border, air- bronchogram, pleural tail, and lymphadenopathy. In contrast, calcification, central low attenuation, cavity with even thickness, well-marginated border, and peri nodular micronodules were more suggestive for benign nodule. (8) The diagnostic yield of percutaneous needle aspiration and biopsy was 57.6%(19/33) of benign SPNs and 81.0%(47/58) of malignant SPNs. The diagnostic value of sputum analysis and bronchoscopic evaluations were relatively very low. (9) 42.3%(11/26) of SPNs of undetermined etiology preoperatively turned out to be malignant after surgical resection. Overall, 75.4%(46/61) of surgically resected SPNs were malignant. Conclusions : We conclude that the likelihood of malignant SPN correlates the age of patient, prior history of malignancy, some CT findings including lobulated or spiculated border, air-bronchogram, pleural tail and lymphadenopathy. However, the history of smoking, the size of the nodule, and the volume doubling time are not helpful to determent whether the SPN is benign or malignant, which have been regarded as valuable clinical parameters previously. We suggest that aggressive diagnostic approach including surgical resection is necessary in patient with SPNs.

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The Role of c-Jun N-terminal Kinase in the Radiation-Induced Lung Fibrosis (방사선에 의한 폐 섬유화증에서 c-Jun N-terminal Kinase(JNK)의 역할)

  • Uh, Soo-Taek;Hong, Ki-Young;Lee, Young-Mok;Kim, Ki-Up;Kim, Do-Jin;Moon, Seung-Hyuk;Kim, Yong-Hoon;Park, Choon-Sik;Yeom, Uk;Kim, Eun-Suk;Choi, Doo-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.450-461
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    • 2001
  • Background : The underlying pathogenesis of radiation-induced lung fibrosis (RTLF) has not been very well defined. However, the role of TGF-$\beta$ in the generation of RTLF has been a major focus because there is an increase in the expression of both the TGF-${\beta}m$-RNA and its protein preceding RTLF lesions. The down stream signal after a TGF-$\beta$ stimulated lung fibrosis includes the activation of many mediators such as Smad and c-Jun N-terminal kinase (JNK) through TAK1. It is we hypothesized that JNK activation may play a pivotal role in RTLF pathogenesis through increased transcription of the fibrogenic cytokines. The present study evaluates JNK activity in alveolar macrophages after irradiation and the relationship between JNK activity and the amount of collagen in the lung tissues. Methods : C57BL/6 mice(20-25 gr, males) received chlorotetracycline(2g/L) in their drinking water 1 week prior to irradiation and continuously there after. The mice were irradiated once with 1400 cGy of $60CO{\gamma}$-ray over the whole chest. The cellular composition of the whole lung bronchoalveoalr lavage fluids(BALF), elastin expression in the lung tissues, the level of hydroxyproline in lung tissues, and an in vitro JNK assay was measured before irradiation and one, four, and eight weeks after irradiation (RT). Results : The volumes of BALF retrieved from instilled 4 mL of saline with 2% heparin were 3.7-3.8 mL for each group. The cell numbers were similar before($4.1{\times}10^4{\pm}0.5{\times}10^4/mL$) and 1 week($3.1{\times}10^4{\pm}0.5{\times}10^4/mL$) after RT. At four and eight weeks after RT, the cell number reached to $14.0{\times}10^4{\pm}1.5{\times}10^4mL$ and $10.0{\times}10^4{\pm}1.3{\times}10^4/mL$, respectively. There we no changes in the lymphocytes and neutrophils population observed in the BALF after RT. The H-E stain of the lung tissues did not show any structural and fibrotic change in the lung tissues at 4 and 8 weeks after RT. In addition, the amount of elastin and collagen were not different on Verhoeff staining of the lung tissues before RT to eight weeks after RT. The hydroxyproine content was measured with the left lung dissected from the left main bronchus. The lung were homogenized and hydrolyzed with 6 N Hel for 12 hours at $110^{\circ}C$ then measured as previously described. The content of hydroxyproline, standardized with a lung protein concentration, reached a peak 4 weeks after RT, and thereafter showed a plateau. AnIn vitro JNK assay using c-$Jun_{1-79}$-GST sepharose beads were performed with the alveolar macrophages obtained from the BAL. JNK activity was not detected prior to RT, However, the JNK activity increased from one week after RT and reached a peak four weeks after RT. Conclusion : JNK may be involved in the pathogenesis because the JNK activity showed similar pattern observed with the hydroxyproine content. However, it is necessary to clarify that the JNK increases the transcription of fibrogenic cyiokines through the transcription factor.

