• Radiation Oncology Journal
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• v.27 no.4
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• pp.173-180
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• 2009

Purpose: To investigate the role of radiotherapy for squamous cell carcinomas of the external auditory canal and middle ear. Materials and Methods: A series of 35 patients who were treated at a single institution from 1981 through 2007 were retrospectively analyzed. Thirteen patients were treated by radiotherapy alone; four by surgery only and 18 by a combination of surgery and radiotherapy. The total radiation dose ranged from 39~70 Gy (median, 66 Gy) in 13~35 fractions for radiotherapy alone and 44~70 Gy (median, 61.2 Gy) in 22~37 fractions for the combined therapy. Clinical end-points were the cause of specific survival (CSS) and local relapse-free survival (LRFS). The median follow-up time was 2.8 years (range, 0.2~14.6 years). Results: The 3-year CSS and LRFS rate was 80% and 63%, respectively. Based on a univariate analysis, performance status and residual disease after treatment had a significant impact on CSS; performance status and histologic grade for LRFS. Patients treated by radiotherapy alone had more residual disease following the course of treatment compared to patients treated with the combined therapy; 69% vs. 28%, respectively. Conclusion: Our results suggest that radiation alone was not an inferior treatment modality for CSS compared to the combined therapy for squamous cell carcinoma of the external auditory canal and middle ear. However, local failure after radiotherapy is the main issue that will require further improvement to gain optimal local control.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.281-288
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• 2006

Background: Extracardiac pericardial-flap lateral tunnel Fontan operation has theoretical advantage of growth potentiality of the extracardiac tunnels. The mid-term results of this technique and morphologic change of the lateral tunnel were studied. Material and Method: Clinical data was reviewed in 42 patients who underwent extracardiac pericardial-flap lateral tunnel Fontan operation between November 1993 and December 2004. The age was $2.8{\pm}1.5$ years and the body weight was $12.3{\pm}3.2$ kg. Extracardiac tunnel was constructed using the pedicled pericardium with the base undetached. By reviewing the follow-up cardiac angiograms, the diameter and the cross-sectional area of the lateral tunnel was compared to those of inferior vena cava. Result: There were four operative mortality cases (9.8%) and the causes of death were low cardiac output for all four cases. Postoperatively, five patients had prolonged pleural effusion longer than two weeks and one patient required a permanent pacemaker due to complete heart block. Follow-up was possible in 37 patients and the follow up duration was $3.8{\pm}2.2$ years. During that period, one patient died, of upper gastrointestional bleeding combined with heart failure and one patient died a sudden death of unknown cause. Two patients required reoperation due to subaortic stenosis and anastomosis site stenosis between inferior vena cava and lateral tunnel. In one patient, bradyarrhythmia was anew but there was no thromboembolic complication. The lateral tunnel showed growth in proportion to the size of the inferior vena cava. Conclusion: Extracardiac pericardial-flap lateral tunnel Fontan operation is relatively simple and safe. The mid-term result was favorable and the extracardiac tunnel showed potential for growth.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.14 no.5
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• pp.93-104
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• 2019

The entrepreneurship can be a source of national growth potential as behavioral tendencies of people who seek innovation, take risks of failure, and proactively respond to opportunities. In particular, in the economic situation of Korea where growth has been stagnated, it is necessary to strengthen the entrepreneurship of women which is relatively lower than men's in order to activate the start-up and economic participation of the whole people. In this regard, this study focuses not only on gender differences in entrepreneurship but also on the hidden impact of social contexts that cause gender differences in entrepreneurship. Specifically, this study examined the moderating effects of childbirth, a factor that reflects the social context of Korea in the relationship between gender and entrepreneurship. According to the results of the model that includes the interaction effect of these variables in addition to the independent effects of gender and childbirth, the gender effect disappeared, while the significant effect of both the childbirth variable and the interaction variable of gender and childbirth were confirmed. Furthermore, according to additional analysis, which identified the differences in entrepreneurship by creating four types of treatment groups based on gender and childbirth status, entrepreneurship was significantly lower in the 'female and childbirth' group than in all other groups. The difference between the remaining treatment groups was not statistically significant. These results indicate that differences in entrepreneurship levels between men and women overlap not with the unique trait of men and women, but with the social contextual effects of Korea, where women are under the full burden of childbirth and parenting. This study suggests implications that effective policy measures to promote women's entrepreneurship or economic activity should be taken by taking into account the social context of Korea that suppresses women's entrepreneurial behavior.

