• Journal of Chest Surgery
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• v.32 no.2
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• pp.164-170
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• 1999

Background: The diffuse infiltrative lung disease often requires biopsy for its final diagnosis. Unlike the limited exposure that can be achieved through small thoracotomy incisions in open lung biopsy technique, the thoracoscopic approach allows visualization and biopsy of nearly entire surface of the lung without morbidity of large standard thoracotomy. The purpose of this study was to compare the diagnostic efficacy and operative safety of thoracoscopic lung biopsy(TLB) with open lung biopsy(OLB) in the diagnosis of diffuse infiltrative lung disease. Material and Method: From March 1993 to August 1997, 81 patients were referred for diagnostic lung biopsy. 51 of them underwent standard open lung biopsy and the remaining 30 patients underwent thoracoscopic lung biopsy. Result: Mean operative time was 63 minutes for TLB and 79 minutes for OLB (p=0.04). The volume of biopsy specimen was not different between two groups(TLB 7.8 cm3, OLB 6.9 cm3 : p=0.72) and the diagnostic accuracy of each methods was comparable (TLB 100%, OLB 96%). The duration of hospital stay was significantly less in TLB (TLB 13days, OLB 22days : p=0.01). The duration of parenteral narcotics administration was also less for TLB(TLB 2.5days, OLB 5.2days, p=0.05). Meanwhile, the duration of chest tube drainage, the frequency of parenteral narcotic injection were not significantly different between two groups. Complications occurred in 2 among the TLB patients (6.67%) and 4 among the OLB patients (7.84%). There was no operative mortality in both groups. Conclusion: We concluded that TLB is a good alternative procedure to OLB in the diagnosis of diffuse infiltrative lung disease with lower morbidity and comparable diagnostic accuracy.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.724-728
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• 2008

Background: The purpose of this study was to identify factors associated with recurrent pneumothorax after wedge resection in primary spontaneous pneumothorax in our hospital. Material and Method: Two hundred thirty-five consecutive patient (98% males; mean age, $23.9{\pm}4.5$ years) who had undergone video-assisted thoracoscopic surgery (VATS) were reviewed retrospectively. The two groups were divided as follows: group A, non-recurrent patients (225 patients [96%]); and group B, recurrent group (10 patients [4%]); the risk factors were compared between the two groups. The single and multiple factors that influenced the recurrence rate were analyzed using Cox's proportional hazard model. Result: There were no significant differences between the recurrent and non-recurrent groups in terms of gender, smoking, site of recurrence, degree of collapse, operative time, and number or weight of resected bullae. The recurrence rate was significantly more common in the following: younger ages, increased height/weight ratio, longer initial air leakage period, and shorter duration of chest drainage. Early aggressive exercise (<30 days) of patients after wedge resection increased the tendency for recurrence. Conclusion: Thoracoscopic wedge resection does not have a higher recurrence rate than open thoracotomy. However, young age, height/weight ratio, continuous air, and duration of chest tube placement were risk factors for a recurrent pneumothorax.

• Journal of Chest Surgery
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• v.51 no.1
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• pp.29-34
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• 2018

Background: We evaluated the feasibility and outcomes of pulmonary resection and mediastinal node dissection (MND) by video-assisted thoracoscopic surgery (VATS) following neoadjuvant therapy for stage IIIA N2 non-small cell lung cancer (NSCLC). Methods: From November 2009 to December 2013, a total of 35 consecutive patients with pathologically or radiologically confirmed stage IIIA N2 lung cancer underwent pulmonary resection and MND, performed by a single surgeon, following neoadjuvant chemoradiation. Preoperative patient characteristics, surgical outcomes, postoperative drainage, postoperative complications, and mortality were retrospectively analyzed. Results: VATS was completed in 17 patients. Thoracotomy was performed in 18 patients, with 13 planned thoracotomies and 5 conversions from the VATS approach. The median age was $62.7{\pm}7.9years$ in the VATS group and $60{\pm}8.7years$ in the thoracotomy group. The patients in the VATS group tended to have a lower diffusing capacity for carbon monoxide (p=0.077). There were no differences between the 2 groups in the method of diagnosing the N stage, tumor response and size after induction, tumor location, or histologic type. Complete resection was achieved in all patients. More total and mediastinal nodes were dissected in the VATS group than in the thoracotomy group (p<0.05). The median chest tube duration was 5.3 days (range, 1 to 33 days) for the VATS group and 7.2 days (range, 2 to 28 days) for the thoracotomy group. The median follow-up duration was 36.3 months. The 5-year survival rates were 76% in the VATS group and 57.8% in the thoracotomy group (p=0.39). The 5-year disease-free survival rates were 40.3% and 38.9% in the VATS and thoracotomy groups, respectively (p=0.8). Conclusion: The VATS approach following neoadjuvant treatment was safe and feasible in selected patients for the treatment of stage IIIA N2 NSCLC, with no compromise of oncologic efficacy.

