• Journal of Chest Surgery
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• v.38 no.8 s.253
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• pp.538-544
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• 2005

Background: Pulmonary artery banding (PAB) is an initial palliative procedure for a diverse group of patients with congenital cardiac anomalies and unrestricted pulmonary blood flow. We proved the usefulness of PAB through retrospective investigation of the surgical indication and risk analysis retrospectively. Material and Method: One hundred and fifty four consecutive patients (99 males and 55 females) who underwent PAB between January 1986 and December 2003 were included. We analysed the risk factors for early mortality and actuarial survival rate. Mean age was $2.5\pm12.8\;(0.2\sim92.7)$ months and mean weight was $4.5\pm2.7\;(0.9\sim18.0)\;kg$. Preoperative diagnosis included functional single ventricle $(88,\;57.1\%)$, double outlet right ventricle $(22,\;14.2\%)$, transposition of the great arteries $(26,\;16.8\%)$, and atrioventricular septal defect $(11,\;7.1\%)$. Coarctation of the aorta or interrupted aortic arch $(32,\;20.7\%)$, subaortic stenosis $(13,\;8.4\%)$ and total anomalous pulmonary venous connection $(13,\;8.4\%)$ were associated. Result: The overall early mortality was $22.1\%\;(34\;of\;154)$, The recent series from 1996 include patients with lower age $(3.8\pm15.9\;vs.\;1.5\pm12.7,\;p=0.04)$ and lower body weight $(4.8\pm3.1\;vs.\;4.0\pm2.7,\;p=0.02)$. The early mortality was lower in the recent group $(17.5\%;\;16/75)$ than the earlier group $(28.5\%;\;18/45)$. Aortic arch anomaly (p=0.004), subaortic stenosis (p=0.004), operation for subaortic stenosis (p=0.007), and cardiopulmonary bypass (p=0.007) were proven to be risk factors for early death in univariate analysis, while time of surgery (<1996) (p=0.026) was the only significant risk factor in multivariate analysis. The mean time interval from PAB to the second-stage operation was $12.8\pm10.9$ months. Among 96 patients who survived PAB, 40 patients completed Fontan operation, 21 patients underwent bidirectional cavopulmonary shunt, and 35 patients underwent biventricular repair including 25 arterial switch operations. Median follow-up was $40.1\pm48.9$ months. Overall survival rates at 1 year, 5 years and 10 years were $81.2\%\;65.0\%,\;and\;63.5\%$ respectively. Conclusion: Although it improved in recent series, early mortality was still high despite the advances in perioperative management. As for conventional indications, early primary repair may be more beneficial. However, PA banding still has a role in the initial palliative step in selective groups.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.150-156
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• 2003

Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid re-gurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. Material and Method: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. Result: There were 43 cases of tricuspid an-nuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 29 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regur-gitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p > 0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. Conclusion: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent sig-nificant tricuspid regurgitation that may develop later.

• The Korean Journal of Nuclear Medicine
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• v.39 no.4
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• pp.239-245
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• 2005

Purpose: Hypereosinophilic syndrome (HES) is an infiltrative disease of eosinophils affecting multiple organs including the iung. F-18 2-fluoro-2-deoxyglucose (F-18 FDG) may accumulate at sites of inflammation or injection, making interpretation of whole body PET scan difficult in patients with cancer. This study was to evaluate the PET findings of HES with lung involvement and to find out differential PET features between lung malignancy and HES with lung involvement. Material and Methods: F-18 FDG PET and low dose chest CT scan was performed for screening of lung cancer. light patients who showed ground-glass attenuation (GGA) and consolidation on chest CT scan with peripheral blood eosinophilia werr included in this study. The patients with history of parasite infection, allergy and collagen vascular disease were excluded. CT features and FDG PET findings were meticulously evaluated for the distribution of GGA and consolidation and nodules on CT scan and mean and maximal SUV of abnormalities depicted on F-18 FDG PET scan. In eight patients, follow-up chest CT scan and FDG PET scan were done one or two weeks after initial study. Results: F-18 FDG PET scan identified metabolically active lesions in seven out of eight patients. Maximal SUV was ranged from 2.8 to 10.6 and mean SUV was ranged from 2.2 to 7.2. Remaining one patient had maximal SUV of 1.3. On follow-up FDG PET scan taken on from one to four weeks later showed decreased degree of initially noted FDG uptakes or migration of previously noted abnormal FDG uptakes. Conclusions: Lung involvement in the HES might be identified as abnormal uptake foci on FDG PET scan mimicking lung cancer. Follow-up FDG PET and CT scan for the identification of migration or resolution of abnormalities and decrement of SUV would be of help for the differentiation between lung cancer and HES with lung involvement.