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Effect of mixtures of gibberellic acid and several herbicides on the herbicidal activity against wild oat (Avena fatua L.) (Gibberellic acid와 여러 가지 제초제와의 혼합처리가 메귀리에 대한 제초활성에 미치는 영향)

  • Kim, Jin-Seog;Choi, Jung-Sup;Hong, Kyung-Sik;Cho, Kwang-Yun
    • The Korean Journal of Pesticide Science
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    • v.2 no.3
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    • pp.107-116
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    • 1998
  • Based on the differential growth response to exogenous gibberellic acid ($GA_{3}$) between semi-dwarf wheat(Triticum aestivum) and wild oat(Avena fatua), we examined the possibility of improving the selective performance of several herbicides by $GA_{3}$ application and the physiological background of $GA_{3}$-induced increase in herbicidal activity. Growth of wild oat was 4 to 5 times higher than that of wheat by $GA_{3}$ treatment. Pretreatment of wild oat seed with 300 ppm $GA_{3}$ increased the herbicidal activities of trifluralin and isoproturon by soil-surface application, but not of alachor and metsulfuron-methyl. $GA_{3}$ applied simultaneously with post-emergence herbicides resulted in a significant or moderate improvement of the efficacy of such herbicides as tralkoxydim, fenoxaprop-ethyl, metsulfuron-methyl, metribuzine and isoproturon, but not in the mixtures of oxyfluorfen or paraquat with $GA_{3}$. In the sequencial treatment of tralkoxydim and $GA_{3}$ at interval of one-day, $GA_{3}$ applied prior to tralkoxydim significantly increased a chlorosis and desiccation of leaf without affecting the growth inhibition by tralkoxydim. Tralkoxydim followed by $GA_{3}$ application had lower herbicidal activity than that of $GA_{3}$ followed by tralkoxydim treatment. Electrolyte leakage response of $GA_{3}$-pretreated or $GA_{3}$-untreated wild oat leaf against several compounds inducing membrane. peroxidation was compared. Differencial responses were observed in oxyfluorfen and isoproturon treatments with an increased electrolyte leakage in $GA_{3}$-pretreated tissue, but not in paraquat and rose bengal treatments. These results suggest that $GA_{3}$-induced increase in herbicidal activity is likely to be dependent on a herbicide type and may be due to activation of a metabolic ability related with herbicidal reponse as well as an increase in the herbicide absorbtion and translocation, rather than due to membrane and cell wall extention induced by $GA_{3}$, which in turn makes the herbicides easily enter.

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The Relationship of Spiritual Well-being and Anxiety, Depression and Quality of Life in Active Old Age (노년기 영성과 불안.우울 및 삶의 질과의 관계)

