• Journal of Chest Surgery
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• v.36 no.7
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• pp.463-471
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• 2003

The long-term results of combined mitral valve repair and aortic valve replacement (AVR) have not been well evaluated. This study was performed to investigate the early and long-term results of mitral valve repair with AVR. Material and Method: We retrospectively reviewed 45 patients who underwent mitral valve repair and AVR between September 1990 and April 2002. The average age was 47 years: 28 were men and 17 women. Twelve patients had atrial fibrillation and three had a previous cardiac operation. The mitral valve disease consisted of pure insufficiency (MR) in 34 patients, mitral stenosis (MS) in 3, and mixed lesion in 8. Mitral valve disease was due to rheumatic origin in 24 patients, degenerative in 11, annular dilatation in 8, and ischemia or endocarditis in 2. The functional anatomy of mitral valve was annular dilatation in 31 patients, chordal elongation in 19, leaflet thickening in 19, commissural fusion in 13, chordal fusion in 10, chordal rupture in 6, and so on. Aortic prostheses used included mechanical valve in 32 patients, tissue valve in 12, and pulmonary autograft in one. The techniques of mitral valve repair included annuloplasty in 32 patients and various valvuloplasty of 54 techniques in 29 patients. Total cardiopulmonary bypass and aortic cross clamp time were 204$\pm$62 minute and 153$\pm$57 minutes, respectively. Result: Early death was in one patient due to low output syndrome (2.2%). After follow up of 57$\pm$37 months, late death was in one patient and the actuarial survival at 10 years was 96$\pm$4%. Recurrent MR developed grade II or III in 11 patients and moderate MS in 3. Three patients required reoperation for valve-related complications. The actuarial freedom from recurrent MR, MS, and reoperation were 64$\pm$11%, 86$\pm$8%, and 89$\pm$7% respectively. Conclusion: Combined mitral valve repair with AVR offers good early and long-term survival, and adequate techniques and selection of indication of mitral valve repair, especially in rheumatic disease, are prerequisites for better long-term results.

• The Korean Journal of Air & Space Law and Policy
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• v.32 no.1
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• pp.177-200
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• 2017

This writer have thus far reviewed the civil and criminal obligations of the directors of a parent company that sponsored financially troubled affiliates. What was discussed here applies to logistics companies in the same manner. Hanjin Shipping cannot expect its parent company, Korean Air to prop it up financially. If such financial aid is offered without any collateral, under Korean criminal law, the directors of the parent company bears the burden of civil and criminal responsibility. One way to get around this is to secure fairness in terms of the process and the content of aid. Fairness in terms of process refers to the board of directors making public all information and approving such aid. Fairness in terms of content refers to impartial transactions that block out any possibilities of the chairman of the corporate group acting in his private interest. In the case of Korean Air bailing out Hanjin, the meeting of board of directors were held five times and a thorough review was conducted on the risks involved in the loans being repaid or not. After the review, measures to guard against undesirable scenarios were established before finally deciding on bailing out Hanjin. As such, there are no issues. In terms of the fairness of content, too, there were practically no room for the majority shareholder or controlling shareholder to pocket profits at the expense of the company. This is because the continued aid offered to a financially troubled company (i.e. Hanjin Shipping) was a posing a burden to even the controlling shareholder. This writer argues that the concept of the interest of the entire corporate group needs to be recognized. That is, it must be recognized that the relationship of control and being controlled between parent company and affiliate company, or between affiliate companies serves a practical benefit to the ongoing concern and growth of the group and is therefore just. Moreover, the corporate group and its affiliates, as well as their directors and management must recognize that they have an obligation to prioritize the interests of the corporate group ahead of the interests of the company that they are directly associated with. As such, even if Korean Air offered a loan to Hanjin Shipping without collateral, the act cannot be treated as an offense to law, nor can the directors be accused of damages that they bear the responsibility of compensating under civil law.