• The Korean Journal of Air & Space Law and Policy
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• v.25 no.2
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• pp.139-162
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• 2010

In terms of the international air transport, the open skies policy implies freedom in the sky or opening the sky. In the normative respect, the open skies policy is a kind of open-door policy which gives various forms of traffic right to other countries, but on the other hand it is a policy of free competition in the international air transport. Since the Airline Deregulation Act of 1978, the United States has signed an open skies agreement with many countries, starting with the Netherlands, so that competitive large airlines can compete in the international air transport market where there exist a lot of business opportunities. South Korea now has an open skies agreement with more than 20 countries. The frequent flyer program (FFP) is part of a broad-based marketing alliance which has been used as an airfare strategy since the U.S. government's airline deregulation. The membership-based program is an incentive plan that provides mileage points to customers for using airline services and rewards customer loyalty in tangible forms based on their accumulated points. In its early stages, the frequent flyer program was focused on marketing efforts to attract customers, but now in the environment of intense competition among airlines, the program is used as an important strategic marketing tool for enhancing business performance. Therefore, airline companies agree that they need to identify customer needs in order to secure loyal customers more effectively. The outcomes from an airline's frequent flyer program can have a variety of effects on international competition. First, the airline can obtain a more dominant position in the air flight market by expanding its air route networks. Second, the availability of flight products for customers can be improved with an increase in flight frequency. Third, the airline can preferentially expand into new markets and thus gain advantages over its competitors. However, there are few empirical studies on the airline frequent flyer program. Accordingly, this study aims to explore the effects of the program on international competition, after reviewing the types of strategic alliance between airlines. Making strategic airline alliances is a worldwide trend resulting from the open skies policy. South Korea also needs to be making open skies agreements more realistic to promote the growth and competition of domestic airlines. The present study is about the performance of the airline frequent flyer program and international competition under the open skies policy. With a sample of five global alliance groups (Star, Oneworld, Wings, Qualiflyer and Skyteam), the study was attempted as an empirical study of the effects that the resource structures and levels of information technology held by airlines in each group have on the type of alliance, and one-way analysis of variance and regression analysis were used to test hypotheses. The findings of this study suggest that both large airline companies and small/medium-size airlines in an alliance group with global networks and organizations are able to achieve high performance and secure international competitiveness. Airline passengers earn mileage points by using non-flight services through an alliance network with hotels, car-rental services, duty-free shops, travel agents and more and show high interests in and preferences for related service benefits. Therefore, Korean airline companies should develop more aggressive marketing programs based on multilateral alliances with other services including hotels, as well as with other airlines.

• Clinical and Experimental Reproductive Medicine
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• v.33 no.3
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• pp.179-187
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• 2006