• Journal of the Korean Society for Marine Environment & Energy
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• v.19 no.4
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• pp.332-340
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• 2016

Sunken ships cause damage to the environment due to the dispersal of fuel oil and harmful cargo goods in the hull. Since the sunken ship is mostly flooded by the seabed, it tends to be in a relatively stable condition. However, the heavy body, together with the load of remaining goods in the cargo hold, the constant contact with the seabed, and ocean currents and tidal waves, can affect dispersal of residual fuel oils out of the sunken ship. Corrosion of the sunken ship starts upon sinking, decreasing the thickness of the hull structure and sub-materials. Therefore, it is necessary to assess the structural stability against the potential breakdown of the sunken ship. Whilst evaluating the danger of the sunken ship, this result should be reflected in 'the possible discharge'. This study was undertaken to suggest a procedure for a step by step evaluation to assess the structural stability a sunken ship. The structural stability assessment to estimate the collapsibility of the hull was structure targeted at the sunken ship 'No. 7 HaeSung', which was classified as the prime example for the intensive management of sunken ships. This study was undertaken to suggest a procedure for a step by step evaluation to assess the structural stability a sunken ship and to propose a method to conduct a structural safety assessment that estimates the collapsibility of the hull by targeting the sunken ship 'No. 7 HaeSung',which was classified as the prime example for the intensive management of sunken ships. The collapsibility of the hull structure was estimated Based on the damage size of the hull structure, and the corrosion rate of the hull structure and sub-materials due to the seawater after sinking. It was confirmed that there was a low possibility of the total destruction of the hull structure at the current time. However, there is a high possibility in the potential failure of the hull structure due to increased rate of corrosion thereafter. Therefore, we believe continuous study on influence of corrosion and marine environment change to sunken ship's structural safety is necessary.

• Journal of Navigation and Port Research
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• v.39 no.6
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• pp.545-552
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• 2015

This study One of the key elements of corporate competitiveness in the modern world of unlimited competition is human resource management. The reason that the world's leading companies are devoting a lot of investment and effort for good human resource development and management is that human resource can impact firm survival. In particular, there is little research on the internal and external environmental stimuli and job stress in the employee of small business which are often led to turnover, while they have suffered from chronic shortage of manpower. The purpose of this study is to determine the turnover factors in the small logistics companies and contribute to stable maintenance of workforce, facilitating human resource management and minimizing turnover. This study empirically analyzed the factors of the turnover in the organization of logistics companies from Busan Port, South Korea, which became one of the national infrastructure and the fifth world largest harbor. The conclusion proposed the development and direction of the human resource management which could promote the job environment improving the turnover factors and creating sustainable work condition through conducting preventive measures. The results indicated that the highest turnover rates was found in the category of field work, and the highest turnover group was from the 'less than one year', which implies that high turnover rates after and during job training might be greater cost to the companies than early turnover. The most common reasons for the high employee turnover were 'excessive workload' and 'dissatisfaction with wages'. Followed reasons including 'troubles with managers' and 'failure in organizational adaptation' can be understood in line with worse working conditions of the small logistic companies. It turned out that the preventive programs of the logistic enterprises had little effect through 'incentives system' and 'improving wage system' which are mainly conducted. The human resource managers appreciated the importance of 'wage raise' and 'benefits improvement'. This study is aimed at contributing to efficient human resource management through understanding of the turnover causes and human resource managers applying preventive measures. In particular, this can benefit small port logistics companies securing competitiveness and promoting persistent growth and development.