• The Korean Journal of Nuclear Medicine
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• v.39 no.6
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• pp.413-420
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• 2005

Purpose: Neuroreceptor PET studies require 60-120 minutes to complete and head motion of the subject during the PET scan increases the uncertainty in measured activity. In this study, we investigated the effects of the data-driven head mutton correction on the evaluation of endogenous dopamine release (DAR) in the striatum during the motor task which might have caused significant head motion artifact. Materials and Methods: $[^{11}C]raclopride$ PET scans on 4 normal volunteers acquired with bolus plus constant infusion protocol were retrospectively analyzed. Following the 50 min resting period, the participants played a video game with a monetary reward for 40 min. Dynamic frames acquired during the equilibrium condition (pre-task: 30-50 min, task: 70-90 min, post-task: 110-120 min) were realigned to the first frame in pre-task condition. Intra-condition registrations between the frames were performed, and average image for each condition was created and registered to the pre-task image (inter-condition registration). Pre-task PET image was then co-registered to own MRI of each participant and transformation parameters were reapplied to the others. Volumes of interest (VOI) for dorsal putamen (PU) and caudate (CA), ventral striatum (VS), and cerebellum were defined on the MRI. Binding potential (BP) was measured and DAR was calculated as the percent change of BP during and after the task. SPM analyses on the BP parametric images were also performed to explore the regional difference in the effects of head motion on BP and DAR estimation. Results: Changes in position and orientation of the striatum during the PET scans were observed before the head motion correction. BP values at pre-task condition were not changed significantly after the intra-condition registration. However, the BP values during and after the task and DAR were significantly changed after the correction. SPM analysis also showed that the extent and significance of the BP differences were significantly changed by the head motion correction and such changes were prominent in periphery of the striatum. Conclusion: The results suggest that misalignment of MRI-based VOI and the striatum in PET images and incorrect DAR estimation due to the head motion during the PET activation study were significant, but could be remedied by the data-driven head motion correction.

• Radiation Oncology Journal
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• v.25 no.1
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• pp.7-15
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• 2007

[ $\underline{Purpose}$ ]: To determine the patterns of evaluation and treatment in patients with breast cancer after mastectomy and treated with radiotherapy. A nationwide study was performed with the goal of improving radiotherapy treatment. $\underline{Materials\;and\;Methods}$: A web- based database system for the Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Randomly selected records of 286 eligible patients treated between 1998 and 1999 from 17 hospitals were reviewed. $\underline{Results}$: The ages of the study patients ranged from 20 to 80 years (median age 44 years). The pathologic T stage by the AJCC was T1 in 9.7% of the cases, T2 in 59.2% of the cases, T3 in 25.6% of the cases, and T4 in 5.3% of the cases. For analysis of nodal involvement, N0 was 7.3%, N1 was 14%, N2 was 38.8%, and N3 was 38.5% of the cases. The AJCC stage was stage I in 0.7% of the cases, stage IIa in 3.8% of the cases, stage IIb in 9.8% of the cases, stage IIIa in 43% of the cases, stage IIIb in 2.8% of the cases, and IIIc in 38.5% of the cases. There were various sequences of chemotherapy and radiotherapy after mastectomy. Mastectomy and chemotherapy followed by radiotherapy was the most commonly performed sequence in 47% of the cases. Mastectomy, chemotherapy, and radiotherapy followed by additional chemotherapy was performed in 35% of the cases, and neoadjuvant chemoradiotherapy was performed in 12.5% of the cases. The radiotherapy volume was chest wall only in 5.6% of the cases. The volume was chest wall and supraclavicular fossa (SCL) in 20.3% of the cases; chest wall, SCL and internal mammary lymph node (IMN) in 27.6% of the cases; chest wall, SCL and posterior axillary lymph node in 25.9% of the cases; chest wall, SCL, IMN, and posterior axillary lymph node in 19.9% of the cases. Two patients received IMN only. The method of chest wall irradiation was tangential field in 57.3% of the cases and electron beam in 42% of the cases. A bolus for the chest wall was used in 54.8% of the tangential field cases and 52.5% of the electron beam cases. The radiation dose to the chest wall was $45{\sim}59.4\;Gy$ (median 50.4 Gy), to the SCL was $45{\sim}59.4\;Gy$ (median 50.4 Gy), and to the PAB was $4.8{\sim}38.8\;Gy$, (median 9 Gy) $\underline{Conclusion}$: Different and various treatment methods were used for radiotherapy of the breast cancer patients after mastectomy in each hospital. Most of treatment methods varied in the irradiation of the chest wall. A separate analysis for the details of radiotherapy planning also needs to be followed and the outcome of treatment is needed in order to evaluate the different processes.

