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Postoperative Evaluation of Congenital Atrial Septal Defect in Adult (성인 심방중격결손증의 술후평가)

  • Kim, Ae-Jung;Jo, Jung-Gu;Gu, Ja-Hong;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.386-392
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    • 1996
  • Preoperative and postoperative evaluation was done in 60 adult patients above 20 years of age among 152 patients, who had operation for the congenital atrial septal defect from January 1984 to June 1993 in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Anatomically, the secundum type defect was present In 58 cases and the other two were ostium primum type defect. The defect were closed directly in 45 cases and with patches in 15 cases. Preopera ive EKG findings revealed regular sinus rhythm in 81%, arrhythmia 19%, RVH 32%, RAD 30%, Postoperative findings were regular sinus rhythm in 76%, arrhythmia 24%, RVH 25%. RAD 25%. In hemodynamic data, the mean SPAP in patients over 40 years old was 41.91 $\pm$ 14.33mmHg compared to 31.46 $\pm$ 13.77 mmHg in patients under 40 years old, and the difference between the two groups was stastistically significant. And then the patients were classified into two groups (group A sinus group, and group B : arrhythmia group) according to their preoperative rhythm. The patients in group B were older, had greater value of mean SPAP and Rp/Rs. Mean Qp/qs was higher in group A. But the difference between two groups about the mean Qp/qs and Rp/Rs was not significant. Postoperative complications such as arrhythmia, pneumothorax or hemothorax occurred in 7 cases, but there was no operative mortality. The functional improvement were remarkable in half of the patients who underwent surgery.

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Studies on the soybean varieties in Korea -III. Relationships between the ecotypes and various characteristics- (대두의 품종에 관한 연구 -제3보 생태형과 제 특성간 그리고 수량과 제 특성간의 관계-)

  • Kwon-Yawl Chang
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.2
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    • pp.27-29
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    • 1964
  • Experiments were carried out to clarify the relationships between seed yields and some ecological characteristics, seed yields and some morphological characteristics, and the relationships among the varietal yields on the several sowing plots when grown under different climatic conditions. Twenty-four soybean varieties were used as the material, selected at random from 138 varieties which were cultivated the year before. These varieties were grown in the Experimental Farm, Chinju Agricultural College, Kyung Sang Namdo, Korea, and seed sowing was conducted at 5 times, from April to July, in 1962 and 1963. The results obtained are summarized as follows: 1. Correlations between seed yields and some ecological characteristics on the sowing date bases are shown in Table 1. Among some ecological characteristics, it was observed that there wert close relationships between seed yields and days to flowering, and between seed yields and the total growing length, except on the late sowing, i.e. July sowing plots, However, there was no clear correlation between seed yields and durations of flowering, and between seed yields and days from flowering to maturity. 2. Correlations between seed yields and some morphological characteristics on the sowing date bases are shown in Table 2. From this table, it was also observed that there were some close relationships between seed yields and branch number for plant, stem diameter, plant weight, pod number per plant, and grain number per plant, but there was no clear relationship between seed yields and stem length, and between seed yields and 100 grain weight, on every sowing plot. 3. Relations between varietal yields and the sowing dates are shown in Table 3. Our leading varieties such as Ulsan, Sangdoo, Changdan Backmok, Iksan, Haman, Barchongdeo, and Anion Daerip, which belong to the maturity groups of IV, V, and VI, have been significantly high in yield at each sowing date plot, but the extreme early varieties, that frequently are damaged by insects, moisture and diseases, and the extreme late varieties, that frequently are caught by frost suffering reduced yield, are showed a lower yield than the others. However, extreme early varieties, for instance, Black Hawk, an American variety, and Chung Buk Baek, a Korean early variety, showed high productivity on the late sowing, June and July sowing plots, and Do san No. 6, which is late Japanese variety, showed a high yield on the extreme early sowing, i.e. April sowing plots. 4. Relations between seed yields and the sowing dates on the varietal bases are shown in Table 4. It was observed that, the early varieties did not differ much in yields at the various sowing dates while the yields of late varieties decreased progressively with subsequent dates. However, the extreme late varieties, such as Tamanishiki, that frequently are caught by frost suffering reduced yield, may be difficult to harvest at this location. The results in these experiments showed that in most cases maximum yields were obtained when leading varieties, which are medium or late varieties, were shown in Mid-May, and progressively lower yields were produced from June and July sowings. On the other hand, the late sowings of the early varieties, such as Black Hawk and Chung Buk Baek, in these experiments showed favorable yields compared with the others. From these results, we can predict that our local medium or late varieties produce higher yields at this location than was produced by early varieties in most of the sowing dates, especially the May sowing, and early varieties such as Black Hawk and Chung Buk Baek should be used in the late sowing, June sowing time.

