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A Study on the Change of the Cheomcha-chogak of the Neungwon-Jeongjagak (능원(陵園) 정자각(丁字閣)의 첨차초각(檐遮草刻) 변화에 대하여)

  • Jeon, Jongwoo
    • Korean Journal of Heritage: History & Science
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    • v.54 no.1
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    • pp.280-301
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    • 2021
  • Chogak has been regarded as originating from the paintings decorating building elements. Various curved shape drawings that were first seen in the paintings of Goguryeo tomb murals evolved into the vine patterned Dancheong of Geuklakjeon in Bongjeongsa. Cheomcha of Geuklakjeon was chiseled with Yeonhwadusik relievo at the bottom on top of Dancheong, and this was the beginning of Cheomcha-Chogak. Also, Cheomcha, which was carved with a preliminary vine patterned Chogak in Daeungjeon in Bongjeongsa, opened the era of engraving Chogak directly on the surface of structural elements. Since then, vine patterned Chogak was a significant decoration technique for the Cheomcha of traditional wooden construction for a long time. Because Jeongjagak is a structure that was continuously built between the end of the Japanese invasion of Korea in 1592 and the late Joseon Dynasty, the transition of Cheomcha-Chogak over time can be seen through Jeongjagak architecture. The early Cheomcha-Chogak presents stems that climb up (Upbound-type) towards the headpiece on a column, while stems of Chogak later reversed direction to descend (Downbound-type) from the headpiece. This study examined the transition process and reasons for the change, with a focus on the findings above, and identified a new type of Chogak that is unrelated to the direction type and was adopted during the transition from Upbound-type to Downbound-type. The new type appeared when the Jeongjagaks for the Royal Tomb of Kyeongjo and those of the Injo were built, and it matches with the transitional period wherein lotus vanishes from Hwaban-Chogak. The study also inferred that the direction change of Cheomcha-Chogak stems was caused by the separation of vine patterned Chogak, carved with a two-stepped inner Ikgon, into both upward and downward from the headpiece, and this led to the changes that manifested as the inside of Choikgong being the Downbound-type Chogak and the variegated vine patterned Chogak of Choikgong affecting the direction of Cheomcha-Chogak. This is the follow-up study of "A Study on the Hwaban-Chogak of the Neungwon-Jeongjagak," a paper published in 2018, and is limited in n that Cheomcha, the focus of the research, is just one of the construction elements of Jeongjagak. The entirety ofChogak cannot be understood only by observing Cheomcha.

A Study of sacrificial rites related Royal Mausoleums in early Joseon Dynasty (조선초기 왕릉제사의 정비와 운영)

  • Han, Hyung-Ju
    • Journal of Korean Historical Folklife
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    • no.33
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    • pp.115-143
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    • 2010
  • The purpose of this study is to analyze contents and process of rites about sacrificial rites related Royal Mausoleums in early Joseon Dynasty, and to conclude, to review the position of Royal Mausoleums in the whole National Rites System. The sacrificial rites related Royal Mausoleums started from building Royal Mausoleums of 8 persons-ancestors since King T'aejo's great-great-grandparents, in 1392, founding Joseon Dynasty. In 1408, King T'aejo had died and his Kŏnwŏnnŭng (健元陵) was builted in Yangju, Gyeonggi-do. Since then, after kings of many generations died, each of Royal Mausoleums was builted solemnlly. In the process of this, sacrificial rituals modified and supplemented, especially during the reign of king Sejong(1418~1450). After all, the sacrificial rites related Royal Mausoleums was settled in KukchoOryeūi(國朝五禮儀, Five State Rites) compiled during the reign of King Sŏngjong. In process of Institutionalization of sacrificial rituals, the argument between king and vassals about four-seasons' ancestral rites was properly or not was occurred. That was because the memorial times of Royal Mausoleums overlaped Chongmyo's and more important Chongmyo's ancestral rites was neglected. But four-seasons' ancestral rites of Royal Mausoleums was continued until 17th century. Sacrificial rites related Royal Mausoleums as royal personal rites had simple processes compared to sacrificial rites of Chongmyo, upper-graded formal ancestral rites, under National Rites system. Justifying to served his parents with devotion, the kings in early Joseon Dynasty went to Royal Mausoleums 2-3 times annually. During coming and going, he show off his presence as king in power to his subjects through magnificent guard of honor. On the one hand, he met his subjects directly and acceded to various petition. Above all things, The kings in early Joseon Dynasty emphasized his military power through military training, namely, hunting, disposition of troops, and so on.

