• Title/Summary/Keyword: 남아

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CLINICAL STUDY OF THE ABUSE IN PSYCHIATRICALLY HOSPITALIZED CHILDREN AND ADOLESCENTS (소아청소년 정신과병동 입원아동의 학대에 대한 임상 연구)

  • Lee, Soo-Kyung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.145-157
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    • 1999
  • This study was performed by the children and adolescents who were abused or neglected physically, emotionally that were selected in child & adolescents psychiatric ward. We investigated the number of these case in admitted children & adolescents, and also observed characteristics of symptoms, developmental history, characteristics of abuse style, characteristics of abusers, family dynamics and psychopathology. We hypothesized that all kinds of abuse will influnced to emotional, behavioral problems, developmental courses on victims, interactive effects on family dynamics and psychopathology. That subjects were 22 persons of victims who be determined by clinical observation and clinical note. The results of the study were as follows:1) Demographic characteristics of victims:ratio of sex was 1:6.3(male:female), mean age was $11.1{\pm}2.5$. According to birth order, lst was 12(54.5%), 2nd was 5(23%), 3rd was 2(9%) and only child was 3(13.5%). 2) Characteristics of family:According to socioeconomic status, middle to high class was 3(13.5%), middle one was 9(41.% ), middle to low one was 9(41%), low one was 1(0.5%). according to number of family, under the 3 person was 3(13.5%), 4-5 was 17(77.5%), 6-7 was 2(9%). according to marital status of parents, divorce or seperation were 5(23%), remarriage 2(9%), severe marital discord was 19(86.5%). In father, antisocial behavior was 7(32%), alcohol dependence was 10(45.5%). In mother, alcohol abuse was 5(23%), depression was 17(77.3%), history of psychiatric management was 6(27%). 3) Characteristics of abuse:Physical abuse was 18(81.8%), physical and emotional abuse and neglect were 4(18.2%). according to onset of abuse, before 3 years was 15(54.5%), 3-6 years was 5(27.5%), schooler was 1(15%). Only father offender was 2(19%), only mother offender was 8(35.4%), both offender was 8(35.4%), accompaning with spouse abuse was 7(27%), and accompaning with other sibling abuse was 4(18.2%). 4) General characteristics and developmental history of victims:Unwanted baby was 12(54.5%), developmental delay before abuse was9(41%), comorbid developmental disorder was 15(68%). there were 6(27.5%) who didn‘t show definite sign of developmental delay before abuse. 5) Main diagnosis and comorbid diagnosis:According to main diagnosis, conduct disorder 6(27.3%), borderline child 5(23%), depression4(18%), attention deficit hyperactivity disorder(ADHD) 4(18%), pervasive developmental disorder not otherwise specified 2(9%), selective mutism 1(5%). According to comorbid diagnosis, ADHD, borderline intelligence, mental retardation, learning disorder, developmental language disorder, oppositional defiant disorder, chronic tic disorder, functional enuresis and encoporesis, anxiety disorder, dissociative disorder, personality disorder due to medical condition. 5) Course of treatment:A mean duration of admission was $2.4{\pm}1.5$ months. 11(15%) showed improvement of symtoms, however 11(50%) was not changed of symtoms.

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A study on Operation Rules of Korean Air Defence Identification Zone (한국 방공식별구역 운영규칙에 관한 고찰)

  • Kwon, Jong-Pil;Lee, Yeong H.
    • The Korean Journal of Air & Space Law and Policy
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    • v.32 no.2
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    • pp.189-217
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    • 2017
  • Declaration of Air Defense and Identification Zones started with the United States in 1950, which was followed by declaration of KADIZ by the Republic of Korea in 1951. Initial ADIZ were solely linked with air defense missions, but their roles have changed as nations around the globe manifested a tendency to expand their influence over maritime resources and rights. In particular, China declared ADIZ over the East China Sea in October 2013 and forced all passing aircraft to submit flight plan to ATC or military authority, saying failure of submission will be followed by armed engagement. China announced it would declare another zone over the South China Sea despite the ongoing conflict in the area, clearly showing ADIZ's direct connection with territorial claim and EEZ and that it serves as a zone within which a nation can execute its rights. The expanded KADIZ, which was expanded in Dec 15, 2013 in response to Chinese actions, overlaps with the Chinese ADIZ over the East China Sea and the Japanese ADIZ. The overlapping zone is an airspace over waters where not only the Republic of Korea but also of China and Japan argue to be covering their continental shelf and EEZ. Military conventions were signed to prevent contingencies among the neighboring nations while conducting identifications in KADIZ, including the overlapping zone. If such military conventions and practice of air defense identification continue to be respected among states, it is under the process of turning into a regional customary law, although ADIZ is not yet recognized by international law or customary law. Moreover, identification within ADIZ is carried out by military authorities of states, and misguided customary procedures may cause serious negative consequences for national security since it may negatively impact neighboring countries in marking the maritime border, which calls for formulation of operation rules that account for other state activities and military talks among regional stake holders. Legal frameworks need to be in place to guarantee freedom of flights over international seas which UN Maritime Law protects, and laws regarding military aircraft operation need to be supplemented to not make it a requirement to submit flight plan if the aircraft does not invade sovereign airspace. Organizational instructions that require approval of Chairman of Joint Chiefs of Staff for entrance and exit of ADIZ for military aircraft need to be amended to change the authority to Minister of National Defense or be promoted to a law to be applicable for commercial aircraft. Moreover, in regards to operation and management of ADIZ, transfer of authority should be prohibited to account for its evolution into a regional customary law in South East Asia. In particular, since ADIZ is set over EEZ, military conventions that yield authority related to national security should never be condoned. Among Korea, China, Japan and Russia, there are military conventions that discuss operation and management of ADIZ in place or under negotiation, meaning that ADIZ is becoming a regional customary law in North East Asia region.