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Serum Tumor Marker Levels might have Little Significance in Evaluating Neoadjuvant Treatment Response in Locally Advanced Breast Cancer

  • Wang, Yu-Jie;Huang, Xiao-Yan;Mo, Miao;Li, Jian-Wei;Jia, Xiao-Qing;Shao, Zhi-Min;Shen, Zhen-Zhou;Wu, Jiong;Liu, Guang-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4603-4608
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    • 2015
  • Background: To determine the potential value of serum tumor markers in predicting pCR (pathological complete response) during neoadjuvant chemotherapy. Materials and Methods: We retrospectively monitored the pro-, mid-, and post-neoadjuvant treatment serum tumor marker concentrations in patients with locally advanced breast cancer (stage II-III) who accepted pre-surgical chemotherapy or chemotherapy in combination with targeted therapy at Fudan University Shanghai Cancer Center between September 2011 and January 2014 and investigated the association of serum tumor marker levels with therapeutic effect. Core needle biopsy samples were assessed using immunohistochemistry (IHC) prior to neoadjuvant treatment to determine hormone receptor, human epidermal growth factor receptor 2(HER2), and proliferation index Ki67 values. In our study, therapeutic response was evaluated by pCR, defined as the disappearance of all invasive cancer cells from excised tissue (including primary lesion and axillary lymph nodes) after completion of chemotherapy. Analysis of variance of repeated measures and receiver operating characteristic (ROC) curves were employed for statistical analysis of the data. Results: A total of 348 patients were recruited in our study after excluding patients with incomplete clinical information. Of these, 106 patients were observed to have acquired pCR status after treatment completion, accounting for approximately 30.5% of study individuals. In addition, 147patients were determined to be Her-2 positive, among whom the pCR rate was 45.6% (69 patients). General linear model analysis (repeated measures analysis of variance) showed that the concentration of cancer antigen (CA) 15-3 increased after neoadjuvant chemotherapy in both pCR and non-pCR groups, and that there were significant differences between the two groups (P=0.008). The areas under the ROC curves (AUCs) of pre-, mid-, and post-treatment CA15-3 concentrations demonstrated low-level predictive value (AUC=0.594, 0.644, 0.621, respectively). No significant differences in carcinoembryonic antigen (CEA) or CA12-5 serum levels were observed between the pCR and non-pCR groups (P=0.196 and 0.693, respectively). No efficient AUC of CEA or CA12-5 concentrations were observed to predict patient response toward neoadjuvant treatment (both less than 0.7), nor were differences between the two groups observed at different time points. We then analyzed the Her-2 positive subset of our cohort. Significant differences in CEA concentrations were identified between the pCR and non-pCR groups (P=0.039), but not in CA15-3 or CA12-5 levels (p=0.092 and 0.89, respectively). None of the ROC curves showed underlying prognostic value, as the AUCs of these three markers were less than 0.7. The ROC-AUCs for the CA12-5 concentrations of inter-and post-neoadjuvant chemotherapy in the estrogen receptor negative HER2 positive subgroup were 0.735 and 0.767, respectively. However, the specificity and sensitivity values were at odds with each other which meant that improving either the sensitivity or specificity would impair the efficiency of the other. Conclusions: Serum tumor markers CA15-3, CA12-5, and CEA might have little clinical significance in predicting neoadjuvant treatment response in locally advanced breast cancer.

A Study on the Methodology of Land-Consolidation Sloping Paddies in land Vallry for the Farm-Mechanization (II) (기계화를 전제로 한 산간경사지답경지정리방안에 관한 연구(II))