A Study on Baettaragi Performance in Northwestern Province of Korea (관서지방 배따라기 연행고(演行考))

  • Lim, Soojung
    • (The) Research of the performance art and culture
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    • no.23
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    • pp.105-158
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    • 2011
  • Due to the system of sending selected hyanggi(local entertaining woman) to the government office in Seoul after the abolition of the system of gyeonggi(entertaining woman in capital area) during the reign of King Injo(1595~1649), the kyobang-jeongjae(local dance performed for the provincial government office) had gotten into the court to be performed at the royal banquet as gungjung-jeongjae(court dance), one of which was seonyurak(dance of boating). It used to be performed for finale of the royal banquet in the late Joseon Dynasty and appeared in several uigwes(record for royal banquet) since its first appearance in the wonhaeng-eulmyo-jeongri-uigwe, documented in 1795, the 19th year of the reign of King Jeongjo. Considering that the yeoggi(female entertainer) responsible for the court dance, seonyurrak was the seonsanggi(selected entertaining woman from provinces) from the northwestern provincial villages such as Euiju, Ahnju, and Seongcheon etc., we can assume that the baettaragi, one of kyobang-jeongjaes whould have been getting into the court to become the seonyurrak as court dance. The baettaragi, kyobang-jeongjae of northwestern province that affected the development of the court dance, seonyurak was created as performance executed by entertaining women of kyobang(local supervisory office for entertaining women) on the basis of the fact that the envoy of Joseon dynasty to the Ming dynasty could not help but taking a sea route when Amaga Aisin Gurun had a grip on the northeastern area of China during the shift of power from Ming to Qing. There had been a lot of banquets for envoys in the northwestern province because of its geographical feature as gateway to trip to China and the baettaragi used to be performed by entertaining women belonged to local provincial office to consolate the sadness of separation with those who destined to depart to China and to hope for their safe return. The kyobang-jeongjae, baettaragi of northwestern province is recorded as performance with sorrowful song to put the pain of parting into work, according to many related documents. It puts together painted boats as props, the march of a couple of dancer dressed up as soldier with marching music called gochiak, the song and musical accompaniment before getting on boat, the dramatic expression of sailing, and the farewell song praying for safe return etc. It turns the situation of dispatching envoys for China by sea into performance with combination of music, song and dance. Created in this way, the kyobang-jeongjae, baettaragi had been performed at the various banquets for envoys departing for China and it affected the formation of court dance or gungjung-jeongjae called seonyurak through the activities of selected local entertaining women. It also exerted influence on other similar performance in provincial area because of the returning home of the selected local entertainers who finished their performance in Seoul and it had been performed with different variation at local banquet including locality in it.

Operative Treatment of Congenitally Corrected Transposition of the Great Arteries(CCTGA) (교정형 대혈관 전위증의 수술적 치료)