• Journal of Chest Surgery
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• v.39 no.7 s.264
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• pp.511-519
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• 2006

Background: Loss of cardiomyocytes in the myocardial infarction leads to regional contractile dysfunction, and necrotized cardiomyocytes in infracted ventricular tissues are progressively replaced by fibroblasts forming scar tissue. Although cardiomyoplasty, or implantation of ventricular assist device or artificial heart was tried in refractory heart failure, the cardiac transplantation was the only therapeutic modality because these other therapeutic strategies were not permanent. Cell transplantation is tried instead of cardiac transplantation, especially bone marrow is the most popular donated organ. But because bone marrow aspiration procedure is invasive and painful, and it had the fewer amounts of cellular population, the adipose tissue is recommended for harvesting of mesenchymal stem cells. Material and Method: After adipose tissues were extracted from abdominal subcutaneous adipose tissue and intra-abdominal adipose tissue individually, the cellular components were obtained by same method. These cellular components were tried to transformation with the various titers of 5-azacytidine to descript the appropriate concentration of 5-azacytidine and possibility of transformation ability of adipose tissue. Group 1 is abdominal subcutaneous adipose tissue and Group 2 is intra-abdominal adipose tissue-retroperitoneal adipose tissue and omentum. Cellular components were extracted by collagenase and $NH_4Cl$ et al, and these components were cultured by non-induction media - DMEM media containing 10% FBS and inducted by none, $3{\mu}mol/L,\;6{\mu}mol/L,\;and\;9{\mu}mol/L$ 5-azacytidine after the 1st and 2nd subculture. After 4 weeks incubation, tile cell blocks were made, immunostaining was done with the antibodies of CD34, heavy myosin chain, troponin T, and SMA. Result: Immunostaining of the transformed cells for troponin T was positive in the $6{\mu}mol/L\;&\;9{\mu}mol/L$ 5-azacytidine of Group 1 & 2, but CD34 and heavy myosin chain antibodies were negative and SMA antibody was positive in the $3{\mu}mol/L\;&\;6{\mu}mol/L$ 5-azacytidne of Group 2. Conclusion: These observations confirm that adult mesenchymal stem cells isolated from the abdominal subcutaneous adipose tissues and intra-abdominal adipose tissues can be chemically transformed into cardiomyocytes. This can potentially be a source of autologous cells for myocardial repair.

• Food Science of Animal Resources
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• v.27 no.2
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• pp.235-243
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• 2007