  • Hwang, Eun
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.24 no.4
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    • pp.57-68
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    • 1982
  • The paddy fiels slope located in Kangweon province Hwyongsung gun Gonggeun myon Shinchonri was considerably steep and so it was impossible to economically consolidate the field up to date. But for the porpose of farm mechanization, the field (32. 27ha) was consolidated by the auther under the assitance of the Ministry of Agriculture and Fishery and,;the Administration of Kangweon province. This paddy field consolidation was caused by the treatise on "Land-consolidation methods for farm mechanization in the steep-sloped paddy field", of which the auther is the same. The constrution was carried out from September, 1981 to April, 1982. During the 4esign and construction, some Peculiarities were found and discussed. That is, in design, besides the common condititions for a design, some special conditions were considered and written below; (1) The ranges of field slope in this design were 1/100-1/30. (2) Long sides of the land readjustment blocks must be arranged abreast contour line, and so they make the amount of cutting and banking decreased so as to take the maximum advantage of the configuration of the field. (3) In design, the main principles of dividing blocks were written below; i) First of all, long side of a block should be drawn straight abreast a contour line. ii) Long side of a block should arrange abreast contour line and make its length 100-150m, if not, l)reak the side in order to make a bended rectangle. iii) Length of a short side should be determinded within differences of elevation (0.6 -1. 2m) between the two adjacent blocks toward the normal to a contour line. iv) Length of a short side should be above 15m and the ratio of long and short side should be slso kept 1: (4-6). v) A new field surface leveling was determinded from the elevation which produce the least amount of cuttingand banking within the range of 0.6-1. 2m diffe rences of elevation between the two adjacent blocks. vi) In the course of dividing blocks with the same width along the line which was normal to a contour line, all blocks connot keep their shape in a retangle because of steep slope of the field and so on, and so it was also necessory to make some non-retanglar and small blocks such as a trianglar or trapezoidal shape, which was impossible to use some of farm machinery. But because this non-rectanglar and small blocks were divided, larger and many rectanglar blocks can be divided and construction cost can also be lowered. According to the conditions discussed above, the paddy field consolidation project designed and constructed. And the results of this study were obtained as below; (1) Three-forth of total cost of this paddy field consolidation was not construction cost, and these cost consist of land grading (1/4), road and canal construction cost (1/4) and the other cost (1/4) such as surveying or materials and 56 on. (2) The steeper the land slope, the greater cost was assigned for road and canal construction, and than land grading. (3) Curtailment of the road and canal construction cost depended on simplificating their strutures. (4) In the case of the land slopes were low, the land grading cost was high by 1: 1.4 in comparison with the road and canal construction cost, and conversely when the slops were steep, the road and canal construction cost was high by 1 : 5 in compa- rison with the land grading cost. (5) The densities of irrigation canal, drainage canal and trunk and branch road were 150. Sm/ha, 60. im/ha and 17. 4m/ha respectively. The density of irrigation canal of the area was high by 2 times in comparison with the average one of Kangweon Province, and the others were nearly the same. (6) Most farmers (above 85%) knew the effects of paddy field consolidation. The effects are; 1) Improvement of irrigation 2) Improvement of farm management 3) Improvement of transportarion 4) farm mechanization and 5) grouping of the scattered land. And the more farm modernization was accomplished by these projects, the more farmers wanted to live in their land. (7) In spite of the very steep sloped paddy field, the diminution rate of the net farm land caused by consolidation was 7.7% which was nearly the same as the one of Chulweon plain of Kangweon province. Land grading cost was 971, OOOwon/ha which was rather cheap by 13.2% than the one of Ghulweon plain, and unit construction cost was 5, 341, OOOwon/ha (included soil addition) which was also nearly the same as the one of Chulweon plain and FNFIA (The federation of national farmland improvement association).

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Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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Vegetation Structure, Regeneration Niche, and Dynamics of the Saplings in Abies koreana Forest of the Mt. Chiri (지리산(智異山) 구상나무임분(林分)의 식생구조(植生構造)와 치수(稚樹) 발생(發生) 및 생육(生育) 동태(動態))

  • Chung, Jae Min;Lee, Soo Won;Lee, Kang Young
    • Journal of Korean Society of Forest Science
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    • v.85 no.1
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    • pp.34-43
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    • 1996
  • We investigated the vegetation structure, and effects of canopy degree(gap or purlieu to 25%, 50%, 75%, over 75%) of the overstory on seedling regeneration and survivorship, and sapling density, growth and growth type of Abies koreana in subalpine of Mt. Chiri. The stem density in Abies koreana stand was higher in middle story than upper story, individual trees in upper story occupied larger area and were more apart, resulted in uniform distribution. The regeneration and survivorship of seedlings and saplings were best in 25% of crown closure, in order of 50%, gap, but lowest in over 75% of crown closure. The annual growth rate and recent 5 years growth rate of saplings were highest in gap or purlieu and getting lower toward gradually higher coverage of overstory. And 10- to 20-Year-old saplings were mainly regenerated in stands with lower density(I or II), but most of 20 to 30 years old saplings were growing in stands with higher density (III or IV). The number of "A" type saplings grown normally in gap or purlieu was gradually decreased in stand with higher density but the number of "D" or "E" types of which growth was supressed or prohibited by the high density was abruptly increased. Saplings normally growing in the gap and purlieu showed the panicle type, but those grown under dense crown were greatly suppressed and showed the umbellate type.