  • 이정렬;조광리;김용진;노준량;서결필
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.621-627
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    • 1999
  • Background: Sixty five cases with congenitally corrected transposition of the great arteries (CCTGA) indicated for biventricular repair were operated on between 1984 and september 1998. Comparison between the results of the conventional(classic) connection(LV-PA) and the anatomic repair was done. Material and Method: Retrospective review was carried out based on the medical records of the patients. Operative procedures, complications and the long-term results accoding to the combining anomalies were analysed. Result: Mean age was 5.5$\pm$4.8 years(range, 2 months to 18years). Thirty nine were male and 26 were female. Situs solitus {S,L,L} was in 53 and situs inversus{I,D,D} in 12. There was no left ventricular outflow tract obstruction(LVOTO) in 13(20%) cases. The LVOTO was resulted from pulmonary stenosis(PS) in 26(40%)patients and from pulmonary atresia(PA) in 26(40%) patients. Twenty-five(38.5%) patients had tricuspid valve regurgitation(TR) greater than the mild degree that was present preoperatively. Twenty two patients previously underwent 24 systemic- pulmonary shunts previously. In the 13 patients without LVOTO, 7 simple closure of VSD or ASD, 3 tricuspid valve replacements(TVR), and 3 anatomic corrections(3 double switch operations: 1 Senning+ Rastelli, 1 Senning+REV-type, and 1 Senning+Arterial switch opera tion) were performed. As to the 26 patients with CCTGA+VSD or ASD+LVOTO(PS), 24 classic repairs and 2 double switch operations(1 Senning+Rastelli, 1 Mustard+REV-type) were done. In the 26 cases with CCTGA+VSD+LVOTO(PA), 19 classic repairs(18 Rastelli, 1 REV-type), and 7 double switch operations(7 Senning+Rastelli) were done. The degree of tricuspid regurgitation increased during the follow-up periods from 1.3$\pm$1.4 to 2.2$\pm$1.0 in the classic repair group(p<0.05), but not in the double switch group. Two patients had complete AV block preoperatively, and additional 7(10.8%) had newly developed complete AV block after the operation. Other complications were recurrent LVOTO(10), thromboembolism(4), persistent chest tube drainage over 2 weeks(4), chylothorax(3), bleeding(3), acute renal failure(2), and mediastinitis(2). Mean follow-up was 54$\pm$49 months(0-177 months). Thirteen patients died after the operation(operative mortality rate: 20.0%(13/65)), and there were 3 additional deaths during the follow up period(overall mortality: 24.6%(16/65)). The operative mortality in patients underwent anatomic repair was 33.3%(4/12). The actuarial survival rates at 1, 5, and 10 years were 75.0$\pm$5.6%, 75.0$\pm$5.6%, and 69.2$\pm$7.6%. Common causes of death were low cardiac output syndrome(8) and heart failure from TR(5). Conclusion: Although our study could not demonstrate the superiority of each classic or anatomic repair, we found that the anatomic repair has a merit of preventing the deterioration of tricuspid valve regurgitations. Meticulous selection of the patients and longer follow-up terms are mandatory to establish the selective advantages of both strategies.

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The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

Historical Studies on the Characteristics of Buyongjeong in the Rear Garden of Changdeok Palace (창덕궁 후원 부용정(芙蓉亭)의 조영사적 특성)