  • Youm, Hyong-Uk;Cheung, Seung-Deuk;Seo, Wan-Seok;Koo, Bon-Hoon;Bai, Dai-Seg
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.27-42
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    • 2005
  • Background: This study assessed the mental health, in order to determine the effect of the subject's spiritual well-being on anxiety depression and quality of life in active old people, and to verify whether or not spiritual well-being is a new factor for comprehensive health in old people. Materials and Methods: This study selected 184 old people aged over 65 years. The subject's spiritual well-being was assessed by the Korean Spiritual Well-Being Scale (SWS) that was composed of the Religious Well-being Scale (RWS) and Existential Well-being Scale (EWS). The quality of life was assessed using Quality of Life Scale, which was composed of the subjective feeling about life and the subject's satisfaction of their whole life. Results: Among the psychosocial factors, the educational level and physical health, showed significant discriminative score in the SWS. A prior medical history was associated with a significantly low SWS score. Satisfaction with life was associated with a significantly high SWS score. These factors a showed significant discriminative EWS score rather than a RWS. Among the religion factors, the satisfaction with their religion showed significant difference in the SWS. The SWS score especially the EWS affected the anxiety and depression of the Korean Combined Anxiety and Depression Scale (CADS). The subjective feeling of life score was associated with a significantly EWS low score and the subject's satisfaction with their whole life score was associated with a significantly high EWS score. Conclusion: Spiritual well being has significantly effects on anxiety depression and the quality of life in active old age people, and the subject;s spiritual well-being might be a new factor for assessing health in old age.

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Social Network-based Hybrid Collaborative Filtering using Genetic Algorithms (유전자 알고리즘을 활용한 소셜네트워크 기반 하이브리드 협업필터링)

  • Noh, Heeryong;Choi, Seulbi;Ahn, Hyunchul
    • Journal of Intelligence and Information Systems
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    • v.23 no.2
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    • pp.19-38
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    • 2017
  • Collaborative filtering (CF) algorithm has been popularly used for implementing recommender systems. Until now, there have been many prior studies to improve the accuracy of CF. Among them, some recent studies adopt 'hybrid recommendation approach', which enhances the performance of conventional CF by using additional information. In this research, we propose a new hybrid recommender system which fuses CF and the results from the social network analysis on trust and distrust relationship networks among users to enhance prediction accuracy. The proposed algorithm of our study is based on memory-based CF. But, when calculating the similarity between users in CF, our proposed algorithm considers not only the correlation of the users' numeric rating patterns, but also the users' in-degree centrality values derived from trust and distrust relationship networks. In specific, it is designed to amplify the similarity between a target user and his or her neighbor when the neighbor has higher in-degree centrality in the trust relationship network. Also, it attenuates the similarity between a target user and his or her neighbor when the neighbor has higher in-degree centrality in the distrust relationship network. Our proposed algorithm considers four (4) types of user relationships - direct trust, indirect trust, direct distrust, and indirect distrust - in total. And, it uses four adjusting coefficients, which adjusts the level of amplification / attenuation for in-degree centrality values derived from direct / indirect trust and distrust relationship networks. To determine optimal adjusting coefficients, genetic algorithms (GA) has been adopted. Under this background, we named our proposed algorithm as SNACF-GA (Social Network Analysis - based CF using GA). To validate the performance of the SNACF-GA, we used a real-world data set which is called 'Extended Epinions dataset' provided by 'trustlet.org'. It is the data set contains user responses (rating scores and reviews) after purchasing specific items (e.g. car, movie, music, book) as well as trust / distrust relationship information indicating whom to trust or distrust between users. The experimental system was basically developed using Microsoft Visual Basic for Applications (VBA), but we also used UCINET 6 for calculating the in-degree centrality of trust / distrust relationship networks. In addition, we used Palisade Software's Evolver, which is a commercial software implements genetic algorithm. To examine the effectiveness of our proposed system more precisely, we adopted two comparison models. The first comparison model is conventional CF. It only uses users' explicit numeric ratings when calculating the similarities between users. That is, it does not consider trust / distrust relationship between users at all. The second comparison model is SNACF (Social Network Analysis - based CF). SNACF differs from the proposed algorithm SNACF-GA in that it considers only direct trust / distrust relationships. It also does not use GA optimization. The performances of the proposed algorithm and comparison models were evaluated by using average MAE (mean absolute error). Experimental result showed that the optimal adjusting coefficients for direct trust, indirect trust, direct distrust, indirect distrust were 0, 1.4287, 1.5, 0.4615 each. This implies that distrust relationships between users are more important than trust ones in recommender systems. From the perspective of recommendation accuracy, SNACF-GA (Avg. MAE = 0.111943), the proposed algorithm which reflects both direct and indirect trust / distrust relationships information, was found to greatly outperform a conventional CF (Avg. MAE = 0.112638). Also, the algorithm showed better recommendation accuracy than the SNACF (Avg. MAE = 0.112209). To confirm whether these differences are statistically significant or not, we applied paired samples t-test. The results from the paired samples t-test presented that the difference between SNACF-GA and conventional CF was statistical significant at the 1% significance level, and the difference between SNACF-GA and SNACF was statistical significant at the 5%. Our study found that the trust/distrust relationship can be important information for improving performance of recommendation algorithms. Especially, distrust relationship information was found to have a greater impact on the performance improvement of CF. This implies that we need to have more attention on distrust (negative) relationships rather than trust (positive) ones when tracking and managing social relationships between users.