This study was conducted to evaluate the effects of feeding rye silage on growth performance, blood and carcass characteristics in finishing pigs. The total of eighteen($Landrace{\times}Yorkshire{\times}Duroc$) pigs($74.22{\pm}0.71kg$) were used for 49-day assay. Dietary treatments included 1) CON(basal diet), 2) S1(1.66% rye silage) and 3) S2(3.32% rye silage). In growth performance, from 4 to 7 weeks, average daily feed intake(ADFI) in pigs fed CON diet was higher than pigs fed S1 and S2 diets. Through the entire experimental period($0{\sim}7$ weeks), a ADFI in CON and S2 treatments was higher than S1 treatment (p<0.05). Serum cortisol concentration of pigs fed rye silage decreased significantly compared to pigs fed basal diet (p<0.05). The Hunter's $L^*$(lightness) value of loin in the pigs fed S2 diet was higher than that of loin in the pigs fed CON diet(p<0.05). The $b^*$(yellowness) value of loin in the pigs fed S1 and S2 diets were higher than CON treatment(p<0.05). Backfat thickness in CON treatment increased significantly compared to S1 and S2 treatments(p<0.05). Among fatty acid contents of lean meat, the contents of palmitic and stearic acids were significantly higher in CON than others(p<0.05), where as eicosenoic and linolenic acids were the highest in S2 treatment among treatments(p<0.05). Total SFA(saturated fatty acid) was the highest in CON(p<0.05) and S1 and S2 treatments were higher USFA/SFA(unsaturated fatty acid/saturated fatty acid) ratio than CON treatment. In fats, linolenic acid was higher in S2 treatment than those of S1 and CON treatments(p<0.05). Digestibility of dry matter in pigs fed S1 and S2 diets was greater than that of pigs fed CON diet(p<0.05) and S1 treatment was higher than others on digestibility of nitrogen(p<0.05). VFA(volatile fatty acid) emission from focal, measured after 1 day, increased significantly in pigs fed S1 and S2 diets(p<0.05). In conclusions, our results showed that feeding rye silage might be beneficial in decrease of cortisol concentration, hunter's $L^*$(lightness) value and $b^*$(yellowness), fatty acid contents, and nutrient digestibility. However, there should be more study on the relationship between feeding rye silagr and finishing pigs.

• Journal of Distribution Research
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• v.17 no.3
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• pp.25-57
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• 2012

This study identified motives for writing apparel product reviews in online stores, and determined what motives increase the behavior of writing reviews. It also classified store customers based on the type of writing motives, and clarified the characteristics of internet purchase behavior and of a demographic profile. Data were collected from 252 females aged 20s' and 30s' who have experience of reading and writing reviews on online shopping. The five types of writing motives were altruistic information sharing, remedying of a grievance and vengeance, economic incentives, helping new product development, and the expression of satisfaction feelings. Among five motives, altruistic information sharing, economic incentives, and helping new product development stimulate writing reviews. Store customers who write reviews were classified into three groups based on their writing motive types: Other consumer advocates(29.8%), self-interested shoppers(40.5%) and shoppers with moderate motives(29.8%). There were significant differences among three groups in writing behavior (the frequency of writing reviews, writing intent of reviews, duration of writing reviews, and frequency of online shopping) and age. Based on results, managerial implications were suggested. Long Abstract : The purpose of present study is to identify the types of writing motives on online shopping, and to clarify the motives affecting the behavior of writing reviews. This study also classifies online shoppers based on the motive types, and identifies the characteristics of the classified groups in terms of writing behavior, frequency of online shopping, and demographics. Use and Gratification Theory was adopted in this study. Qualitative research (focus group interview) and quantitative research were used. Korean women(20 to 39 years old) who reported experience with purchasing clothing online, and reading and writing reviews were selected as samples(n=252). Most of the respondents were relatively young (20-34yrs., 86.1%,), single (61.1%), employed(61.1%) and residents living in big cities(50.9%). About 69.8% of respondents read and 40.5% write apparel reviews frequently or very frequently. 24.6% of the respondents indicated an "average" in their writing frequency. Based on the qualitative result of focus group interviews and previous studies on motives for online community activities, measurement items of motives for writing after-purchase reviews were developed. All items were used a five-point Likert scale with endpoints 1 (strongly disagree) and 5 (strongly agree). The degree of writing behavior was measured by items concerning experience of writing reviews, frequency of writing reviews, amount of writing reviews, and intention of writing reviews. A five-point scale(strongly disagree-strongly agree) was employed. SPSS 18.0 was used for exploratory factor analysis, K-means cluster analysis, one-way ANOVA(Scheffe test) and ${\chi}^2$-test. Confirmatory factor analysis and path model analysis were conducted by AMOS 18.0. By conducting principal components factor analysis (varimax rotation, extracting factors with eigenvalues above 1.0) on the measurement items, five factors were identified: Altruistic information sharing, remedying of a grievance and vengeance, economic incentives, helping new product development, and expression of satisfaction feelings(see Table 1). The measurement model including these final items was analyzed by confirmatory factor analysis. The measurement model had good fit indices(GFI=.918, AGFI=.884, RMR=.070, RMSEA=.054, TLI=.941) except for the probability value associated with the ${\chi}^2$ test(${\chi}^2$=189.078, df=109, p=.00). Convergent validities of all variables were confirmed using composite reliability. All SMC values were found to be lower than AVEs confirming discriminant validity. The path model's goodness-of-fit was greater than the recommended limits based on several indices(GFI=.905, AGFI=.872, RMR=.070, RMSEA=.052, TLI=.935; ${\chi}^2$=260.433, df=155, p=.00). Table 2 shows that motives of altruistic information sharing, economic incentives and helping new product development significantly increased the degree of writing product reviews of online shopping. In particular, the effect of altruistic information sharing and pursuit of economic incentives on the behavior of writing reviews were larger than the effect of helping new product development. As shown in table 3, online store shoppers were classified into three groups: Other consumer advocates (29.8%), self-interested shoppers (40.5%), and moderate shoppers (29.8%). There were significant differences among the three groups in the degree of writing reviews (experience of writing reviews, frequency of writing reviews, amount of writing reviews, intention of writing reviews, and duration of writing reviews, frequency of online shopping) and age. For five aspects of writing behavior, the group of other consumer advocates who is mainly comprised of 20s had higher scores than the other two groups. There were not any significant differences between self-interested group and moderate group regarding writing behavior and demographics.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.19-26
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• 2004