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Effects of Green Manure Crops on Tomato Growth and Soil Improvement for Reduction of Continuous Cropping Injury through Crop Rotation in Greenhouse (토마토 시설재배지 토양에서 단기 녹비작물 재배가 연작장해 토양 개량 및 토마토 생육에 미치는 영향)

  • Jung, Yu Jin;Nou, III Sup;Kang, Kwon Kyoo
    • Korean Journal of Plant Resources
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    • v.28 no.2
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    • pp.263-270
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    • 2015
  • To reduce the injury by continuous cropping system of tomato cultivation, green manure crops (GMCs) such as hairy vetch and rye were applied, Nutrient contributions of N, P2O5, K2O, CaO, and MgO in hairy vetch were 26.2, 5.8, 10.2, 6.6, and 1.5 ㎏/10a, respectively. Nutrient contributions of N, P2O5, K2O, CaO, and MgO in rye were 9.1, 4.2, 11.8, 3.8, and 3.1 ㎏/10a, respectively. After incorporation of GMCs into soil, bulk density in soil with GMCs was lower than that in soil without GMCs (control). In soil after incorporation of GMCs, pH was not different in all treatment conditions, and ranged from 6.37~6.52. EC in soil after incorporation of GMCs was lower than that in soil without GMCs. The OM, T-N, and avail. P2O5 contents in soil with GMCs were higher than those in soil without GMCs. The tomato growths were increased in the rotational cropping system (RCS) as compared to continuous cropping system (control and without NPK). Also the density of Pseudomonas corrugata in soil with GMCs was lower than that in soil without GMCs (control). This study suggest that the RCS using GMCs showed lower disease outbreak density in soil for tomato cultivation as compared to RCS without GMCs. Especially, the GMCs was good effect for reduction of continuous cropping injury of tomato.

Effects of Replacing Soy Protein Concentrate with Fermented Soy Protein in Starter Diet on Growth Performance and Ileal Amino Acid Digestibility in Weaned Pigs

  • Min, B.J.;Cho, J.H.;Chen, Y.J.;Kim, H.J.;Yoo, J.S.;Wang, Q.;Kim, I.H.;Cho, W.T.;Lee, S.S.
    • Asian-Australasian Journal of Animal Sciences
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    • v.22 no.1
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    • pp.99-106
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    • 2009
  • For Exp. 1, 120 ((Yorkshire${\times}$Landrace)${\times}$Duroc) weaned pigs (7.96${\pm}$0.01 kg average initial BW, 21 days weaning) were used in a 28 d-growth assay to determine the effects of replacing soy protein concentrate (SPC) with fermented soy protein (FSP) in a starter diet (d 0 to 7) on the growth performance, apparent fecal amino acid digestibility and subsequent performance in weaned pigs. Dietary treatments included: i) FSP0 (basal diet; whey-skim milk powder-SPC based diet); ii) FSP5 (replacing SPC with 5% FSP); iii) FSP10 (replacing SPC with 10% FSP). Pigs were fed the phase I diet for 7 days, and then each group was fed a common commercial diet for 21 days to determine the effect of previous diet on subsequent performance. Average daily gain (ADG) from d 5 to 7 (linear effect, p = 0.01) and d 7 to 14 (linear effect, p<0.001) were increased as FSP level increased. The pigs fed with FSP was heavier than the pigs fed with SPC at d 5 to 7 and d 7 to 14 after weaning (p<0.05). In the entire period (d 0 to 28), there were no significant differences in weight gain and final weight between SPC and FSP diets (p>0.05). Average daily feed intake (ADFI) was higher in pigs fed with the 5% FSP diet than those fed with the other diets at d 0 to 2 post-weaning (quadratic effect, p = 0.05). Also, for the entire period of phase I (d 0 to 7), pigs consumed more 5% FSP diet compared to other treatments (quadratic effect, p = 0.03). Gain/feed (G/F) was not affected by dietary SPC or FSP in phase I and subsequent periods, but G/F from d 5 to 7 after weaning was improved linearly (p = 0.04) as dietary FSP level increased. Pigs fed with 10% FSP also improved G/F compared with those fed only SPC (p<0.05). At d 7, there were linear increments in fecal dry matter (DM) (p<0.1) and nitrogen (N) (p<0.01) digestibilities as the dietary FSP level increased. The digestibilities of fecal essential and total amino acids were increased as the FSP level increased (linear effect, p<0.1). For Exp. 2, three ((Yorkshire${\times}$Landrace)${\times}$Duroc) weaned barrows (average initial BW of 7.32 kg) were surgically fitted with a simple T-cannula approximately 15 cm prior to the ileo-cecal junction. The experimental designs were 3${\times}$3 latin squares with pigs and periods as blocking criteria. Dietary treatments and composition were the same as in Exp. 1. Apparent ileal N digestibility was increased as FSP level was increased (linear effect, p<0.05). The dietary treatments (SPC and FSP) did not affect apparent ileal DM digestibility (p>0.05). Among essential amino acids, apparent digestibility of ileal arginine (Arg), lysine (Lys), methionine (Met) and phenylalanine (Phe) were improved as the FSP level increased (linear effect, p<0.1). Also, apparent ileal total essential, non-essential and total amino acid digestibilities were increased linearly (p<0.1). In conclusion, replacing SPC with fermented soy protein appeared beneficial in growth performance, N and amino acid digestibility during the early 7 days after weaning, and an equivalent effect showed on growth performance in subsequent period of 7 to 28 days after weaning.

