• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.42-50
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• 2003

Purpose : The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. Methods : Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994. Results : A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune compromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, $PaO_2$, $PaCO_2$, PEEP, and $PaO_2/FiO_2$ on the seventh day after the onset of the ARDS. Conclusion : According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.

• Korean Journal of Cognitive Science
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• v.27 no.3
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• pp.441-467
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• 2016

This fMRI study is aim to investigate effects of competitive environment in cognitive empathic process in human brain. Empathy is known as a crucial factor for human's adaptive behavior in aspects of social cognition and it is almost automatic process, on the other hand competitive situation is psychologically devastated environment to win someone for getting rewards. We hypnotized that reading and understanding of other person's mind are a specific characteristic related to survival evolutionarily, however competition would have an effect on the empathic cognitive process because of mechanisms of competition. To manipulate the competitive atmosphere, one researcher took a role of competitor against participants and they were instructed to get monetary rewards when their performance was better than a competitor. 21 participants(9 males and 12 females) performed to judge the emotional valence of the empathic task consisted of illustrated images with various situation could be experienced in real world as on $1^{st}$ person perspective in both competitive and non-competitive condition, and did same performance with objects stimulus in control condition. In order to examine the competition effects on empathic process,, hemodynamic response were obtained during fMRI session and the imaging data were analyzed to identify brain regions where responses to each condition across the two consecutive runs. Participants' reaction time in competitive condition was faster statistically significant than non-competitive one. Activation for competitive condition increased in the following areas: ACC, mPFC, SMG, thalamus extended caudate and Nacc, parahippocampal gyrus, and for non-competitive condition increased paracingulate gyrus, temporal pole, vmPFC, superior occipital gyrus. As a result of regression analysis using empathic scores as covariance, the rSMG, IFG, fusiform gyrus, thalamus, putamen were correlated with higher empathic levels, and TPJ were correlated with lower empathic scores. We suggest that these observations could mean competitive environment have an effect on neural base of cognitive empathic process.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.78
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• pp.93-117
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• 2018

In all countries of the world, the development of trade is an important factor for the survival of the national economy. Increased export will lead to national economic growth. Export is directly linked to employment, and the industrial structure will be developed in the direction to produce products of comparative advantages. Therefore, every country around the world is trying to promote export regardless of the size of its economy. Accordingly, this paper focused on the promotion of export of domestic companies. It proposed to cultivate trade experts to promote export of domestic companies. The following five methods were proposed to materialize the proposal. First, it is important to foster trade experts to expand and foster the one-person creative companies. In particular, it is important to develop a professional education curriculum. It is necessary to design and conduct a systematic curriculum throughout the process including follow-up after education such as teaching detailed procedures for establishing a trade business, identification of relevant regulations and related organizations, understanding of special features of each exporting country, and details of exporting procedures through specialist training for the individual industries, helping themto keep their network steady so that they can easily get help from consultants. Second, it is necessary to educate traders working in the field to make them trade experts and utilize themin on-the-job training and consulting. To do this, it is necessary to introduce systematic consultant selection process, and to introduce a systemto educate and manage them. It is because, we must select the most appropriate candidates, educate themto be lecturers and consultants, and dispatch themto the field, in order to make the best achievement in export. Nurturing trading professionals utilizing the current trading workers to activate export of domestic companies can be more efficient through cooperation of trading education agencies and related agencies in various industries. Third, it is also proposed to cultivate female trade experts by educating female trade workers whose career has been disrupted. It is to provide career disrupted women with opportunities to work after training them as trade professionals and to give manpower pool to domestic companies that are preparing for export. Fourth, it is also proposed to educate foreign students living in Korea to be trading experts and to utilize them as trading infra. They can be trading professionals who will contribute to the promotion of export. In the short term, they will be provided with opportunities for employment and start-upin the field of trade, and in the mid- to long-term, they may develop a business network between Korea and their own countries. To this end, we need to improve the visa system, expand free trade education opportunities, and support them so that they can establish small but strong enterprises. Fifth, it is proposed to proactively expand trade education to specialized high school students. Considering that most of domestic companies pursuing activation of export are small but strong companies or small and mediumsized companies, they may prefer high school graduates rather than university graduates because of financial limitations. Besides, the specialized high school students may occupy better position in the job market if they are equipped with expertise in trading. This study can be meaningful, in that it is the first research that focuses on cultivating trading experts to contribute to the export activation of domestic companies. However, it also has a limitation that it has failed to reflect the more specific field voices. It is hoped that detailed plans will be derived from the opinions of the employees of domestic companies making efforts to become an export company in the related researches in the future.

