• Journal of Chest Surgery
• /
• v.36 no.9
• /
• pp.646-650
• /
• 2003

Many surgical techniques for ischemic mitral regurgitation (IMR) have been used with their excellent results and advantages. Here, we report our simple posterior annuloplasty techniques using vascular graft strip with their early results. Material and Method: Twenty two patients (13 male) underwent the operations for IMR (excluding the papillary muscle rupture) from December 2001 to January 2003. Preoperative risk factors were low ejection fraction (<35％, n=9), hypertension (n=13), diabetes (n=9), and renal failure (Cr>2.5, n=4). The wide dissection beneath the both vena cavae and interatrial groove after bicaval cannulation enabled the easy exposure of mitral valve even in the small left atrium. After eight or nine interrupted sutures in posterior annulus for anchoring the 6 mm width vascular graft strip, symmetric (n=8) or asymmetric (n=14) annuloplasty were done. Combined surgeries were CABG (n=21), Dor procedures (n=3), tricuspid valve annuloplasty (n=1), Maze operation (n=1), and aorto-right subclavian artery bypass (n=1). Result: Except for one surgical mortality, all the patients were doing well and the mean grade of regurgitation was decreased from 2.95 to 0.88, however the ejection fraction had not changed significantly just before discharge. Post-operative valve function evaluated before discharge revealed no residual regurgitation in 8 (including 1 patient with mild stenosis due to over reduction), minimal in 11, mild in 2, and mild to moderate regurgitation in 1. One patient who had ischemic cardiomyopathy and renal failure died of the arrhythmia during the hemodialysis. Conclusion: These observations suggest that the annuloplasty with vascular graft strip could be a safe and cost effective techniques for ischemic mitral regurgitation. However, the long term evaluation for the mitral valve function should be defined for the final conclusion.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.37 no.6
• /
• pp.57-65
• /
• 2010

Physical activity of the people has decreased due to a sedentary lifestyle according to developing the economy throughout the world. It is thought to increase the risk of chronic diseases, including obesity, diabetes, etc. People are interested in walking, which is an easy activity to engage in as an antidote to chronic diseases. The aim of this study is to increase the diminishing physical activity of modem society by inducing walking as part of everyday life through building a walking-based activity-friendly city where people can live merrily, safely and pleasantly. For this purpose, this study conducted a satisfaction survey to dwellers of Jinhae on the physical pedestrian environments which affect determining walking participation and intentions of people, and also provided a valid model to evaluate the effects of the physical environmental factors on walking satisfaction using factor analysis and multiple linear regression analysis. The results are summarized as follows. The 18 variables of the physical pedestrian environments were selected based on pre-literature reviews. The results of the satisfaction surveys showed that the satisfaction of crossing aids in segments was highest, while the building feature was the lowest. Factor analysis was run through a two-step process. The first analysis was conducted to examine the adequacy of this factor analysis on the selected 18 variables. As a result, two variables were removed and the remaining 16 variables were extracted to the four factors by second analysis. Each factor was named function of path, effect of traffic, amenity and safety based on the each factor's commonality. Each factor score of the extracted four factors was set as the independent variable, while the overall walking satisfaction was set as the dependent variable. Then, the multiple linear regression analysis was conducted and showed that all four factors had a positive influence on the overall satisfaction of walking, especially the 'function of path' and 'amenity' factors, followed by 'effect of traffic' and 'safety'. The results of this research will be used as foundational data for creating a walking-based activity-friendly city.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.9 no.2
• /
• pp.79-84
• /
• 2010

