• Journal of Chest Surgery
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• v.31 no.4
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• pp.346-352
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• 1998

Rheumatic valvulitis produces at least three distinct pathologic changes, the degree varying widely among the patients: fusion of the valve leaflets at the commissures; fusion and shortening of chordae tendinae: and fibrosis of the leaflets with subsequent stiffening, contraction and calcification. The most extensive changes usually are seen in patients with recurrent attacks of rheumatic fever. We studied on outcome of the surgical treatments of rheumatic valvular diseases that have been experienced for 12 years since 1982 at Pusan National University Hospital. The diagnoses were made by rheumatic fever history, echocardiographic findings, gross operative findings and microscopic findings. Total 502 patients were performed surgery for valvular heart diseases and 440 patients of rheumatic origin have bene analysed. There were more female than male patients as 1.3:1, and the mean age was 37.8 years old. 96.3% of them affected to the mitral valve, 19.8% to aortic valve, 16.3% affected to the tricuspid valve. Most of them underwent valve replacement, and valve repair was done in 3.9% of patients. There were 36 hospital deaths(8.2%) mainly from low cardiac output syndrome, and 15 late deaths equally due to embolism and hemorrhage. Follow up was 90.1% completed(2890 patient- year). Linealized rates of late complication events are follows : thromboembolism 1.3% per patient year; anticoagulant related hemorrhage 0.8% per patient year. Overall actuarial survival including hospital mortality was 92.7＋/-2.9% in 1 year, 88.0＋/-4.5% in 5 year, 82.3＋/-7.7% in 10 year. We conclude that the rheumatic disease is still the most frequent and the most important cause of heart valve disease. So more intensive study is needed in spite of the abrupt decreasing rate of rheumatic fever in U.S.A. and other industrial country.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.799-805
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• 1999

Background: Leakage, stricture formation, and tumor recurrence at the anastomotic site are serious problems after esophagectomy for cancer of the esophagus or cardia. The prevalence of these postoperative complications may be affected by whether an anastomosis is made in the neck or in the chest, therefore a comparison was made between anastomoses made at these two sites. Material and Method: Between 1987 and 1998, 36 patients with cancer of the esophagus underwent transthoracic esophagectomy with cervical(NA, n=20) or thoracic anastomosis(CA, n=16). The tumors were staged postoperatively(stage IIA, n=13; s tage IIB, n=7; stage III, n=16) and were located in the middle thoracic(n=22) or lower thoracic esophagus and cardia(n=14). Result: The overall operative mortality was 8.3%(5% for NA group, 12.5% for CA group). The anastomotic leak rate for the NA group was 15.0% and 12.5% for the CA group. The anastomotic leak rate differed according to the manual(27.3%) or stapled(8.0%) techniques(p < 0.05). The median proximal resection margins in the NA and CA groups were 9.6 cm and 5.8 cm, and the corresponding rates of anastomotic tumor recurrence were 5.3% and 28.6%(p < 0.05). The prevalence of benign stricture formation (defined as moderate/severe dysphagia) was higher in the NA group(36.8%) than in the CA group(21.4%). When an anastomosis was made by the stapled technique, smaller size of the staple increased the prevalence of stricture formation - 41.7% with 25-mm staple and 9.1% with 28-mm staple(p < 0.05). Conclusion: Wider resection margin could decrease the anastomotic tumor recurrence, and the stapled technique could decrease the anastomotic leak. The prevalence of benign stricture was higher in the cervical anastomosis but the anastomotic leak and smaller size(25-mm) of the staple should be considered as risk factors.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.401-409
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• 2004