• Radiation Oncology Journal
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• v.15 no.2
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• pp.105-111
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• 1997

group($22\%\;vs.\;38\%$, p=0.24). The 5YSRs of 21 patients of primary tumor extension to adjacent sites and the other 13 patients of tonsillar proper site were $28\%\;and\;38\%$, respectively but the difference was not significant statistically(p=0.52) There was a statistically significant difference in 5YSRs between the groups of the Patients who received radiotherapy in less than 61days vs more than 60days($60\%\;vs.\;18\%$, p=0.027). All living Patients without any tumor progression(n=11) had suffered from serious late sequelae such as xerostomia, edentia, dental caries and one patient had the osteoradionecrosis of mandible. On univariate analysis. the duration of radiotherapy and T-stage were the significant prognostic factors affecting 5YSR. On multivariate analysis, also the duration of radiotherapy was the only significant Prognostic factor(p=0.01). Conclusion : There was no survival difference between the radiotherapy alone and with neoadiuvant chemothe groups. Although it was a retrospective study, the role of conventional radiotherapy alone could be effective as the local treatment modality only for the early stage of tonsillar carcinomas. But for the purpose of more improved survivals and better quality of lives of living patients, other altered fractionation such as hyperfractionated radiotherapy with shorter treatment time and smaller fraction size rather than conventional radiotherapy might be beneficial and these prospective studies are needed.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.317-322
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• 1996

Purpose : Patients with cervical cancer who have positive resection margins after radical hysterectomy are at increased risk for local recurrence. The result of postoperative pelvic radiotherapy for cervix cancer with positive resection margins were analyzed to evaluate the role of radiotherapy. Materials and Methods : Between n 1979 and 1992, 60 patients of cervix carcinoma were treated with postoperative radiotherapy after radical hysterectomy and pelvic lymphadenectomy because of positive vaginal (48 patients) or parametrial resection margins (12 patients). Patients were treated with external beam radiation therapy (EBRT) alone (12 Patients) or EBRT plus vaginal ovoid irradiation (VOI) (48 patients). The median followup period was 55 months. Results : The 5-year actuarial disease free and overall survival rates for all patients were $75.2\%$, $84.1\%$, respectively. The overall recurrence rate was $23\%$ (14/60). In 48 patients with Positive vaginal resection margins, the pelvic recurrence was $8\%$ (4/48). Distant metastasis was $15\%$(7/48). Of the 43 patients with positive vaginal resection margins treated with EBRT and VOI, recurrence rate was $21\%$(9/43) , while recurrence rate was $40\%$(2/5) in the EBRT only treated group. In 12 patients with positive parametrial margins, three patients ($25\%$) had distant metastases. The most significant prognostic factor was lymph node metastasis. Complications resulting from radiotherapy occurred at a rate of $32\%$(19/60) and grade III complications occurred in three patients ($5\%$). Conclusion : Postoperative radiotherapy can produce excellent pelvic control rates in patients with positive resection margins. In patients with positive vaginal margins, whole pelvic EBRT and VOI is recommended.

• Journal of Chest Surgery
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• v.39 no.2 s.259
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• pp.99-105
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• 2006