Purpose: In patients with meniscal tear with degenerative arthritis, controversy remains as to whether arthroscopic menisectomy is worthwhile or not. The purpose of this study was to evaluate the effect of arthroscopic medial meniscectomy in degenerative arthritis of the knee with meniscal tear. We also intended to identify pertinent indications and risk factors. Materials and Methods: 287 patients underwent arthroscopic medial meniscectomy from 2006 to 2008; 103 patients who had Kellgren-Lawrence grade II, III arthritis of the knee, were over 50 years old, and had minimum 1 year follow-up, were analyzed in this study. Clinical assessment was performed retrospectively using the arthroscopic surgery database, medical records, questionnires and interviews. Assessment included visual analogue scale (VAS) scores and Lysholm scores. Results: The mean Lysholm score increased from 69 to 85 after surgery. The mean VAS score improved from 7 to 3.1 after surgery. Kellgren-Lawrence grade II group and group with trauma history showed significant improvement of pain and function compared with grade III and group without trauma history. Outerbridge grade I showed significantly more improvement of pain than grade III and IV. Multiple regression analysis showed that trauma history and Outerbridge grade affect the improvement of Lysholm score. Conclusion: In one year follow-up, arthroscopic medial menisectomy can improve pain and function of patients in Kellgren-Lawrence grade II, III degenerative arthritis of the knee. We could expect good results especially in group with low Kellgren-Lawrence grade, trauma history, and mild articular cartilage lesion.

• Journal of Korean Ophthalmic Optics Society
• /
• v.18 no.4
• /
• pp.357-363
• /
• 2013

Purpose: To investigate the visual function with prescription swimming goggles. Methods: 15 university students (mean age: $22{\pm}1.54$ years) participated, with a mean distance refractive error of RE: S-1.67 D/C-0.40 D, LE: S-1.70D/C-0.37 D. Inclusion criteria were no ocular pathology, able to wear soft contact lenses to correct their refractive error to emmetropia and able to swim. Participants were fitted with contact lenses to correct all ametropia. Subjective evaluation for satisfaction of visual acuity, asthenopia and balance were also measured using a questionnaire while wearing swimming goggles with cylinder (C+1.50 D, Ax $90^{\circ}$) compared with plano sphere outside the swimming pool area. Visual acuity was assessed using the same ETDRS chart. The prescription swimming goggles powers were assessed in random order and ranged in power from S+3.00 D to S-3.00 D in 0.50 D steps. Results: Subjective evaluation was significantly worse for the swimming goggles with cylinder than for the plano powered goggles for all 3 questions, visual acuity, asthenopia and balance. Visual acuity were significantly affected by the different power of the swimming goggles (p<0.05), but there was no significant difference between the in-air in-clinic and underwater in-swimming pool measures (p=0.173). However, visual acuity measured in the clinic was significantly better than underwater for some swimming goggle powers (+3.00, +1.00, +0.50, 0, -1.00 and -2.00 D). Conclusions: Wearing swimming goggles underwater may degrade the visual acuity compared to within air but as the difference is less than 1 line of Snellen acuity, and it is unlikely to result in significant real-life effects. Having an incorrect cylinder correction was found to be detrimental resulting in lower score of satisfaction. Considering slippery floor of swimming pool area, it can be a potential risk factor. Therefore, it is important to correct any refractive error in addition to astigmatism for swimming goggle.

• Journal of Chest Surgery
• /
• v.37 no.8
• /
• pp.652-659
• /
• 2004

Background: In this study, we retrospectively analyzed the outcomes of aortic valvuloplasty in pediatric age. Material and Method: Between January 1993 and March 2004, 35 patients underwent aortic valvuloplasty for aortic stenosis (AS) or aortic regurgitation (AR). The mean age was 81.1$\pm$61.5 (1∼223) months. The mean follow up was 50.8$\pm$30.2 (3∼121) months. Nine patients had AS, 21 had AR, and 6 had AS and AR. Valve morphology was tricuspid in 24 patients, bicuspid in 9, quadricuspid in 1, and unicuspid in 1. The mean peak pressure gradients of AS were 72.0$\pm$33.0 mmHg, and the mean grades of AR were 3.1$\pm$0.9. Result: There was one late mortality without early mortality. After operation, AS improved with mean peak pressure gradients of 23.5$\pm$21.0 mmHg (p < 0.05), and AR improved with mean grades of 1.9$\pm$0.8 (p < 0.05). At mean follow up of 35.0$\pm$23.0 months, AS maintained with mean peak pressure gradients of 31.5$\pm$24.0 mmHg, but AR progressed with mean grades of 2.8$\pm$1.3 (p < 0.05). Reoperation was required in 6 patients 38.3$\pm$21.8 months after the original operation. The actuarial figures for freedom from reoperation at 2, 5 and 8 years were 96.9$\pm$3.1%, 79.5$\pm$5.5%, and 56.8$\pm$11.4%, respectively. Age at operation, presence of AS, preoperative severity of AS or AR, and morphology of aortic valve were not significant risk factors for reoperation, and improvement of AS or AR. Conclusion: Aortic valvuloplasty showed good immediate postoperative valve function. Aortic valvuloplasty offers children many years with tolerable valve function and allows to postpone aortic valve replacement or Ross procedure in pediatric patients.