• Water for future
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• v.26 no.1
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• pp.115-124
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• 1993

This study is to determine the critical duration of design rainfall and to utilize it for the design of detention pond with pump station. To examine the effect of the duration and temporal distribution of the design rainfall, Huff's quartile method is used for the 9 cases of durations ranging from 20 to 240 minutes with 10 years return period, and the ILLUDAS model is used for runoff analysis. The storage ration which is the ratio of maximum storage amounts to total runoff volume, is introduced to determine the critical duration of design rainfall. The duration which maximizes the storage ratio is adopted as the critical duration. This study is applied to 18 urban drainage watersheds with pump station in Seoul, of which the range of watershed area is $0.24-12.70\textrm{km}^2.$ The result of simulation shows that the duration which maximizes storage ration is 30 and 60 minutes on the whole. It is shown also that the storage ration of 2nd- and 3rd-quartile pattern is larger than that of 1st- and 4th-quartile pattern of temporal distribution. A simplified empirical formula for Seoul area is suggested by using the regression analysis between the maximum storage ration and the peak ratio, and can be utilized for the preliminary design and planning of detention pond with pump station.

• Research in Community and Public Health Nursing
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• v.18 no.1
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• pp.165-176
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• 2007

Purpose: The purpose of this study was to investigate the needs of home care nursing services in relation to the patients in hospital. Method: Subjects were 129 patients who admitted hospital and were selected through convenience sampling. Data were collected using the Home Health Care Need Assessment Questionnaire constructed by the Korea Health Industry Development Institute. Data were analyzed using SAS 8.12 program by applying percentage. Results: 1. According to the diagnosis of the subjects, the majority had cancer (25.0%), followed by musculoskeletal disease (15,6%), neuro/cerebral vascular disease (14.1%), digestive (10.9%) and respiratory disease (10.9%). 2. With regard to fundamental nursing service, subjects wanted to receive home care services for the following reasons: Problem identification and diagnosis (77.5%), vital sign check (49.6%); and intake and output measure (20.9%). 3. With regard to clinical laboratory tests, 62.8% wanted to receive blood tests, and followed by urine tests 26.4%, and wound drainage 26.4%. 4. With regard to medication and treatment service, 40.3% of the subjects wanted to receive intravenous fluid therapy, 26.4% intravenous antibiotics, and 26.4% the monitoring of fluid therapy. 5. With regard to therapeutic nursing service, 33.3% wanted to receive wound care, 26.4% ROM exercise, and 27.9% foley catheter change and care. 6. With regard to educational needs, 42.6% wanted education on infection monitoring, 41.4% on medication, and 34.9% on diet. 7. With regard to counseling needs, 65.9% wanted to receive telephone counseling about patient condition, 52.7% counseling about re-admission and 51.9% direct counseling about patient condition. In the group of injury and toxicity, and cardiovascular/circulatory diseases, 100% wanted telephone and direct counseling about the patient condition. Conclusion: Therefore, in order to improve the quality of hospital based home health care services, various factors that affect to the need of home health care should be analyzed and specified nursing care should be looked into.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.161-163
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• 2002