Relationship Between Exercise Induced Asthma and Gastroesophageal Reflux (운동유발성 천식과 위식도역류와의 연관성)

  • Lee, Heung-Bum;Lee, Yang-Deok;Kim, Hyun-Chul;Lee, Yong-Chul;Lee, Soo-Teik;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.2
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    • pp.203-209
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    • 2000
  • Background: Exercise is a very common precipitant of asthma. Bronche-constriction associated with exercise can occur in 75~90% of individuals with asthma The estimated prevalence(30~85%) of gastroesophageal reflux(GER) in patients with asthma is significantly higher than in general population. We performed pH monitoring during the exercise in order to evaluate whether exercise induced asthma(EIA) could be related to GER and acid reflux-induced esophagobronchial reflex-mediated bronchospasm might be a factor for EIA. Method: Following an overnight fast, 18 patients with a suspected EIA(6 men, 12 women) were studied. Monitoring of intraesophageal pH, ECG and spirometry was done for 1 hour before treadmill exercise. After baseline monitoring, subjects underwent symptom-limited treadmill exercise with Bruce protocol and continuous monitoring for 60 min after exercise. Spirometry was done at baseline prior to exercise, and repeated every 10 min after full exercise for 60 min. Results: Exercise-induced bronchoconstriction was noted in 15 patients, who performed MBPT and 12 patients confirmed for bronchial asthma and 3 patients were diagnosed exercise-induced astham. Five of 15 EIA patients demonstrated a pathologic degree of GER. Conclusion: We suggest that GER may be one of pathophysiologic factors of EIA and evoke further concentration on the GER in the EIA patients.

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A Study on Lyricism Expression of Color & Realistic Expression reflected in Oriental Painting of flower & birds (전통화조화의 사실적(寫實的) 표현과 시정적(詩情的) 색채표현)