• Childhood Kidney Diseases
• /
• v.7 no.1
• /
• pp.60-66
• /
• 2003

Purpose : Neonatal hydronephrosis has been detected with increasing frequency with the widespread use of prenatal ultrasonography, but the consensus about its postnatal management has not yet been reached, especially about surgical intervention. We attempted to determine the guideline of follow-up study and surgical intervention of hydronephrosis by analyzing clinical outcomes of neonates with hydronephrosis. Materials and Methods : Between 1994 and 2000, 128 hydronephrotic kidneys were postnatally confirmed. Cases associated with other urologic anomalies were excluded and 90 unilateral hydronephrotic kidneys with a minimum follow-up of 12 months were enrolled in this study. We classified the patients into 6 groups according to the anterior posterior pelvic diameter(APPD) at initial ultrasonography(USG) within 1 month after birth. Renal USG and $Tc^{99m}-mercaptoacetyl$ triglycerine(MAG3) scan were done according to a set protocol, and pyeloplasty was performed when indicated according to our protocol. Results : Most cases whose APPD were below 10 mm improved or resolved. Only few cases with APPD above 20 mm showed spontaneous improvement and most(88%) had undergone operation. Those with initial APPD within 10-19 mm showed variable outcomes. When the risk factors for irreversible renal functional deterioration were analyzed, the age at pyeloplasty and pre-operative functional deficit were significant. Conclusion : We concluded that in infants with initial APPD below 10 mm, consideration of surgery is not needed, and in those with initial APPD above 20 mm, early operation is recommended. Our set protocol based on initial USG is useful, but the cut-off value of relative renal function(RRF) for operation might be increased to 40% to improve post operative RRF.

• Clinical and Experimental Pediatrics
• /
• v.53 no.3
• /
• pp.420-427
• /
• 2010

Purpose : Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods : One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid function, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction. Results : Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were $0.08{\pm}1.04$, $-0.09{\pm}1.02$, and $-0.27{\pm}1.18$, respectively (P =0.001). Height SDS significantly decreased in patients who received total body irradiation (TBI) (P =0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P =0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P =0.001). Conclusion : The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.6
• /
• pp.888-899
• /
• 1995

Background: Topical inhaled steroids, budesonide(Bu) and beclomethasone dipropionate (BOP), are now established as effective drugs in the management of chronic asthma. These drugs have high topical anti-inflammatory effect with low systemic activity. This study was performed to determine the effects of two inhaled corticosteroids, Bu and BOP, on the adrenocortical supression in 44 patients with bronchial asthma or chronic obstructive pulmonary disease. Methods: The adrenocortical function was assessed by measurement of serum cortisol concentration at 8 o'clock in morning and free cortisol in 24-hour urine collection at interval in 44 patients. No steroid was administered during the pretreatment period of 10 days and the final 6 days of the study. Each subject inhaled BOP or Bu, in daily doses of 800 or 1,600 micrograms for 12 days. The dose was delivered by metered dose inhaler (MDI) or diskhaler or large spacing device attached to MDI. Results: The levels of serum cortisol and 24-hour urinary free cortisol were decreased during the treatment period in patients inhaled Bu delivered by MDI in daily doses of 800 and 1,600 micrograms. In contrast, serum cortisol level was decreased on 6 and 12th day of treatment period in patients with BDP diskhaler in daily doses of 800 micrograms. In daily doses of 1,600 micrograms, the serum cortisol and 24hour urine free cortisol levels were decreased on 6, 9 and 12th day of treatment period in patients with BDP disk haler. The serum cortisol and 24-hour urinary free cortisol levels were not significantly decreased during the treatment period in patients inhaled Bu delivered by large spacing device attached to a MDI. Conclusion: These results showed that 1) the endogenous cortisol secretion was suppressed after inhalation of BDP and Bu in daily doses of 800 and 1,600micrograms, 2) Bu with MDI suppressed the adrenocortical function more than BDP with diskhaler, in daily doses of 1600 micrograms. and 3)large spacing device attached to a MDI might decrease the risk of suppression in the hypothalamic -pituitary- adrenal axis.