The BNCT(Boron Neutron Capture Therapy) facility has been developed in Hanaro(High-flux Advanced Neutron Application Reactor), a research reactor of Korea Atomic Energy Research Institute. A typical tangenial beam port is utilized with this BNCT facility. Thermal neutrons can be penetrated within the limits of the possible maximum instead of being filtered fast neutrons and gamma rays as much as possible using the silicon and bismuth single crystals. In addition to, the liquid nitrogen (LN$_2$) is used to cool down the silicon and bismuth single crystals for the increase of the penetrated thermal neutron flux. Neutron beams for BNCT are shielded using the water shutter. The water shutter was designed and manufactured not to interfere with any other subsystem of Hanaro when the BNCT facility is operated. Also, it is replaced with conventional beam port plug in order to cut off helium gas leakage in the beam port. A circular collimator, composed of $\^$6/Li$_2$CO$_3$ and polyethylene compounds, is installed at the irradiation position. The measured neutron flux with 24 MW reactor power using the Au-198 activation analysis method is 8.3${\times}$10$\^$8/ n/cm$^2$ s at the collimator, exit point of neutron beams. Flatness of neutron beams is proven to ${\pm}$ 6.8% at 97 mm collimator. According to the result of acceptance tests of the water shutter, the filling time of water is about 190 seconds and drainage time of it is about 270 seconds. The radiation leakages in the irradiation room are analyzed to near the background level for neutron and 12 mSv/hr in the maximum for gamma by using BF$_3$ proportional counter and GM counter respectively. Therefore, it is verified that the neutron beams from BNCT facility in Hanaro will be enough to utilize for the purpose of clinical and pre-clinical experiment.

• Spatial Information Research
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• v.10 no.2
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• pp.247-261
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• 2002

There are much damage of people and property because of heavy rain every year. Especially, there are problem to major facility such as dam, bridge, road, tunnel, and industrial complex in the ground stability. So the counter plan for landslide or ground failure must be necessary In the study, the technique of regional landslide susceptibility assessment near the Ulsan petrochemical complex and Kumgang railway bridge was developed and applied using GIS. For the assessment, the geological structures such as bedding and fault were surveyed and the geological structure, topographic, soil, forest, and land use spatial database were constructed using CIS. Using the spatial database, the factors that influence landslide occurrence, such as slope, aspect, curvature and type of topography, texture, material, drainage and effective thickness of soil, type, age, diameter and density of forest, and land use were calculated or extracted from the spatial database. For application of geological structure, the geological structure line and fault density were calculated. Landslide susceptibility was analyzed using the landslide-occurrence factors by probability method that is summation of landslide occurrence probability values per each factors range or type. The landslide susceptibility map can be used to assess ground stability to protect major facility.

• Archives of Reconstructive Microsurgery
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• v.20 no.1
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• pp.32-37
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• 2011

Purpose: Canalicular laceration is relatively common due to its exposed, vulnerable location in case of facial trauma. Conjunctivodacryocystorhinostomy has been the standard treatment for canalicular obstruction secondary to unrepaired canalicular laceration. In spite of a high rate of relieving tear-duct obstruction, this method is noted to be associated with low rate of patient satisfaction and a number of complications. The goal of this study is to report the good results of delayed lacrimal stent implantation with Mini Monoka$^{(R)}$ for patients whose canaliculi were not repaired by initial surgery. Methods: From May of 2005 to February of 2007, four patients who underwent delayed lacrimal stent implantation using Mini Monoka$^{(R)}$ in canalicular laceration were retrospectively reviewed. First, the previous scar incision was made over the lower lid and we identified the cut end of proximal lacerated canaliculus. The Mini Monoka$^{(R)}$ was passed through the punctum to the cut end of the proximal lacerated canaliculus. We identified the cut end of the distal lacerated canaliculus, whose cut end has rolled white edges after careful excision of the scarred lid tissue. We then passed Mini Monoka$^{(R)}$ through the lacerated inferior canaliculus. Using an operating microscope, we placed three interrupted sutures of 8-0 Ethilon to join the canalicular ends. Silicone stent was left in place for 6 months. The mean age of the patients was 48.5 years (range, 35 to 59 years). The time interval from initial trauma to delayed lacrimal stent implantation was between 3 and 31 days. Follow-up periods ranged from 12 and 20 months. Results: The results of reconstruction were classified into normal, fair and poor. Patent lacrimal drainage systems were achieved in three of the four cases. In one case, epiphora was encountered. No cases of stent displacement, conjunctivitis or granuloma formation were encountered. Conclusion: Even though canalicular reconstruction was delayed for a long time, attempting canalicular reconstruction would be acceptable before considering secondary operations like dacryocystorhinostomy and conjunctivodacryocystorhinostomy.

• Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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• 2004.09a
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• pp.37-47
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• 2004

In Korea, over three hundreds of the coal mines were closed or abandoned due to the depression of the mining industry since the late 1980s. Many of them locate in the steep mountain valleys and the coal mine wastes had been disposed without a proper treatment From these mines, enormous amounts of coal mine overburdens have been abandoned in the slopes and the ample amounts of acid mine drainage (AMD) from either portal or overburdens have been discharging directly to the streams, causing the detrimental effects on soil and water qualities. Objectives of this research were to reclaim the coal mine overburdens using the lime waste cake from the soda ash production by stabilizing the overburden slopes, introducing the vegetation alleviate the environmental problems caused by the closed coal mines. The percentages of the grass distribution ratio (%) and the surface coverage ($\textrm{cm}^2$) in each treatment plot were determined during June to August after seed spraying grasses such as orchard grass (Dactylis glomerata L), Kentucky Bluegrass (Poa pratensis L.) and Eulalia (Miscanthus sinensis Anderss) at the end of May. The grasses covered only 15.5 % of the coal overburden plot at the early stage but the coverage was increased with time to 33% in August. Growth of such grasses was enhanced with the combined treatments of lime waste and topsoil resulting in the increased surface coverage by the grasses. The Increment of the surface coverage from June to August was higher with lime waste treatments. The distribution percentages and surface coverage were highest when the lime wastes were treated at 25 % of the lime requirement. This might be related with the high salt contents in the hire wastes. Results demonstrated that the amounts of lime wastes at 25% of the lime requirement were sufficient for neutralizing the acidic coal overburden and introducing the re-vegetation. Either layering between the coal waste and topsoil or mixing with coal overburdens could be adopted as the lime waste treatment method. The combined treatment of lime wastes and topsoil was recommended for re-vegetation in the coal overburden slopes. The lime wastes from the soda ash production might have a potential to be recycled for the reclamation of the abandoned coal mines to alleviate the environmental problems associated with coal mine waste.

• Journal of Chest Surgery
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• v.31 no.7
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• pp.650-659
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• 1998

Between August 1996 and August 1997, 22 patients underwent extracardiac Fontan operations. The basic diagnoses included univentricular heart of the right ventricular type (n=12); univentricular heart of the left ventricular type (n=4); tricuspid atresia (n=4); left isomerism, transposition of great arteries, ventricular septal defect and pulmonary stenosis (n=1); and criss-cross heart with uneven ventricle (n=1). The median age of the 14 men and 8 women was 29 months (range from 21 months to 26 years). Previous procedures included bidirectional cavopulmonary shunt (n=15, interval=15.6$\pm$3.4 months), Kawashima operation (n=4, interval=37.5$\pm$20 months), and classic Glenn shunt (n=1, interval=14 years). In 2 patients, extracardiac Fontan operations were done without any previous procedures. A 16- to 22-mm flexible Gore-Tex tube graft (n=18), Hemashield graft (n=3), or, alternatively, a nonvalved aortic allograft (n=1) was cut and anastomosed end-to-end between inferior vena cava and undersurface of pulmonary artery using Gore-Tex or Prolene suture in a running fashion. In risk Fontan patients (n=12), a communication between the extracardiac conduit and the right atrium was constructed. In the most 13 recent patients, the procedures were done without cross-clamping of the aorta and with a beating heart. Operative mortality was 9.1% (n=2). Complications included persistent chest tube drainage for more than 7 days (n=5), chorea (n=2), and low cardiac output (n=1). There were no late deaths. Follow-up echocardiogram (mean: 6 months) demonstrated satisfactory hemodynamic results in the surviving 20 patients. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, creationof a uniform and stable inferior vena cava-to-pulmonary artery conduit, and increased flexibility and safety in certain high-risk patients such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired ventricular function. Further investigations during a longer follow-up are needed to confirm the intermediate and long-term results, especially the reduction of late atrial arrhythmias.