• Journal of Dairy Science and Biotechnology
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• v.32 no.2
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• pp.93-100
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• 2014

In general, whey obtained from various cheese batches is being reused, so as to improve the texture and to increase the yield and the nutrient value of the various final milk-based products. In fact, re-usage of whey proteins, including whey cream, is a common and routine procedure. Unfortunately, most bacteriophages can survive heat treatments such as pasteurization. Hence, there is a high risk of an increase in the bacteriophage population during the cheese-making process. Whey samples contaminated with bacteriophages can cause serious problems in the cheese industry. In particular, the process of whey separation frequently leads to aerosol-borne bacteriophages and thus to a contaminated environment in the dairy production plant. In addition, whey proteins and whey cream reused in a cheese matrix can be infected by bacteriophages with thermal resistance. Therefore, to completely abolish the various risks of fermentation failure during re-usage of whey, a whey treatment that effectively decreases the bacteriophage population is urgently needed and indispensable. Hence, the purpose of this review is to introduce various newly developed methods and state-of-the-art technologies for removing bacteriophages from contaminated whey and whey products.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.82-88
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• 2008

Background: Descending necrotizing mediastinitis (DNM) is a serious disease originating in odontogenic or oropharyngeal infection with high mortality despite adequate antibiotics and aggressive surgery. We analyzed results of treatment for DNM. Material and Method: We studied 8 cases diagnosed as DNM from 1998 to 2007. All patients received emergent surgical drainage and debridement with broad spectrum antibiotics just after diagnosis. Antibiotics were changed after bacterial susceptibility testing. The surgical approach included 2 cases of cervicotomy, 6 cases of cervicotomy, and a thoracotomy. Result: The interval between symptom onset and hospitalization was $4.6{\pm}1.8$ days ($1{\sim}9$ day). DNM originated in 4 cases of odontogenic infection (50%), 2 cases of oropharyngeal infection (25%), and 2 cases of unknown origin (25%). Causative organisms were found in 6 cases; Streptococcus in 4 cases, Staphylococcus in 1 case, and Klebsiella in 1 case. The Endo DNM classification was type I (2 cases), IIA (3 cases), and IIB (3 cases). The incidence of thoracotomy was 75%. The surgical mortality rate was 25% (2/8). The cause of death was multiple organ failure caused by septic shock. All mortality cases received only cervicotomy and aggravated infections after initial drainage. Conclusion: Early diagnosis, immediate surgical drainage, and adequate antibiotics, including covered anaerobes, are required. Thoracotomy should be performed with cervicotomy even for localized DNM.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.3
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• pp.87-94
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• 2018

We present the case of long-term observation of a patient with chronic kidney disease (CKD) caused by advanced focal segmental glomerulosclerosis (FSGS) resulting from underlying congenital chloride diarrhea (CLD). A 20-year-old woman was admitted for prolonged proteinuria despite conservative treatment for CLD. She was diagnosed with CLD and started taking KCl salt supplementation from the time of birth. Mild proteinuria was first found at 12 years of age, which progressed to moderate proteinuria at 16 years of age. At 16 years of age, CKD stage 2 with FSGS was diagnosed based on the initial assessment of the glomerular filtration rate (GFR) and kidney histology. On admission, we re-assessed her renal function, histology and genetic analysis. GFR had deteriorated to CKD stage 4 and renal histology revealed an advanced FSGS combined with tubulointerstitial fibrosis. A homozygous mutation in the SLC26A3 gene (c.2063-1G>T) was found by diagnostic exome sequencing and may have been inherited from both parents. CLD patients can be more vulnerable to renal injury, which may also cause progression of renal failure. Therefore, even if there is an early diagnosis and adequate salt supplementation, close monitoring of renal function and tailored treatment should be emphasized for renal protection and favorable CLD prognosis.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.725-731
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• 2009