Objectives: The risk of aneuploidies of embryos increases in advanced maternal age or parental karyotype abnormality and it results in poor reproductive outcomes such as recurrent spontaneous abortion (RSA) or repeated implantation failure (RIF). Preimplantation genetic diagnosis for aneuploidy screening (PGD-AS) can be applied for better ART outcome by selecting chromosomally normal embryos. The aim of this study is to evaluate the clinical outcome of PGD-AS and which group can get much benefit from PGD-AS among the patients expected to have poor reproductive outcome. Methods: In 42 patients, 77 PGD cycles were performed for aneuploidy screening. Patients were allocated to 3 groups according to the indication of PGD-AS: group I-patients with old age (${\geq}37$) and RIF more than 3 times (n=11, mean age=42.2 yrs.), group II-patients with RSA (${\geq}3$ times) associated with aneuploid pregnancy (n=19, mean age=38.9 yrs.), group III-parental sex chromosome abnormality or mosaicism (n=18, mean age=29.6 yrs.) including Turner syndrome, Klinefelter syndrome and 47, XYY. PGD was performed by using FISH for chromosome 13, 16, 18, 21, X and Y in group I and II, and chromosome X, Y and 18 (or 17) in group III. Results: Blastomere biopsy was successful in 530 embryos and FISH efficiency was 92.3%. The proportions of transferable embryos in each group were $32.5{\pm}17.5%$, $23.0{\pm}21.7%$ and $52.6{\pm}29.2%$ (mean ${\pm}$ SD), respectively, showing higher normal rate in group III (group II vs. III, p<0.05). The numbers of transferred embryos in each group were $3.9{\pm}1.5$, $1.9{\pm}1.1$ and $3.1{\pm}1.4$ (mean ${\pm}$ SD), respectively. The clinical pregnancy rates per transfer was 0%, 30.0% and 20.0%, and it was significantly higher in group II (group I vs. group II, p<0.05). The overall pregnancy rate per transfer was 19.6% (10/51) and the spontaneous abortion rate was 20% (2/10) of which karyotypes were euploid. Nine healthy babies (one twin pregnancy) were born with normal karyotype confirmed on amniocentesis. Conclusion: Our data suggests that PGD-AS provides advantages in patients with RSA associated with aneuploidy or sex chromosome abnormality, decreasing abortion rate and increasing ongoing pregnancy rate. It is not likely to be beneficial in RIF group due to other detrimental factors involved in implantation.

• Tuberculosis and Respiratory Diseases
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• v.53 no.5
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• pp.497-509
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• 2002

Background : The mechanisms through which cellular activation results in intracellular mycobacterial killing is only partially understood. However, in vitro studies of human immunity to Mycobacterium tuberculosis have been largely modeled on the work reported by Crowle, which is complicated by several factors. The whole blood culture is simple and allows the simultaneous analysis of the relationship between bacterial killing and the effect of effector cells and humoral factors. In this study, we attempted to determine the extent to which M. tuberculosis is killed in a human whole blood culture and to explore the role of the host and microbial factor in this process. Methods : The PPD positive subject were compared to the umbilical cord blood and patients with tuberculosis, diabetes and lung cancer. The culture is performed using heparinized whole blood diluted with a culture medium and infected with a low number of M. avium or M. tuberculosis $H_{37}Ra$ for 4 days by rotating the culture in a $37^{\circ}C$, 5% $CO_2$ incubator. In some experiments, methlprednisolone- or pentoxifyline were used to inhibit the immune response. To assess the role of the T-cell subsets, CD4+, CD8+ T-cells or both were removed from the blood using magnetic beads. The ${\Delta}$ log killing ratio was defined using a CFU assay as the difference in the log number of viable organisms in the completed culture compared to the inoculum. Results : 1. A trend was noted toward the improved killing of mycobacteria in PPD+ subjects comparing to the umbilical cord blood but there was no specific difference in the patients with tuberculosis, diabetes and lung cancer. 2. Methylprednisolone and pentoxifyline adversely affected the killing in the PPD+ subjects umbilical cord blood and patients with tuberculosis. 3. The deletion of CD4+ or CD8+ T-lymphocytes adversely affected the killing of M. avium and M. tuberculosis $H_{37}Ra$ by PPD+ subjects. Deletion of both cell types had an additive effect, particularly in M. tuberculosis $H_{37}Ra$. 4. A significantly improved mycobacterial killing was noted after chemotherapy in patients with tuberculosis and the ${\Delta}$ logKR continuously decreased in a 3 and 4 days of whole blood culture. Conclusion : The in vitro bactericidal assay by human whole blood culture model was settled using a CFU assay. However, the host immunity to M. tuberculosis was not apparent in the human whole blood culture bactericidal assay, and patients with tuberculosis showed markedly improved bacterial killing after anti-tuberculous chemotherapy compared to before. The simplicity of a whole blood culture facilitates its inclusion in a clinical trial and it may have a potential role as a surrogate marker in a TB vaccine trial.