Background: As the rupture of chordae and/or papillary muscle became the main cause of mitral valve regurgitation, mitral reconstructive surgery has a very important role. In this regard, we analyzed the clinical result and postoperative early result of operative treatment performed in our hospital, Material and Method: For this analysis, forty nine patients (male 26, female 23, mean age 49.0$\pm$16.5) who underwent mitral valve operation caused by the rupture of chordae and/or papillary muscle from August 1991 to April 2002 were reviewed. Among forty nine patients, twenty two (44.9%) received mital valve reconstruction and twenty seven (59.2%) received mitral valve replacement. Result: As to the pathological etiology of rupture of mitral and papillary muscle, twenty five cases (51.0%) were nonspecific degeneration, eleven cases (22.4%) were myxomatous degeneration, seven cases (14.3%) were subacute bacterial endocarditis. Three patients suffered mortality after operation (6.1%) and valve replacement was performed again on one patient because of remnant mitral insufficiency after valve reconstruction. The 5-year survival rate after operation for the entire mitral valve regurgitation patients was 81 .4%. We have also compared and analyzed the operation results of a group of patients who underwent valve reconstruction and the other group of patients who underwent valve replacement from thirty six patients who had suffered from mitral valve regurgitation caused by degenerative disease. The mortalities were 0% and 14.3%, respectively and the 5-year survival rates were 90.2% and 64.3%, respectively, but there were no statistical significance. Conclusion: The most common pathological etiology of mitral valve regurgitation caused by rupture of chordae and/or papillary muscle was nonspecific degeneration, In case of degenerative disease is the cause of mitral valve regurgitation, valve reconstruction showed better long-term effects in many respects and better operation results compared to valve replacement.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.275-280
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• 2006

Background: Aortopulmonary window (APW) is a very rare congenital heart anomaly, often associated with other cardiac anomalies. It causes a significant systemic to pulmonary artery shunt, which requires early surgical correction. Accurate diagnosis and surgical correction will bring good outcomes. The purpose of this study was to describe our 20-year experience of aortopulmonary window. Material and Method: Between March 1985 and January 2005, 16 patients with APW underwent surgical repair. Mean age at operation was $157.8{\pm}245.3$ ($15.0{\sim}994.0$) days and mean weight was $4.8{\pm}2.5$ ($1.7{\sim}10.7$) kg. Patent ductus arteriosus (8), atrial septal defect (7), interruptedaortic arch (5), ventricular septal defect (4), patent foramen ovate (3), tricuspid valve regurgitation (3), mitral valve regurgitation (2), aortic valve regurgitation (1), coarctation of aorta (1), left superior vena cavae (1), and dextrocardia (1) were associated. Repair methods included 1) division of the APW with primary closure or patch closure of aorta and pulmonary artery primary closure or patch closure (11) and 2) intra-arterial patch closure (3). 3) Division of the window and descending aorta to APW anastomosis (2) in the patients with interrupted aortic arch or coarctation. Result: There was one death. The patient had 2.5 cm long severe tracheal stenosis from carina with tracheal bronchus supplying right upper lobe. The patient died at 5th post operative day due to massive tracheal bleeding. Patients with complex aortopulmonary window had longer intensive care unit and hospital stay and showed more morbidities and higher reoperation rates. 5 patients had reoperations due to left pulmonary artery stenosis (4), right pulmonary artery stenosis (2), and main pulmonary artery stenosis (1). The mean follow-up period was $6.8{\pm}5.6$ (57.0 days$\sim$16.7 years)years and all patients belonged to NYHA class 1. Conclusion: With early and prompt correction of APW, excellent surgical outcome can be expected. However, optimal surgical method needs to be established to decrease the rate of stenosis of pulmonary arteries.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.294-298
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• 1999