Background: Interrupted aortic arch is a rare congenital heart anomaly which still shows high surgical mortality. In this study, we investigated the causes of and the risk factors for mortality to improve the surgical outcomes for this difficult disease entity. Material and Method: From 1984 to 2004, 42 patients diagnosed as IAA were reviewed retrospectively. Age, body weight at operation, preoperative diagnosis, preoperative PGE1 requirement, type of interrupted aortic arch, degree of left ventricular outflow stenosis, CPB time, and ACC time were the possible risk factors for mortality. Result: There were .14 hospital deaths. Preoperative use of PGE1, need for circulartory assist and aortic cross clamp time proved to be positive risk factors for mortality on univariate analysis. Preoperative left ventricular outflow stenosis was considered a risk factor for mortality but it did not show statistical significance (p-value=0.61). Causes of death included hypoxia due to pulmonary banding, left ventricular outtract stenosis, infection, mitral valve regurgitation, long cardiopulmonary bypass time and failure of coronary transfer failure in TGA patients. Conclusion: In this study, we demonstrated that surgical mortality is still high due to the risk factors including preoperative status and long operative time. However preoperative subaortic dimension was not related statistically to operative death statistically. Adequate preoperative management and short operation time are mandatory for better survival outcome.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1197-1204
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• 1997

Between April 1981 and June 1996, 65 patients had aortic root replacement at our institution. Disease entities were pure aortic annuloectasia in 31 patients(47.7%), Stanford type A aortic dissection with annuloectasia in 8(43.1%), atherosclerotic aneurysm with aortic regurgitation in 4(6.2%), and paravalvular leakage after aortic valve replacement in 2(3.1 %). 34 patients(52.3%) had the clinical stigmata of the Marfan syndrome. The operative procedures were Bentall operation in 61 patients(93.8%); 3 of conventional procedure and 58 of Cabrol's modification, aortic valve-sparing operation in 2(3.1 %), and root replacement with homograft in 2(3.1%). Hospital deaths occurred in 3 patients(4.8%) because of uncontrolled bleeding(1) and bypass weaning failure due to low cardiac output(2), and all had emergency operation with Cabrol's procedure. Postoperative complications developed in 19(29.2%) patients and most of them were transient. Surviving 62 patients have been followed up to cumulative total 315.0 patient-years(mean 60.2 $\pm$42.4 months). Late deaths occurred in 7 patients(11.3%), aneurysmal changes of remaining aorta were detected in 12 patients(19.4%). Actuarial survival rate at 10 years was 72.0 $\pm$ 9.7%, and the subsequent aortic operation-free rate at 10 years was 68.0$\pm$ 8.9% In a multivariate analysis, Marfan syndrome, emergency operation, preoperative dissection, combined arch replacement, and total circulatory arrest emerged as significant risk factors for hospital death or subsequent aortic operation. Over 60 years of age was the only risk factor for late death. Our 16 years'cummulative experience shows that aortic root replacement, mainly by means of Cabrol's procedure, can be applied successfully to variety of aortic root disease. However, long-term follow up will be needed to determine the late result of aortic valve-saving operation and root replacement with homograft. When dissection is present or the distal native aorta is diseased in'Marfan patients, close follow-up is necessary because of the subsequent aneurysmal change of remaining aorta.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.56-63
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• 2004

Background: Patch angioplasty is an alternative surgical procedure to coronary artery bypass grafting (CABG) for left main coronary ostial stenosis. The purpose of this study is to evaluate the outcome of patch angioplasty by analyzing the short-term and long-term results. Material and Method: Twenty nine patients who had undergone patch angioplasty due to left main coronary ostial stenosis between July 1991 and May 2003 were enrolled in the study. The mean age of the patients was 53.1 $\pm$12.5 years. There were 8 males and 21 females, and there were 12 female patients who had no risk factor for atherosclerosis. Twenty six (89.7%) patients showed isolated coronary ostial stenosis without any distal coronary lesion. Result: Anterior approach was used in 28 patients and superior approach was used in one patient. Transsection of the main pulmonary artery was used in one patient. Concomitant CABG was performed in 4 patients because of left anterior descending artery lesions in 3 patients and unstable postoperative hemodynamic status in one patient. Hospital mortality had occurred in one patient (3.4%) and late mortality also in one patient, therefore the overall 5 year survival rate was 91.2$\pm$6.1%. Seventeen coronary angiographies were done in 13 patients (44.8%) postoperatively. Two distal patch stenoses, 1 proximal patch stenosis, and 1 new right coronary ostial lesion were identified and 3 percutaneous interventions and 1 CABG were performed during the follow-up period. The overall 5 year freedom from reintervention rate was 82.4 $\pm$ 8.5%. Aortic regurgitation less than grade 1 had developed postoperatively in 4 patients and one patient showed progression of preexisting aortic regurgitation from grade II to III. Conclusion: Patch angioplasty in left main coronary ostial lesion showed acceptable short-term and long-term results in this study. However, restenosis at the patch anastomosis site and aortic regurgitation should be carefully investigated during the follow-up period.