  • Ha, Yeon-Su
    • Journal of Science of Art and Design
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    • v.10
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    • pp.183-218
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    • 2006
  • Colors change in time corresponding with the value system and aesthetic consciousness of the time. The roles that colors play in painting can be divided into the formative role based on the contrast and harmony of color planes and the aesthetic role expressed by colors to represent the objects. The aesthetic consciousness of the orient starts with the Civility(禮) and Pleasure(樂), which is closely related with restrained or tempered human feelings. In the art world of the orient including poem, painting, and music, what are seen and felt from the objects are not represented in all. Added by the sentiment laid background, the beauty of the orient emphasizes the beauty of restraint and temperance, which has long been the essential aesthetic emotion of the orient. From the very inception of oriental painting, colors had become a symbolic system in which the five colors associated with the philosophy of Yin and Yang and Five Forces were symbolically connected with the four sacred animals of Red Peacock, Black Turtle, Blue Dragon, and White Tiger. In this color system the use of colors was not free from ideological matters, and was further constrained by the limited color production and distribution. Therefore, development in color expression seemed to have been very much limited because of the unavailability and unreadiness of various colors. Studies into the flow in oriental painting show that color expression in oriental painting have changed from symbolic color expression to poetic expression, and then to emotional color expression as the mode of painting changes in time. As oriental painting transformed from the art of religious or ceremonial purpose to one of appreciation, the mast visible change in color expression is the one of realism(simulation). Rooted on the naturalistic color expression of the orient where the fundamental properties of objects were considered mast critical, this realistic color expression depicts the genuine color properties that the objects posses, with many examples in the Flower & Bird Painting prior to the North Sung dynasty. This realistic expression of colors changed as poetic sentiments were fused with painting in later years of the North Sung dynasty, in which a conversion to light ink and light coloring in the use of ink and colors was witnessed, and subjective emotion was intervened and represented. This mode of color expression had established as free and creative coloring with vivid expression of individuality. The fusion of coloring and lyricism was borrowed from the trend in painting after the North Sung dynasty which was mentioned earlier, and from the trend in which painting was fused with poetic sentiments to express the emotion of artists, accompanied with such features as light coloring and compositional change. Here, the lyricism refers to the artist's subjective perspective of the world and expression of it in refined words with certain rhythm, the essence of which is the integration of the artist's ego and the world. The poetic ego projects the emotion and sentiment toward the external objects or assimilates them in order to express the emotion and sentiment of one's own ego in depth and most efficiently. This is closely related with the rationale behind the long-standing tradition of continuous representation of same objects in oriental painting from ancient times to contemporary days. According to the thoughts of the orient, nature was not just an object of expression, but recognized as a personified body, to which the artist projects his or her emotions. The result is the rebirth of meaning in painting, completely different from what the same objects previously represented. This process helps achieve the integration and unity between the objects and the ego. Therefore, this paper discussed the lyrical expression of colors in the works of the author, drawing upon the poetic expression method reflected in the traditional Flower and Bird Painting, one of the painting modes mainly depending on color expression. Based on the related discussion and analysis, it was possible to identify the deep thoughts and the distinctive expression methods of the orient and to address the significance to prioritize the issue of transmission and development of these precious traditions, which will constitute the main identity of the author's future work.

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Surgical Treatment of Complete Atrioventricular Septal Defect: The Early and Mid-Term Results (완전방실중격결손증의 외과적 교정술: 조기 및 중기 결과)

  • Kim, Hyung-Tae;Jun, Tae-Gook;Yang, Ji-Hyuk;Park, Pyo-Won;Kim, Wook-Sung;Lee, Young-Taek;Sung, Ki-Ick
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.299-304
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    • 2009
  • Background: Although the results of the surgical management for complete atrioventricular septal defect (c-AVSD) have improved, the optimal surgical strategy is still controversial. The aims of this study are to evaluate the outcome of c-AVSD repair and to define the risk factors related to reoperation. Material and Method: We retrospectively reviewed the medical records of 35 patients (8 males and 27 females) who underwent the total correction of c-AVSD from August 1996 to March 2008. The median age at repair was 5.2 months (range: 3 days$\sim$82 months). Sixteen patients (45.7%) were associated with Down syndrome. Prior palliative operations were performed in 4 patients. The one-patch techniques were performed in 3 patients, and the two-patch techniques were done in 32 patients. Result: There was 1 early death (2.9%). The median follow-up period was 68 months (range: $2\sim134$ months) for 34 survivors. There was no late death. Reoperations were performed in 5 patients (14.3%) for severe left atrioventricular valvular regurgitation (AVVR). Nine patients (25.7%) showed left an AVVR of more than grade III. Associated major cardiac anomalies and the use of Gore-Tex patch for ventricular septal closure were the risk factors for postoperative left atrioventricular valve failure and reoperation. Conclusion: In this study, we found that surgical repair of c-AVSD was safe and effective. However, the high reoperation rate after repair remains a problem to be solved.