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The Usefulness of Pressure-regulated Volume Control(PRVC) Mode in Mechanically Ventilated Patients with Unstable Respiratory Mechanics (기계 호흡 중 불안정한 호흡역학을 보인 환자에서 압력조절용적조정양식(Pressure-regulated Volume Control Mode)의 효용)

  • Sohn, Jang-Won;Koh, Youn-Suck;Lim, Chae-Man;Shim, Tae-Sun;Lee, Jong-Deog;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1318-1325
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    • 1997
  • Background : Since the late 1960s, mechanical ventilation has been accomplished primarily using volume controlled ventilation(VCV). While VCV allows a set tidal volume to be guaranteed, VCV could bring about excessive airway pressures that may be lead to barotrauma in the patients with acute lung injury. With the increment of knowledge related to ventilator-induced lung injury, pressure controlled ventilation(PCV) has been frequently applied to these patients. But, PCV has a disadvantage of variable tidal volume delivery as pulmonary impedance changes. Since the concept of combining the positive attributes of VCV and PCV(dual control ventilation, DCV) was described firstly in 1992, a few DCV modes were introduced. Pressure-regulated volume control(PRVC) mode, a kind of DCV, is pressure-limited, time-cycled ventilation that uses tidal volume as a feedback control for continuously adjusting the pressure limit However, no clinical studies were published on the efficacy of PRVC until now. 'This investigation studied the efficacy of PRVC in the patients with unstable respiratory mechanics. Methods : The subjects were 8 mechanically ventilated patients(M : F=6 : 2, $56{\pm}26$ years) who showed unstable respiratory mechanics, which was defined by the coefficients of variation of peak inspiratory pressure for 15 minutes greater than 10% under VCV, or the coefficients of variation of tidal volume greater than 10% under PCV. The study was consisited of 3 modes application with VCV, PCV and PRVC for 15 minutes by random order. To obtain same tidal volume, inspiratory pressure setting was adjusted in PCV. Respiratory parameters were measured by pulmonary monitor(CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). Results : 1) Mean tidal volumes($V_T$) in each mode were not different(VCV, $431{\pm}102ml$ ; PCV, $417{\pm}99ml$ ; PRVC, $414{\pm}97ml$) 2) The coefficient of variation(CV) of $V_T$ were $5.2{\pm}3.9%$ in VCV, $15.2{\pm}7.5%$ in PCV and $19.3{\pm}10.0%$ in PRVC. The CV of $V_T$ in PCV and PRVC were significantly greater than that in VCV(p<0.01). 3) Mean peak inspiratory pressure(PIP) in VCV($31.0{\pm}6.9cm$ $H_2O$) was higher than PIP in PCV($26.0{\pm}6.5cm$ $H_2O$) or PRVC($27.0{\pm}6.4cm$ $H_2O$)(p<0.05). 4) The CV of PIP were $13.9{\pm}3.7%$ in VCV, $4.9{\pm}2.6%$ in PVC and $12.2{\pm}7.0%$ in PRVC. The CV of PIP in VCV and PRVC were greater than that in PCV(p<0.01). Conclusions : Because of wide fluctuations of VT and PIP, PRVC mode did not seem to have advantages compared to VCV or PCV in the patients with unstable respiratory mechanics.