• Korean journal of food and cookery science
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• v.26 no.3
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• pp.335-345
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• 2010

The objective of this study was to model the kinetics of S. aureus survival on high risk foods in school foodservice operations. After inoculating S. aureus ATCC25923 onto the various high risk foods, the effects of competitive microorganism, storage temperatures($25^{\circ}C$, $35^{\circ}C$), and initial contamination levels ($1.0{\times}10^2\;CFU/g$, $1.0{\times}10^5\;CFU/g$) on the growth of S. aureus were investigated. Lag time decreased and specific growth rate increased with a storage temperature ($25^{\circ}C$<$35^{\circ}C$) and with a higher initial inoculation level ($1.0{\times}10^2\;CFU/g$<$1.0{\times}10^5\;CFU/g$). Previously it was shown that S. aureus is a weaker competitor than other organisms, but it proliferates aggressively in a noncompetitive environment. However, in our study, when S. aureus was used to inoculate japchae (glass noodles with sauteed vegetables) and meat ball, the growth of S. aureus was similar and more active with competitive organisms than that without competitive organisms. Regardless of other factors, the initial level of S. aureus was a more significant factor of the growth. High inoculation levels of S. aureus were reached at 6 log CFU/g within 3 hours. An incubation temperature of $35^{\circ}C$ and the animal protein component of menu items also were identified as significant factors influencing the growth of S. aureus. Therefore, the duration of time meals are stored before serving should be considered a critical control point. Food service providers must control time and temperature to insure the safety of cooked foods.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.295-302
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• 2002

Purpose : The Purpose of this study was to establish general guidelines for the treatment of patients with early glottic carcinoma (T1-2N0M0), by assessing the role of primary radiotherapy and by analyzing the tumor-related and treatment-related factors that have an influence on the treatment results. Materials and Methods : This retrospective study was composed of 80 patients who suffered from early glottic carcinoma and were treated by primary radiotherapy at Pusan National University Hospital, between August 1987 and December 1996. The distribution of patients according to T-stage was 66 for stage T1 and 14 for stage T2. All of the patients were treated with conventional radical radiotherapy using a 6MV photon beams, a total tumor dose of $60\~75.6\;Gy$ (median 68.4 Gy), administered in 5 weekly fractions of $1.8\~2.0\;Gy$. The overall radiation treatment time was from 40 to 87 days, median 51 days. All patients were followed up for at least 3 years. Univariate and multivariate analysis was done to identify the prognostic factors affecting the treatment results. Results : The five-years survival rate was $89.2\%$ for all patients, $90.2\%$ for T1 and $82.5\%$ for T2. The local control rate was $81.3\%$ for all patients, $83.3\%$ for T1 and $71.4\%$ for T2. However, when salvage operations were taken into account, the ultimate local control rate was $91.3\%,\;T1\;94.5\%,\;T2\;79.4\%$, reprosenting an increase of $8\~12\%$ in the local control rate. The voice preservation rate was $89.2\%,\;T1\;94.7\%,\;T2\;81.3\%$. Fifteen patients suffered a relapse after radiotherapy, among whom 12 patients underwent salvage surgery. We included T-stage, tumor location, total radiation dose, fraction size, field size and overall radiation treatment time as potential prognostic factors. T-stage and overall treatment time were found to be statistically significant in the univariate analysis, but in the multivariate analysis, only the over-all treatment time was found to be significant. Conclusion : The high cure and voice preservation rates obtained when using a procedure, comprising a combination of radical radiotherapy and salvage surgery, may make this the treatment of choice for patients with early glottic carcinoma. However, the prognostic factors affecting the treatment results must be kept in mind, and more accurate treatment planning and further optimization of the radiation dose are necessary.