  • Song, Suk-ho;Sim, Woo-kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.1
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    • pp.40-52
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    • 2016
  • Buyongjeong, a pavilion in the Rear Garden of Changdeok Palace, was appointed as Treasure No. 1763 on March 2, 2012, by the South Korea government since it shows significant symmetry and proportion on its unique planar shape, spatial configuration, building decoration, and so forth. However, the designation of Treasure selection was mainly evaluated by concrete science, in that the selection has not clearly articulated how and why Buoungjeong was constructed as a present unique form. Therefore, this study aims to clarify the identity of Buyongjeong at the time of construction by considering its historical, ideological, philosophical background and building intention. Summary are as follows: First, Construction backgrounds and characters of Buyongjeong: Right after the enthronement, King Jeongjo had founded Kyujanggak(奎章閣), and sponsored civil ministers who were elected by the national examination, as a part of political reform. In addition, he established his own political system by respecting "Kaksin(閣臣)", Kyujanggak's officials as much as "Kain(家人)", internal family members. King Jeongjo's aggressive political reform finally enabled King's lieges to visit King's Rear Garden. In the reign of King Jeongjo's 16th year(1792), Naekaksangjohoe(內閣賞釣會) based on "Kaksin" was officially launched and the Rear Garden visitation became a regular meeting. The Rear Garden visitation consisted of "Sanghwajoeoyeon(賞花釣魚宴)" - enjoying flowers and fishing, and activities of "Nanjeongsugye". Afterward, it eventually became a huge national event since high rank government officials participated the event. King Jeongjo shared the cultural activities with government officials together to Buyongjeong as a place to fulfill his royal politics. Second, The geographical location and spatial characteristics of Buyongjeong: On the enthronement of King Jeongjo(1776), he renovated Taeksujae. Above all, aligning and linking Gaeyuwa - Taeksujae - a cicular island - Eosumun - Kyujangkak along with the construction axis is an evidence for King Jeongjo to determine how the current Kyujangkak zone was prepared and designed to fulfill King Jeonjo's political ideals. In 17th year(1793) of the reign of King Jeongjo, Taeksujae, originally a square shaped pavilion, was modified and expanded with ranks to provide a place to get along with the King and officials. The northern part of Buyongjeong, placed on pond, was designed for the King's place and constructed one rank higher than others. Discernment on windows and doors were made with "Ajasal" - a special pattern for the King. The western and eastern parts were for government officials. The center part was prepared for a place where government officials were granted an audience with the King, who was located in the nortern part of Buyongjeong. Government officials from the western and eastern parts of Buyongjeong, could enter the central part of the Buyongjeong from the southern part by detouring the corner of Buyongjeong. After all, Buyongjeong is a specially designed garden building, which was constructed to be a royal palace utilizing its minimal space. Third, Cultural Values of Buyongjeong: The Buyongjeong area exhibits a trait that it had been continuously developed and it had reflected complex King's private garden cultures from King Sejo, Injo, Hyunjong, Sukjong, Jeongjo and so forth. In particular, King Jeongjo had succeded physical, social and imaginary environments established by former kings and invited their government officials for his royal politics. As a central place for his royal politics, King Jeongjo completed Buyongjeong. Therefore, the value of Buyongjeong, as a garden building reflecting permanency of the Joseon Dynasty, can be highly evaluated. In addition, as it reflects Confucianism in the pavilion - represented by distinguishing hierarchical ranks, it is a unique example to exhibit its distinctiveness in a royal garden.

Mid-Term Results of 292 cases of Coronary Artery Bypass Grafting (관상동맥 우회술 292례의 중기 성적)

  • 김태윤;김응중;이원용;지현근;신윤철;김건일
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.643-652
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    • 2002
  • As the prevalence of coronay artery disease is increasing, the surgical treatment has been universalized and operative outcome has been improved. We analyzed the short and mid-term results of 292 CABGs performed in Kangdong Sacred Heart Hospital. Material and Method: From June 1994 to December 2001, 292 patients underwent coronary artery bypass grafting. There were 173 men and 119 women and their ages ranged from 39 to 84 years with a mean of $61.8{\pm}9.1$ years. We analyzed the preoperative risk factors, operative procedures and operative outcome. In addition, we analyzed the recurrence of symptoms, long-term mortality and complications via out-patient follow-up for discharged patients. Result: Preoperative clinical diagnoses were unstable angina in 137(46.9%), stable angina in 34(11.6%), acute myocardial infarction in 40(13.7%), non-Q myocardial infarction in 25(8.6%), postinfarction angina in 22(7.5%), cardiogenic shock in 30(10.3%) and PTCA failure in 4(1.4%) patients. Preoperative angiographic diagnoses were three-vessel disease in 157(53.8%), two-vessel disease in 35 (12.0%), one-vessel disease in 11(3.8%) and left main disease in 89(30.5%) patients. We used saphenous veins in 630, internal thoracic arteries in 257, radial arteries in 50, and right gastoepiploic arteries in 2 distal anastomoses. The mean number of distal anastomoses per patient was $3.2{\pm}1.0$ There were 18 concomitant procedures ; valve replacement in 8(2.7%), left main coronary artery angioplasty in 6(2.1%), patch closure of postinfarction ventricular septal defect(PMI-VSD) in 2(0.7%), replacement of ascending aorta in 1(0.3%) and coronary endarterectomy in 1(0.3%) patient. The mean ACC time was $96.6{\pm}35.3 $ minutes and the mean CPB time was $179.2{\pm}94.6$ minutes. Total early mortality was 8.6%, but it was 3.1% in elective operations. The most common cause of early mortality was low cardiac output syndrome in 6(2.1%) patients. The stastistically significant risk factors for early mortality were hypertension, old age($\geq$ 70 years), poor LV function(EF<40%), congestive heart failure, preoperative intraaortic balloon pump, emergency operation and chronic renal failure. The most common complication was arrhythmia in 52(17.8%) patients. The mean follow-up period was $39.0{\pm}27.0$ months. Most patients were free of symptoms during follow-up. Fourteen patients(5.8 %) had recurrent symptoms and 7 patients(2.9%) died during follow-up period. Follow-up coronary angiography was performed in 13 patients with recurrent symptoms and they were managed by surgical and medical treatment according to the coronary angiographic result. Conclusion: The operative and late results of CABG in our hospital, was acceptable. However, There should be more refinement in operative technique and postoperative management to improve the results.