Background: The aims of this study are to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR), Material and Method: Fifteen patients operated on since 1985 were included in the study. The patients operated on before 1998 (n=9) showed heterogeneous properties with various surgical strategies and cardiopulmonary bypass techniques. However, six patients were operated on with the established surgical strategy since 1998; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery, 2) Coronary transfer by rolled-conduit made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not peformed. Result: Median age of the study group was 6 months (1 month to 34 years). The operative methods were left subclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 patients. The mean follow up period was 5.5<5.8 years (2 months 14 years), There were one early death (6.7%) and one late death. Overall 5-year survival rate was 85.6$\pm$9.6%. The Z-value of left ventricular end-diastolic and end-systolic dimensions were 6.4$\pm$3.0 and 5.1 $\pm$3.6 preoperatively, and decreased to 1.7$\pm$ 1.9 and 0.8$\pm$ 1.6 in 3 months (p<0.05). Significant preoperative MR was identified in 6 patients (40%) and all the patients showed immediate improvement of MR within f month postoperatively. There were 3 cases of reoperation due to coronary anastomosis site stenosis and recurrence of MR. However, there was no mortality nor late reoperation in the patients operated on after 1998. Conclusion: The surgical treatment of ALCAPA showed favorable survival and early recovery of ventricular dimensions and mitral valvular function. Although long-term reintervention was required in some cases of earlier period, all the cases after 1998 showed excellent surgical outcome without long-term problem.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.188-198
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• 2002