Changes of symphysis morphology after chincup treatment (이모장치 착용 후 하악 이부의 헝태변화)

  • Kang, Sun;Park, Dong-Cheol;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.30 no.1 s.78
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    • pp.33-41
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    • 2000
  • Although it is well known that the chincup, used to correct a skeletal class III malocclusion in growing children, reduce the mandibular prognathism by arresting the growth of the mandibular length and rotating the mandible posteroinferiorly, the majority of the studies about chincup is focused on condylar head that plays an Important role in mandibular growth. The aim of this study was to evaluate the morphologic change of the mandibular symphysis where extraoral force is applied directly during chincup treatment. The data lot this study were obtained from lateral cephalometric radiographs of 62 growing children(chincup group:32, control group:30) with mixed dentition who had been accepted lot the orthodontic treatment at Chonbuk National University Dental Hospital. The results were as follows : 1. Symphysis height was increased both in chincup therapy group and control group during treatment. Symphysis depth was decreased or maintained the initial values in chin cup therapy group, whereas increased in control group. Posterior symphysis depth was decreased both in chin cup therapy group and control group, but anterior svmphysis detph was increased in control group, whereas decreased in chincup therapy group. 2. Chin depth and chin curvature were increased in control group, whereas maintained or decreased in chincup therapy group during treatment. Chin angle, menton ang1e and symphysis angle were decreased in control group, whereas increased in chincup therapy group. It suggested that bone deposition in pogonion area that occur normally with mandibular growth was supressed by direct contact of chincup. 3. When growing children wear chincup, symphysis morphology was maintained due to inhibition of forward growth at mandibular symphysis. It may be due to the suppression of bone deposition in anterior part of symphysis.

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Strategic Antitrust Policy Promoting Mergers to Enhance Domestic Competitiveness (기업결합규제(企業結合規制)와 국제경쟁력(國際競爭力))

  • Seong, So-mi
    • KDI Journal of Economic Policy
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    • v.12 no.3
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    • pp.153-172
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    • 1990
  • The present paper investigates the potential value of strategic antitrust policy in an oligopolistic international market. The market is characterized by a non-cooperative Cournot-Nash equilibrium and by asymmetry in costs among firms in the world market. The model is useful for two reasons. First, it is important in the context of policy-making to examine the conditions under which it may be beneficial to relax antitrust law to enhance competitiveness. Second, the explicit derivation of the level of cost-saving required for a gain in total domestic surplus provides an empirical rule for excluding industries that do not satisfy the requirements for a socially beneficial antitrust exemption. Results of the analysis include a criterion that tells how the cost-saving and concentration effects of a merger offset each other. The criterion is derived from fairly general assumptions on demand functions and is simple enough to be applied as a part of the merger guidelines. Another interesting policy implication of our analysis is that promoting mergers would not be a beneficial strategy in a net importing industry where cost-saving opportunities are thin. Cost-saving domestic mergers are more likely to increase national welfare in exporting industries. The best candidate industries for application of strategic antitrust policy are those with the following characteristics: (i) a large potential for efficiency enhancement; (ii) high market concentration at the world but not the domestic level; (iii) a high ratio of exports to imports. Recently, many policymakers and economists in Korea have also come to believe that the appropriate antitrust policy in an era of increased foreign competition may actually be to encourage rather than to prohibit domestic mergers. The Industry Development Act of 1986 and the proposed bill for Mergers and Conversions in the Financial Industry of 1990 reflect this changing perspective on antitrust policy. Antitrust laws may burden domestic firms in the sense that they have a more constrained strategy set. Expenditures to avoid antitrust attacks could also increase costs for domestic firms. But there is no clear evidence that the impact of antitrust policy is significant enough to harm the competitiveness of domestic firms. As a matter of fact, it is necessary for domestic financial institutions to become large in scale in this era of globalization. However, the absence of empirical evidence for efficiency enhancement from mergers suggests caution in the relaxation of antitrust standards.

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