Modeling Brand Equity for Lifestyle Brand Extensions: A Strategic Approach into Generation Y vs. Baby Boomer (생활방식품패확장적품패자산건모(生活方式品牌扩张的品牌资产建模): 침대Y세대화영인조소비자적전략로경(针对Y世代和婴儿潮消费者的战略路径))

  • Kim, Eun-Young;Brandon, Lynn
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.1
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    • pp.35-48
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    • 2010
  • Today, the fashion market challenged by a maturing retail market needs a new paradigm in the "evolution of brand" to improve their comparative advantages. An important issue in fashion marketing is lifestyle brand extension with a specific aim to meet consumers' specific needs for their changing lifestyle. For fashion brand extensions into lifestyle product categories, Gen Y and Baby Boomer are emerging as "prospects"-Baby Boomers who are renovating their lifestyle, and generation Y experiencing changes in their life stage-with demands for buying new products. Therefore, it is imperative that apparel companies pay special attention to the consumer cohort for brand extension to create and manage their brand equity in a new product category. The purposes of this study are to (a) evaluate brand equity between parent and extension brands; (b) identify consumers' perceived marketing elements for brand extension; and (c) estimate a structural equation model for examining causative relationship between marketing elements and brand equity for brand extensions in lifestyle product category including home fashion items for the selected two groups (e.g., Gen Y, and Baby boomer). For theoretical frameworks, this study focused on the traditional marketing 4P's mix to identify what marketing element is more importantly related to brand extension equity for this study. It is assumed that comparable marketing capability can be critical to establish "brand extension equity", leads to successfully entering the new categories. Drawing from the relevant literature, this study developed research hypotheses incorporating brand equity factors and marketing elements by focusing on the selected consumers (e.g., Gen Y, Baby Boomer). In the context of brand extension in the lifestyle products, constructs of brand equity consist of brand awareness/association, brand perceptions (e.g., perceived quality, emotional value) and brand resonance adapted from CBBE factors (Keller, 2001). It is postulated that the marketing elements create brand extension equity in terms of brand awareness/association, brand perceptions by the brand extension into lifestyle products, which in turn influence brand resonance. For data collection, the sample was comprised of Korean female consumers in Gen Y and Baby Boomer consumer categories who have a high demand for lifestyle products due to changing their lifecycles. A total of 651 usable questionnaires were obtained from female consumers of Gen Y (n=326) and Baby Boomer (n=325) in South Korea. Structural and measurement models using a correlation matrix was estimated using LISREL 8.8. Findings indicated that perceived marketing elements for brand extension consisted of three factors: price/store image, product, and advertising. In the model of Gen Y consumers, price/store image had a positive effect on brand equity factors (e.g., brand awareness/association, perceived quality), while product had positive effect on emotional value in the brand extensions; and the brand awareness/association was likely to increase the perceived quality and emotional value, leading to brand resonance for brand extensions in the lifestyle products. In the model of Baby Boomer consumers, price/store image had a positive effect on perceived quality, which created brand resonance of brand extension; and product had a positive effect on perceived quality and emotional value, which leads to brand resonance for brand extension in the lifestyle products. However, advertising was negatively related to brand equity for both groups. This study provides an insight for fashion marketers in developing a successful brand extension strategy, leading to a sustainable competitive advantage. This study complements and extends prior works in the brand extension through critical factors of marketing efforts that affect brand extension success. Findings support a synergy effect on leveraging of fashion brand extensions (Aaker and Keller, 1990; Tauber, 1988; Shine et al., 2007; Pitta and Katsanis, 1995) in conjunction with marketing actions for entering into the new product category. Thus, it is recommended that marketers targeting both Gen Y and Baby Boomer can reduce marketing cost for entering the new product category (e.g., home furnishings) by standardized marketing efforts; fashion marketers can (a) offer extension lines with premium ranges of price; (b) place an emphasis on upscale features of store image positioning by a retail channel (e.g., specialty department store) in Korea, and (c) combine apparel with lifestyle product assortments including innovative style and designer’s limited editions. With respect to brand equity, a key to successful brand extension is consumers’ brand awareness or association that ensures brand identity with new product category. It is imperative for marketers to have knowledge of what contributes to more concrete associations in a market entry into new product categories. For fashion brands, a second key of brand extension can be a "luxury" lifestyle approach into new product categories, in that higher price or store image had impact on perceived quality that established brand resonance. More importantly, this study increases the theoretical understanding of brand extension and suggests directions for marketers as they establish marketing program at Gen Y and Baby Boomers.