Background: Lobectomy and more extended anatomic resection are regarded as standard treatment for stage Ia non-small cell lung cancer, but approximately 15~40% of patients suffer from treatment failures such as cancer recurrence or death. The authors analyzed types and causes of treatment failures in surgically treated cases of stage Ia non small cell lung cancer. Material and Method: We retrospectively reviewed the medical records of 156 patients who had undergone complete resection for stage Ia NSCLC between Jan 1992 and Aug 2005. Patients were divided into two different treatment failure groups: cancer-related deaths and non-cancer-related deaths. Risk factors were analyzed in each group by the Kaplan-Meyer survival method and the Cox proportional hazard model. Result: Among the 156 patients, 93 were males; the mean age was 61. The median follow-up period was 33.8 months. The 5 year survival rate was 87.6%. Microscopic lympho-vascular permeation was reported in 10 patients. Recurrence was reported in 19 patients and 12 patients died due to recurrent lung cancer. Noncancer related deaths occurred in 16 patients. Risk factors for cancer recurrence and cancer related death were microscopic lympho-vascular permeation (HR=6.81, p=0.007, HR=7.81, p<0.001); for non-cancer related death, risk factors were pneumonectomy (HR=25.92, p=0.001) and postoperative cardiopulmonary complications (HR=29.67, p=0.002). Conclusion: After complete resection of stage Ia non small cell lung cancer patients, mortality includes not only cancer related deaths but also cancer unrelated deaths. Adjuvant chemotherapy is advised for patients who show microscopic lympho-vascular permeation, which is a risk factor for recurrence and for cancer related death. Patients who had pneumonectomy or who suffered from cardiac or respiratory complications need meticulous care in order to reduce comorbidity-induced death.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.685-695
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• 2009

Background: Calcification is the most frequent cause of clinical failure of bioprosthetic tissues that are fabricated from Glutaraldehyde (GA)-fixed porcine valve or bovine pericardium. We recently used a multi-factorial approach of employing different mechanisms to investigate how to reduce the calcification of bioprosthetic tissues. The purpose of the present study was to evaluate the synchronized synergism using ethanol, L-lysine and $NaBH_4$ in glutaraldehyde treated porcine pericardium from the standpoint of calcification and tissue elasticity. Material and Method: Porcine pericardium was fixed with 0.625% GA (commercial fixation). An interim step of ethanol (80%; 1 day at room temperature) or L-lysine (0.1 M; 2 days at $37^{\circ}C$) or $NaBH_4$ (0.1 M; 2 days at room temperature) was followed by completion of the GA fixation (2 days at $4^{\circ}C$ and 7 days at room temperature). The tensile strength and thickness of the samples were measured. The treated pericardiums were implanted subcutaneously into three-week old Sprague-Dawley rats for 8 weeks. The calcium content was assessed by atomic absorption spectroscopy and the histology of the samples. Result: The amount of calcium in the pericardium pretreated with ethanol (13.6${\pm}$10.0 ug/mg, p=0.008), L-lysine (15.3${\pm}$1.0 ug/mg, p=0.002) and both (16.1${\pm}$11.1 ug/mg, p=0.012) was significantly reduced compared with the control (51.2${\pm}$8.5 ug/mg). However, $NaBH_4$ pretreatment (65.7${\pm}$61.8 ug/mg, p=0.653) and combined pretreatment that including ethanol, L-lysine and $NaBH_4$ (92.9${\pm}$58.3 ug/mg, p=0.288) were not significantly different from the controls(51.2${\pm}$8.5 ug/mg). Both the combined pretreatment using ethanol and L-lysine (7.60${\pm}$1.55, p=0.76) and the combined pretreatment that included ethanol, L-lysine and $NaBH_4$ (7.47${\pm}$1.85, p=0.33) increased the tensile strength/thickness ratio compared with that of the controls (4.75${\pm}$1.88). Conclusion: The combined pretreatment using ethanol and L-lysine seemed to decrease the calcification of porcine pericardium fixed with glutaraldehyde, as compared to single pretreatment, and it increase the tissue elasticity, but to the degree that showed synchronized synergism. $NaBH_4$ pretreatment seemed to increase the calcification of porcine pericardium, irrespective of whether single or combined pretreatment was used.