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Preoperative Evaluation for the Prediction of Postoperative Mortality and Morbidity in Lung Cancer Candidates with Impaired Lung Function (폐기능이 저하된 폐암환자에서 폐절제술후 합병증의 예측 인자 평가에 관한 전향적 연구)

  • Perk, Jeong-Woong;Jeong, Sung-Whan;Nam, Gui-Hyun;Suh, Gee-Young;Kim, Ho-Cheol;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.1
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    • pp.14-23
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    • 2000
  • Background: The evaluation of candidates for successful lung resection is important. Our study was conducted to determine the preoperative predictors of postoperative mortality and morbidity in lung cancer patients with impaired lung function. Method; Between October 1, 1995 and August 31, 1997, 36 lung resection candidates for lung cancer with $FEV_1$ of less than 2L or 60% of predicted value were included prospectively. Age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness were considered as systemic potential predictors for successful lung resection. Smoking history, presence of pneumonia, dyspnea scale(l to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test were also included for the analysis. In addition, predicted postoperative(ppo) pulmonary factors such as ppo-$FEV_1$ ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-$FEV_1%{\times}$ppo-DLco% and ppo-maximal $O_2$ uptake($VO_2$max) were also measured. Results: There were 31 men and 5 women with the median age of 65 years(range, 44 to 82) and a mean $FEV_1$ of $1.78{\pm}0.06L$. Pneumonectomy was performed in 14 patients, bilobectomy in 8, lobectomy in 14. Pulmonary complications developed in 10 patients; cardiac complications in 3, other complications(empyema, air leak, bleeding) in 4. Twelve patients were managed in the intensive care unit for more than 48 hours. Two patients died within 30 days after operation. The ppo-$VO_2$max was less than 10 ml/kg/min in these two patients. MVV was the only predictor for the pulmonary complications. However, there was no predictor for the post operative death in this study. Conclusions: Based on the results, MVV was the useful predictor for postoperative pulmonary complications in lung cancer resection candidates with impaired lung function In addition, ppo-$VO_2$max value less than 10 ml/kg/min was associated with postoperative death, so exercise pulmonary function test could be useful as preoperative test. But further studies are needed to validate this result.

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The Findings of Pulmonary Function Test in Patients with Inhalation Injury (흡입화상 환자에서의 폐기능검사 소견)

  • Kim, Jong Yeop;Kim, Cheol Hong;Shin, Hyun Won;Chae, Young Je;Choi, Chul Young;Shin, Tae Rim;Park, Yong Bum;Lee, Jae Young;Bahn, Joon-Woo;Park, Sang Myeon;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.653-662
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    • 2006
  • Background: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. Methods: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. Results: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial $PaO_2/$FiO_2$ratio and COHb were $286.4{\pm}129.6mmHg$ and $7.8{\pm}6.6%$. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. Conclusions: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.

Difference of Short Term Survival in Patients with ARDS According to Responsiveness to Alveolar Recruitment (급성호흡곤란증후군 환자에서 폐포모집술의 반응에 따른 초기 예후의 차이)

  • Kim, Ho Cheol;Cho, Dae Hyun;Kang, Gyoung Woo;Park, Dong Jun;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.280-288
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    • 2004
  • Background : Lung protective strategies, using low tidal volume in ARDS, improve survival rate in ARDS. However, low tidal volume ventilation may promote alveolar de-recruitment. Therefore, alveolar recruitment is necessary to maintain arterial oxygenation and to prevent repetitive opening and closure of collapsed alveoli in lung protective strategies. There has been a recent report describing improvement in arterial oxygenation with use of recruitment maneuver. However, impact of recruitment on outcome of ARDS is unknown. We evaluated whether short-term survival difference existed in patients with ARDS, who were performed alveolar recruitment maneuver(ARM) and prone position, according to response of alveolar recruitment or not. Methods : All patients who were diagnosed with ADRS and received mechanical ventilation were included. ARM were sustained inflation($35-45cmH_2O$ CPAP for 30-40 sec.) or increasing level of PEEP. If these methods were ineffective, alveolar recruitment with prone position was done for at least 10 hours. $P_aO_2/FiO_2$(P/F) ratio was determined before and at 0.5 and 2 hours after ARM. We defined a responder if the P/F ratio was increased over 50% of baseline value. We compared 10-days and 30-days survival rate between responders and non-responders. Results : 20 patients(M:F=12:8, $63{\pm}14age$) were included. Among them, 12 patients were responders and 8 patients were non-responders. In responders, P/F ratio was increased from $92{\pm}25mmHg$ to $244{\pm}85mmHg$. In non-responders, P/F ratio increased from $138{\pm}37mmHg$ to $163{\pm}60mmHg$. Among non-responders, P/F ratio was improved over 50% in 2 patients after prone position. Overall, 14 patients were responders after ARM and prone position. The 10-days and 30-days survival rate in responders was significantly higher than in non-responders(86%, 57% in responders and 33%, 0% in non-responders)(p<0.05). There was no significant difference between responders and non-responders in age($71{\pm}11$, $60{\pm}14$), lung injury score($2.8{\pm}0.2$, $2.9{\pm}0.45$), simplified acute physiology score(SAPS) II ($35{\pm}4.6$, $34{\pm}5.7$), positive end-positive pressure level($15.6{\pm}1.9cmH_2O$, $14.5{\pm}2.1cmH_2O$). Conclusion : ARM may improve arterial oxygenation in some patients with ARDS. These responders in patients with ARDS showed significant higher 10-days and 30-days survival rate than non-responders patients with alveolar recruitment.