Mid-term results of IntracardiacLateral Tunnel Fontan Procedure in the Treatment of Patients with a Functional Single Ventricle (기능적 단심실 환자에 대한 심장내 외측통로 폰탄술식의 중기 수술성적)

  • 이정렬;김용진;노준량
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.472-480
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    • 1998
  • We reviewed the surgical results of intracardiac lateral tunnel Fontan procedure for the repair of functional single ventricles. Between 1990 and 1996, 104 patients underwent total cavopulmonary anastomosis. Patients' age and body weight averaged 35.9(range 10 to 173) months and 12.8(range 6.5 to 37.8) kg. Preoperative diagnoses included 18 tricuspid atresias and 53 double inlet ventricles with univentricular atrioventricular connection and 33 other complex lesions. Previous palliative operations were performed in 50 of these patients, including 37 systemic to pulmonary artery shunts, 13 pulmonary artery bandings, 15 surgical atrial septectomies, 2 arterial switch procedures, 2 resections of subaortic conus, 2 repairs of total anomalous pulmonary venous connection and 1 Damus-Stansel-Kaye procedure. In 19 patients bidirectional cavopulmonary shunt operation was performed before the Fontan procedure and in 1 patient a Kawashima procedure was required. Preoperative hemodynamics revealed a mean pulmonary artery pressure of 14.6(range 5 to 28) mmHg, a mean pulmonary vascular resistance of 2.2(range 0.4 to 6.9) wood-unit, a mean pulmonary to systemic flow ratio of 0.9(range 0.3 to 3.0), a mean ventricular end-diastolic pressure of 9.0 (range 3.0 to 21.0) mmHg, and a mean arterial oxygen saturation of 76.0(range 45.6 to 88.0)%. The operative procedure consisted of a longitudinal right atriotomy 2cm lateral to the terminal crest up to the right atrial auricle, followed by the creation of a lateral tunnel connecting the orifices of either the superior caval vein or the right atrial auricle to the inferior caval vein, using a Gore-Tex vascular graft with or without a fenestration. Concomitant procedures at the time of Fontan procedure included 22 pulmonary artery angioplasties, 21 atrial septectomies, 4 atrioventricular valve replacements or repairs, 4 corrections of anomalous pulmonary venous connection, and 3 permanent pacemaker implantations. In 31, a fenestration was created, and in 1 an adjustable communication was made in the lateral tunnel pathway. One lateral tunnel conversion was performed in a patient with recurrent intractable tachyarrhythmia 4 years after the initial atriopulmonary connection. Post-extubation hemodynamic data revealed a mean pulmonary artery pressure of 12.7(range 8 to 21) mmHg, a mean ventricular end-diastolic pressure of 7.6(range 4 to 12) mmHg, and a mean room-air arterial oxygen saturation of 89.9(range 68 to 100) %. The follow-up duration was, on average, 27(range 1 to 85) months. Post-Fontan complications included 11 prolonged pleural effusions, 8 arrhythmias, 9 chylothoraces, 5 of damage to the central nervous system, 5 infectious complications, and 4 of acute renal failure. Seven early(6.7%) and 5 late(4.8%) deaths occured. These results proved that the lateral tunnel Fontan procedure provided excellent hemodynamic improvements with acceptable mortality and morbidity for hearts with various types of functional single ventricle.