• Childhood Kidney Diseases
• /
• v.17 no.2
• /
• pp.73-78
• /
• 2013

Purpose: We aimed to investigate the clinical characteristics and associated diseases in children with a horseshoe kidney and compared these data between children and adults. Method: We performed a retrospective analysis of the medical records and radiological findings of 43 patients diagnosed with a horseshoe kidney in the Busan Paik Hospital. The subjects were divided into the children's group (14 cases, age <18 years) and the adult group (29 cases, age ${\geq}18$ years). Results: The study group consisted of 17 males and 26 females with a median age of 34 years. In the children's group (14 cases), 5 subjects were male and 9 were female, with a mean age of $6.7{\pm}6.2$ years. Most of the subjects were asymptomatic and were incidentally diagnosed with horseshoe kidney during their evaluation for another disease. Among the associated diseases in the children's group, Turner syndrome was the most common (5 cases), whereas ureteropelvic junction (UPJ) stricture was observed in 2 cases (14.2%). None of the children exhibited abnormal renal function during the follow-up period. In the adult group (29 cases), 12 subjects were male and 17 were female, with a mean age of 48 years. Eighteen patients were incidentally diagnosed with horseshoe kidney during their evaluation for another disease, and 11 patients had hematuria or abdominal pain due to renal stones. Among the associated diseases in the adult group, Turner syndrome was the most common (5 cases), and UPJ stricture was observed in 5 cases; the other accompanying diseases included hydronephrosis and overactive bladder. Six patients exhibited decreased renal function (serum creatinine level >1.5) during the follow-up period. Conclusion: Horseshoe kidney is usually diagnosed incidentally in both children and adults. In the present study, we noted that Turner syndrome was the most common associated disease in children. In addition, most children were asymptomatic but had a high risk of urologic complications after the transition to adulthood. Therefore, children with horseshoe kidney require continuous follow-up.

• Korean Journal of Soil Science and Fertilizer
• /
• v.33 no.3
• /
• pp.193-204
• /
• 2000

In order to get some basic data on environmental friendly function by Korean organic farming, the chemical characteristics of soil were determined on 100 farm cultivating site in Paldang watershed area of Great Seoul. The EC and content of $NO_3-N$ and Av. $P_2O_5$ in topsoil(0~30cm) showed $2.30dS\;m^{-1}$, $82mg\;kg^{-1}$, $918mg\;kg^{-1}$ in the soil cultivated chinese cabbage. $2.29dS\;m^{-1}$, $86mg\;kg^{-1}$, $954mg\;kg^{-1}$ in the soil of lettuce, $1.83dS\;m^{-1}$, $66mg\;kg^{-1}$, $1114mg\;kg^{-1}$ in the soil of crown daisy. These salt accumulation(EC) and the high concentration of mineral content in topsoil such as nitrate and phosphate showed the soils of organic farming were contaminated by practice of organic farming for the maintenance strategy of soil fertility. The $NO_3-N$ and Av. $P_2O_5$ in the subsoil(30~60cm) showed $75mg\;kg^{-1}$ and $641mg\;kg^{-1}$, $72mg\;kg^{-1}$ and $466mg\;kg^{-1}$, $42mg\;kg^{-1}$ and $873mg\;kg^{-1}$ in soil cultivated chinese cabbage, lettuce and crown daisy respectively. It indicates eventually the high concentration of nitrate and phosphate in topsoil caused penetration to subsoil, and the high concentration of mineral contents in subsoil indicate the potential risk of leaching of ground water by Korean organic farming. The positive correlation at 1% between EC and $NO_3-N$, $K_2O$, T-C, $P_2O_5$ and T-N show the salt accumulation in the both soil depth of Korean organic farming were caused by minerals such as $NO_3-N$, $K_2O$, T-C, $P_2O_5$ and T-N by overuse of organic fertilizer.