Background: Video-assisted thoracoscopic surgery(VATS) has been established as a new method for treatment of spontaneous pneumothorax. We compared the clinical results of VATS with those of thoracotomy performed during the recent 5 years. Material and Method: We analyzed 126 patients whose medical records were available among the 154 patients who underwent operations for spontaneous pneumothorax from 1992 to 1996. The mean age was 27.1 years(15 to 75 years). 87 patients were operated on by VATS(Group A) and the other 39 by thoracotomy(Group B). The mean follow-up period was 14.7 months. Result: The operation time was shorter in group A than in group B(90.6${\pm}$38.6minutes: 117.2${\pm}$58.9minutes, p<0.05). The duration of postoperative hospital stay was shorter in group A than in group B(6.7${\pm}$4.2: 9.4${\pm}$3.3 days, p<0.05). The amount of analgesics(nalbuphin HCl, ketoprofen) used postoperatively were 2.4${\pm}$2.8 ampules in group A, which is less than the 6.5${\pm}$5.6 ampules in group B(p<0.05). The number of staples used in group A was smaller(2.7${\pm}$1.3 in group A, 1.76${\pm}$1.1 in group B, p<0.05). The duration of chest tube indwelling(4.3${\pm}$4.0 days in group A, and 5.6${\pm}$3.0 days in group B, NS), the recurrence rate(13.8% in group A, 2.6% in group B, NS), and the duration of air leakage(1.3${\pm}$3.3 days in group A, and 1.0${\pm}$2.5days in group B, NS) were not statistically different between the two groups. Conclusion: The application of VATS for the treatment of spontaneous pneumothorax has brought in better clinical results(shorter operation time, shorter hospital stay, less pain, and better cosmetic merits) than the thoracotomy without increasing any morbidity. However no advantages in recurrence rates and duration of postoperative air leakages are revealed.

• Korean Journal of Soil Science and Fertilizer
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• v.34 no.2
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• pp.122-128
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• 2001

In order to find out the effect of nitrogen fertilizers on soil pH, EC, $NO_3-N$ and lettuce growth, this study was conducted by pot experiment in plastic film house condition. The square-pot which was $42{\times}54.5{\times}22cm$ in length, width and height, respectively, was filled with two kinds of soils in different soil EC as $0.20dS\;m^{-1}$ and $1.13dS\;m^{-1}$. Seven kinds of nitrogen fertilizers (urea, potassium nitrate, calcium nitrate, ammonium nitrate, ammonium sulphate, complex fertilizer A(11-10-10) and complex fertilizer B(12-12-12)) were treated in same standard rate of nitrogen for lettuce, transplanted the six lettuce seedlings of 10 days grown per pot, and have been grown for 38~44 days with three times harvesting. Soil pH was increased with the potassium and calcium nitrate treatments and decreased with ammonium nitrate, ammonium sulphate, complex fertilzer A and B, and the pH of urea treatments was kept the same value as the pH of before experiment. The growing status of lettuce seedling were surveyed during the early period after transplanting and withering of seedling was occured in all treatments. The withering rates were 10% in soil of EC $0.20dS\;m^{-1}$ and 44% and 42% in complex fertilizer and ammonium sulphate treaments, respectively, in soil of EC $1.13dS\;m^{-1}$. $NO{_3}^-$ contents of lettuce were about $1,000{\sim}2,000mg\;kg^{-1}$ based on fresh weight and these contents were considered to be lower to compare the $NO{_3}^-$ level of EU countries.

• Korean Journal of Soil Science and Fertilizer
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• v.39 no.5
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• pp.268-273
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• 2006

Soil loss induced by erosion has come to be a serious problem in Korea's sloped land since more than 70% of upland fields are located on the sloped land area. The purpose of this study was to investigate the phase of water flow in differently soil textured plot soil types by rainfall amount. Lysimeters with slope of 15%, 5 m in length, 2 m in width, and 1 m in depth were prepared and filled up with three different soil textures, such as sandy loam, loam, and clay loam, then relationships between seasonal rainfall and runoff, percolation were analyzed. Runoff and percolation rate were shown to increase linearly with increasing rainfall intensity in all the soil textures, but the starting threshold and increment rate in runoff and percolation occurrence were dependent differently upon soil textures. Percolation increment rate according to the increasing rainfall amount was 0.52, 0.36, and 0.57 for sandy loam, loam and clay loam soil respectively. The threshold rainfall amounts in which percolation occurs were 5.73 mm, 6.80 mm, and 12.86 mm for sandy loam, loam and clay loam respectively. Runoff increment rates were 0.42, 0.48 and 0.46 for sandy loam, loam and clay loam soil. The threshold rainfall amount in which runoff occurs was 10.50 mm in sandy loam, 7.76 mm in loam and 17.40 mm in clay loam. These different phases of water flow by soil texture could be used to suggest guidelines for the best management practice of the farming slope land.