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A Style Study for Reissued Gongsin-Gyoseo in Joseon Dynasty (조선시대 재발급(再發給) 공신교서(功臣敎書) 양식 연구)

  • Sim, Young-hwan;Lee, Jin-hee
    • Korean Journal of Heritage: History & Science
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    • v.47 no.2
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    • pp.4-19
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    • 2014
  • In Joseon dynasty, Gongsin-Gyoseo(Royal Edicts rewarding meritorious vassals) was issued for the reward of the contribution to the specific event of the nation. The family decided as vassals succeeded this Gongsin-Gyoseo as the family treasure to later generations. When one happened to lose this caused by an unavoidable situation such as war in this process, there were a few cases of reissuing of Gongsin-gyoseo by the nation. The confirmative reissued Gongsin-gyoseo among Gongsin-gyoseo that descended down by now are three pieces which is Park dongnyang Hoseong Gongsin-Gyoseo, Gu goeng Jeongsa Gongsin-Gyoseo, and Park jung Jeongsa Gongsin-Gyoseo. This research considered the form and mounting about these three pieces. It was indicated that the reissued Gongsin-Gyoseo was produced following the same form with the original Gongsin-Gyoseo, that is pyeongchul(moving to next lines) and daedu (writing one or two letters ahead compared to the first letter) and so on. But, it was indicated that the change of the position of the vassals in the reissued time was reflected compared to position of the original Gongsin-Gyoseo. In case of Jeonsa Gongsin-Gyoseo, it was indicated that it was 'Wonjongdaewang-whi' since the original Gongsin-Gyoseo was 'Jeongwongun-bu' and the reissued time he became the father of King Injo. Also, it was confirmed that the case of deprivation because of conspiracy such as 'Kim jajeom, Kim ryeon, Sim kiwon, Sim kisung' was produced as the original document and deleted with black ink stick. It was newly confirmed while the original Gongsin-Gyoseo was produced by a designated writer from the nation, the reissuance was written by a writer from the family of the vassals. Since the mounting of Gongsin-Gyoseo could be changed according to the favor and technique of the craftsman participated in the practical production such as Baezeopjang and economical situation of the country supplying the material, the mounting of these three Gongsin-Gyoseo should be different from the original mounting, especially because of the loss of the original by the Manchu war of 1636. The comparison result of Gongsin-Gyoseo produced in the same period with the original issued one in the record of the related Uigwe (a collection of documents from the Joseon Dynasty), the reissued one seems to be larger in the form or ratio of the mounting compared to the first issued one. First of all, the width of Byunah was expanded as twice bigger, center and both side Hoejang also was bigger as over 2cm, and the below Hoejang was expanded as 10cm, and the ratio of the upper Hoejang and the below Hoejang was wider as 1.5 times and the reissuance was 1:1 ratio. The bisect of upper shaft in Park dongnyang Hoseong Gongsin-Gyoseo is assumed as the form of an equilateral triangle, not a half-moon shape of the present, and Gu goeng and Park jung Jeongsa Gongsin-Gyoseo will be the form whose bisection form is same but the size is smaller. Chuksu is confirmed that the size is not changed significantly. Osaekdahoe can be assumed that the width was smaller compared to the first issued one. The 3 pieces of the reissued versions provide the clue of the verification for the form of the mounting of Bosa Gongsin-Gyoseo in the same production period. In the situation that the mounting of the production time was not confirmed among the currently descended Bosa Gongsin-Gyoseo, they can be very important materials.