Background: Reoperations on the aortic root or the ascending aorta are being performed with increasing frequency and remain a challenging problem. This study was performed to analyze the results of reoperations on the ascending aorta and aortic root. Material and Method: Between May 1995 and April 2001, 30 patients had reoperations on the ascending aorta and aortic root and were reviewed retrospectively. The mean interval between the previous repair and the actual reoperation was 56 months(range 3 to 142 months). Seven patients(23.3%) had two or more previous operations. The indications for reoperations were true aneurysm in 7 patients(23.3%), prosthetic valve endocarditis in 6(20%), false aneurysm in 5(16.7%), paravalvular leak associated with Behcet's disease in 4(13.3%), malfunction of prosthetic aortic valve in 4(13.3%), aortic dissection in 3(10%), and annuloaortic ectasia in 1(3.3%). The principal reoperations performed were aortic root replacement in 17 patients(56.7%), replacement of the ascending aorta in 8(26.7%), aortic and mitral valve replacement with reconstruction of fibrous trigone in 2(6.6%), patch aortoplasty in 2(6.6%), and aortic valve replacement after Bentall operation in 1 (3.3%). The cardiopulmonary bypass was started before sternotomy in 7 patients and the hypothermic circulatory arrest was used in 16(53.3%). The mean time of circulatory arrest, total bypass, and aortic crossclamp were 20$\pm$ 12 minutes, 228$\pm$56 minutes, and 143$\pm$62 minutes, respectively Result: There were three early deaths(10%). The postoperative complications were reoperation for bleeding in 7 patients(23.3%), cardiac complications in 5(16.7%), transient acute renal failure in 2(6.6%), transient focal seizure in 2(6.6%), and the others in 5. The mean follow-up was 22.8 $\pm$20.5 months. There were two late deaths(7.4%). The actuarial survival was 92.6$\pm$5.0% at 6 years. One patient required reoperation for complication of reoperation on the ascending aorta and aortic root(3.7%). The 1- and 6-year actuarial freedom from reoperation was 100% and 83.3$\pm$15.2%, respectively. One patient with Behcet's disease are waiting for reoperation due to false aneurysm, which developed after aortic root replacement with homograft. There were no thromboembolisms or anticoagulant related complications. Conclusions: This study suggests that reoperations on the ascending aorta and aortic root can be performed with acceptable early mortality and morbidity, and adequate surgical strategies according to the pathologi conditions are critical to the prevention of the reoperation.

• Radiation Oncology Journal
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• v.23 no.1
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• pp.22-31
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• 2005

Purpose : To conduct a nationwide survey on the principals in radiotherapy for rectal cancer, and produce a database of Korean Patterns of Care Study. Materials and Methods : We developed web-based Patterns of Care Study system and a national survey was conducted using random sampling based on power allocation methods. Eligible patients were who had postoperative radiotherapy for rectal cancer without gross residual tumor after surgical resection and without previous history of other cancer and radiotherapy to pelvis. Data of patients were Inputted to the web based PCS system by each investigators in 19 institutions. Results : Informations on 309 patients with rectal cancer who received radiotherapy between 1998 and 1999 were collected. Male to female ratio was 59 : 41, and the most common location of tumor was lower rectum ($46\%$). Preoperative CEA was checked in $79\%$ of cases and its value was higher than 6 ng/ml in $32\%$. Pathologic stage were I in $1.5\%$, II in $32\%$, III in $53\%$, and IV in $1.6\%$. Low anterior resection was the most common type of surgery and complete resection was peformed in $95\%$ of cases. Distal resection margin was less than 2 cm in $30\%$, and number of lymph node dissected was less than 12 in $31\%$. Chemotherapy was peformed in $91\%$ and most common regimen was 5-FU and leucovorine ($59\%$). The most common type of field arrangement used for the initial pelvic field was the four field box (Posterior-Right-Left) technique ($65.0\%$), and there was no AP-PA parallel opposing field used. Patient position was prone in $81.2\%$, and the boost field was used in $61.8\%$. To displace bowel outward, pressure modulating devices or bladder filling was used in $40.1\%$. Radiation dose was prescribed to isocenter in $45.3\%$ and to isodose line in 123 cases ($39.8\%$). Percent delivered dose over $90\%$ was achieved in $92.9\%$. Conclusion : We could find the Patterns of Care for the radiotherapy in Korean rectal cancer patients was similar to that of US national survey. The type of surgery and the regimen of chemotherapy were variable according to institutions and the variations of radiation dose and field arrangement were within acceptable range.