• Journal of Food Hygiene and Safety
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• v.20 no.4
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• pp.258-266
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• 2005

Licorice Extract and Erythritol, food additives used in korea, are widely used in foods as sweetener. Its application for use in food is regulated by the standard and specification for food additives but official analytical method far determination of these sweetener in food has not been established. Accordingly, we has been carried out to set up analytical method of the glycyrrhizic acid in several foods by the way of thin layer chromatography and high performance liquid chromatography glycyrrhizic acid is qualitative anaylsis technique consists of clean-up with a sep-pak $C_{18}$ cartridge, separation of the sweeteners by Silica gel 60 F254 TLC plate using 1-butanol:4Nammonia solution:ethanol (50:20:10) as mobile solvent. Also, the quantitative analysis for glycyrrhizic acid, was performed using Capcell prk $C_{18}$ column at wavelength 254nm and DW:Acetonitrile (62:38 (pH2.5)) as mobile phase. and we has been carried out to set up analytical method of the erythritol in several foods by the way of high performance liquid chromatography. erythritol is qualitative anaylsis technique consists of clean-up with a DW and hexane. The quantitative analysis for erythritol, was performed using Asahipak NH2P-50 column, Rl and DW:Acetonitrile (25:75) as mobile phase. The glycyrrhizic acid results determined as glycyrrhizic acid in 105 items were as follows; N.D$\∼$48.7ppm for 18 items in soy sauce, N.D$\∼$5.3ppm for 12 items in sauce, N.D$\∼$988.93ppm for 15 items in health food, N.D$\∼$180.7ppm for 26 items in beverages, N.D$\∼$2.6ppm for 8 items in alcoholic beverages repectively and ND for 63 items in the ethers. The erythritol results determined as erythritol in 52 items were as follows; N.D$\∼$155.6ppm for 13 items in gm, N.D$\∼$398.1ppm for 12 items in health foods repectively and ND for 45 items in the others.

• Korean Journal of Environmental Biology
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• v.22
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• pp.54-62
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• 2004

We examined the impacts of anthyopogenic pollutant (benzo〔a〕pyrene) on the growth and photosynthesis of five marine phytoplankton species (Skeletonema costatum, Heterosigma akashiwo, Prorocentrum dentatum, P. minimum, Aknshiwo sanguinea), which are dominant in Korean coastal water. After the 72 h exposure to benzo〔a〕pyrene, the dramatic decrease in cell numbers was observed in the range of 1 to 10 $\mu\textrm{g}$ L$^{-1}$ for S. costatum, P. minimum, P. dentatum, whereas for A. sanguinea and H. akashiwo at the low concentrations 0.1 to 1 $\mu\textrm{g}$ L$^{-1}$ . Among the 5 phytoplankton species, the highest growth inhibition concentration ($IC_{50}$/) was 6.20 $\mu\textrm{g}$ L$^{-1}$ for P. minimum, followed by 2.14 $\mu\textrm{g}$ L$^{-1}$ for P. dentatum, 1.68 $\mu\textrm{g}$ L$^{-1}$ for S. costatum, 0.74 $\mu\textrm{g}$ L$^{-1}$ for H. akashiwo, 0.10 $\mu\textrm{g}$ L$^{-1}$ for A. sanguinea. The five species exposed to the low concentration of 1 $\mu\textrm{g}$ L$^{-1}$ were recovered after transferring to new media, but the species exposed to the high concentrations of 10 and 100 $\mu\textrm{g}$ L$^{-1}$ were not recovered, with the exception of P. minimum. Those results indicate that the thecate dinoflagellate P. minimum is most tolerant to the chemical and the athecate dinoflagellate A. sanguinea is not. Geneyally, the cell-specific photosynthetic capacity of H. akashiwo exposed to the low concentrations of 0.1 and 1 $\mu\textrm{g}$ L$^{-1}$ was higher than that of the cells in the control, whereas the cells exposed to the high concentrations of 5 and 10 $\mu\textrm{g}$ L$^{-1}$ showed the negligible photosynthetic level by the first few days of the experiment. In the case of the cells exposed to the concentration of 5 $\mu\textrm{g}$ L$^{-1}$ , after 12 days of the experiment the photosynthetic capacity was increased toward the end of the experiment. This indicates that H. akashiwo may utilize the benzo〔a〕pyrene as a carton source for its growth when exposed to low concentrations. Results suggest that anthropogenic pollutants such as benzo〔a〕pyrene may have significant influence on the succession of phytoplankton species composition and the primary production in coastal marine environments.