• Korean Journal of Soil Science and Fertilizer
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• v.27 no.1
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• pp.54-63
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• 1994

Runner-derived(Expt.1) and tissue culture-derived strawbeery plantlets(Expt. 2) were grown in pots under greenhouse condition and inoculated with inocula of the vesicular-arbuscular mycorrhizal(VAM) fungi isolated from a field strawberry plants. Total biomass of mycorrhizal strawberry plants was significantly increased. There was a similar tendency in the number of cluster and flower at 20 weeks after inoculation, and VAM fungi inoculation positively influenced the leaf number, leaf length, leaf width and petiole length of strawberry plants in all investigated times. However, no difference was in the flowering time of strawberry plants. Leaf margin of non-inoculated strawberry plantlets turned into raddish brown(7.5R 4/8) from around 4 weeks after habituation. Inoculation of VAM fungi at the time of habituation was much more effective in stimulating plant growth. VA mycorrhizal dependency were 162.7 % in the runner-derived strawberry plants, Dependency with pre-and post-habituated incoulation in tissue culture-derived plants was respective 116.4% and 106.0%. The levels of mycorrhizal colonization were increased with plant growth and infection rates by endophytes at harvest time were 47.5% in Expt. 1, 56.4% in Expt. 2, respectively. Contents of phosphorus, potassium and calcium in mycorrhizal strawberry plants at harvest time were higher than non-mycorrhizal ones however, magnesium concentration was decreased. These experiments demonstrated that VAM fungi could be introduced into nursery stages of strawberry plantlets including the temporary planting period to improve growth and plant nutrients uptake by mycorrhizal plants.

• Korean Journal of Soil Science and Fertilizer
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• v.27 no.1
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• pp.27-32
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• 1994

These studies were Conducted to survey cultivation methods, and to analyze soil chemical properties for stable production of Aralia continentalis K., a promising medicinal crop, in the main producting districts. Aralia continentalis K. was cultivated with planting budstocks in distances of $90cm{\times}60cm$ for 3~4 years in the same field, and application rates were N 10~31 kg/10a and P, K 8~17/10a using inorganic fertilizer, that is compound fertilizer(21-17-17) for basal dressings and urea for topdressings. Most of all, the soil surveyed was coarse loamy class which was well drained and soil depth is 50~150cm in the valleys. Soil pH was low, and content of organic matters and av. $P_2O_5$ was abundant but that of exchangeable cation such as Ca, Mg, K was deficient. The relationship between growth characteristics and weight of fresh root was positive correlation in the order of No. of root, stem width, No. of node and branch, plant height and root width. On the path coefficiant analysis, the relationship between content of soil K, Ca and root yield was more apparent than other chemical properties.

• Korean Journal of Soil Science and Fertilizer
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• v.27 no.1
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• pp.21-26
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• 1994

Lysimeter experiments were carried out to study the vertical distribution of inorganic nitrogen, the changes in pHs of soil and leachate and the fate of applied nitrogen with or without grass. The concentration of $NO_3-N$ of surface soil(0~20cm) at the rates of 0, 7, 14 and 21kg N/10a ranged from 4 to 13mg/kg, while those of subsurface soi1(20-40cm) were below 10mg/kg at 0, 7 and 14kg N/10a and subsequently increased to 83.8mg/kg at 35kg N/10a. The concentration of $NH_4{^+}-N$ was positively correlated with that of $NO_3-N$ for surface soil(>0.05). However, the concentration of $NH_4{^+}-N$ was negatively correlated with that of $NO_3-N$ for subsurface soil. A positive correlation was observed between $NO_3-N$ and extractable cations of soils. The pH of subsurface soil decreased with the $NO_3-N$ concentration and the N application rate, while that of leachate inereased with the N application rate. The pH differences between subsurface soil and leachate were 2.5 for bare soil and 3.1 for 35kg N/10a. Higher N application rate caused more soil N accumulation and the gas loss and resulted in a larger difference between N uptake by grass and the applied N.