• Solar Energy
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• v.13 no.2_3
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• pp.65-78
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• 1993

An overdose of fossil fuel for greenhouse heating causes not only the high cost and low quality of agricultural products, but also the environmental pollution of farm village. To solve these problems it is desirable to maximize the solar energy utilization for the heating of greenhouse in winter season. In this study phase change materials were selected to store solar energy concentratively for heating the greenhouse and their characteristics of thermal energy storage were analyzed. The results were summarized as follows. The organic $C_{28}H_{58}$, and the inorganic $CH_3COONa{\cdot}3H_2O\;and\;Na_2SO_4{\cdot}10H_2O$ were selected as low temperature latent heat storage materials. The equation of critical radius was derived to define the generating mechanism of the maximum latent heat of phase change materials. The melting point of $C_{28}H_{58}$ was $62^{\circ}C$, and the latent heat was $50.0{\sim}52.0kcal/kg$. The specific heat of liquid and solid phase was $0.54{\sim}0.69kcal/kg^{\circ}C$ and $0.57{\sim}0.75kcal/kg^{\circ}C$ respectively. The melting point of $CH_3COONa{\cdot}3H_2O$ was $61{\sim}62^{\circ}C$, the latent heat was $64.9{\sim}65.8$ kcal/kg and the specific heat of liquid and solid phase was respectively $0.83kcal/kg^{\circ}C$ and $0.51{\sim}0.52kcal/kg^{\circ}C$. The melting point of $Na_2SO_4{\cdot}10H_2O$ was $30{\sim}30.9^{\circ}C$, the latent heat was 53.0 kcal/kg and the specific heat of liquid and solid phase was respectively $0.78{\sim}0.89kcal/kg^{\circ}C$ and $0.50{\sim}0.7kcal/kg^{\circ}C$ When the urea of 21.85% was added to control the melting point of $Na_2SO_4{\cdot}10H_2O$ and the phase change cycles were repeated from 0 to 600, the melting point was $16.7{\sim}16.0^{\circ}C$ and the latent heat was $36.0{\sim}28.0kcal/kg^{\circ}C$.

• Progress in Medical Physics
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• v.21 no.1
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• pp.52-59
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• 2010

To examine among patients with vertebral compression fracture the extent to which signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values at the lumbar vertebral compression fracture site vary on diffusion-weighted MR images according to varying b values on the 1.5T MR device. Diffusion-weighted MR images of 30 patients with compression fracture due to chronic osteoporosis who underwent vertebral MRI from Jan. 2008 to Nov. 2009 were respectively obtained using a 1.5-T MR scanner with the b values increased from 400, 600, 800, 1,000 to $1,200\;s/mm^2$. For diffusion-weighted MR images with different b values, the signal-to-noise ratio (SNR) was assessed at three sites: the site of compression fracture of the lumbar vertebral body at L1 to L5, and both the upper and lower discs of the said fracture site, while for ADC map images with different b values, the SNR and ADC were respectively assessed at those three sites. As a quantitative analysis, diffusion-weighted MR images and ADC map images with b value of $400\;s/mm^2$ (the base b values) were respectively compared with the corresponding images with each different b value. As far as qualitative analysis is concerned, for both diffusion-weighted MR and ADC map images with b value of $400\;s/mm^2$, the extent to which signal intensity values obtained at the site of compression fracture of the lumbar vertebral body at L1 to L5 vary according to the increasing b values were examined. The quantitative analysis found that for both diffusion-weighted MR and ADC map images, as the b values increased, the SNR were relatively lowered at all the three sites, compared to the base b value. Also, it was found that as the b values increased, ADC valueswere relatively lowered at all the three sites on ADC map images. On the other hand, the qualitative analysis found that as the b values increased to more than $400\;s/mm^2$, the signal intensity gradually decreased at all the sites, while at the levels of more than $1,000\;s/mm^2$, severe image noises appeared at all of the three sites. In addition, higher signal intensity was found at the site of compression fracture of the lumbar vertebral body than at the discs. Findings showed that with the b value being increased, both the signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values gradually decreased at all the sites of the lumbar vertebral compression fracture and both the upper and lower discs of the fracture site, suggesting that there is a possibility of a wider range of applications to assessment of various vertebral pathologies by utilizing multi b values in the diffusion-weighted MRI examination.