Usefulness of Troponin-I, Lactate, C-reactive protein as a Prognostic Markers in Critically Ill Non-cardiac Patients (비 순환기계 중환자의 예후 인자로서의 Troponin-I, Lactate, C-reactive protein의 유용성)

  • Cho, Yu Ji;Ham, Hyeon Seok;Kim, Hwi Jong;Kim, Ho Cheol;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.562-569
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    • 2005
  • Background : The severity scoring system is useful for predicting the outcome of critically ill patients. However, the system is quite complicated and cost-ineffective. Simple serologic markers have been proposed to predict the outcome, which include troponin-I, lactate and C-reactive protein(CRP). The aim of this study was to evaluate the prognostic values of troponin-I, lactate and CRP in critically ill non-cardiac patients. Methods : From September 2003 to June 2004, 139 patients(Age: $63.3{\pm}14.7$, M:F = 88:51), who were admitted to the MICU with non-cardiac critical illness at Gyeongsang National University Hospital, were enrolled in this study. This study evaluated the severity of the illness and the multi-organ failure score (Acute Physiologic and Chronic Health EvaluationII, Simplified Acute Physiologic ScoreII and Sequential Organ Failure Assessment) and measured the troponin-I, lactate and CRP within 24 hours after admission in the MICU. Each value in the survivors and non-survivors was compared at the 10th and 30th day after ICU admission. The mortality rate was compared at 10th and 30th day in normal and abnormal group. In addition, the correlations between each value and the severity score were assessed. Results : There were significantly higher troponin-I and CRP levels, not lactate, in the non-survivors than in the survivors at 10th day($1.018{\pm}2.58ng/ml$, $98.48{\pm}69.24mg/L$ vs. $4.208{\pm}10.23ng/ml$, $137.69{\pm}70.18mg/L$) (p<0.05). There were significantly higher troponin-I, lactate and CRP levels in the non-survivors than in the survivors on the 30th day ($0.99{\pm}2.66ng/ml$, $8.02{\pm}9.54ng/dl$, $96.87{\pm}68.83mg/L$ vs. $3.36{\pm}8.74ng/ml$, $15.42{\pm}20.57ng/dl$, $131.28{\pm}71.23mg/L$) (p<0.05). The mortality rate was significantly higher in the abnormal group of troponin-I, lactate and CRP than in the normal group of troponin-I, lactate and CRP at 10th day(28.1%, 31.6%, 18.9% vs. 11.0%, 15.8 %, 0%) and 30th day(38.6%, 47.4%, 25.8% vs. 15.9%, 21.7%, 14.3%) (p<0.05). Troponin-I and lactate were significantly correlated with the SAPS II score($r^2=0.254$, 0.365, p<0.05). Conclusion : Measuring the troponin-I, lactate and CRP levels upon admission may be useful for predicting the outcome of critically ill non-cardiac patients.

The Ontology Based, the Movie Contents Recommendation Scheme, Using Relations of Movie Metadata (온톨로지 기반 영화 메타데이터간 연관성을 활용한 영화 추천 기법)

  • Kim, Jaeyoung;Lee, Seok-Won
    • Journal of Intelligence and Information Systems
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    • v.19 no.3
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    • pp.25-44
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    • 2013
  • Accessing movie contents has become easier and increased with the advent of smart TV, IPTV and web services that are able to be used to search and watch movies. In this situation, there are increasing search for preference movie contents of users. However, since the amount of provided movie contents is too large, the user needs more effort and time for searching the movie contents. Hence, there are a lot of researches for recommendations of personalized item through analysis and clustering of the user preferences and user profiles. In this study, we propose recommendation system which uses ontology based knowledge base. Our ontology can represent not only relations between metadata of movies but also relations between metadata and profile of user. The relation of each metadata can show similarity between movies. In order to build, the knowledge base our ontology model is considered two aspects which are the movie metadata model and the user model. On the part of build the movie metadata model based on ontology, we decide main metadata that are genre, actor/actress, keywords and synopsis. Those affect that users choose the interested movie. And there are demographic information of user and relation between user and movie metadata in user model. In our model, movie ontology model consists of seven concepts (Movie, Genre, Keywords, Synopsis Keywords, Character, and Person), eight attributes (title, rating, limit, description, character name, character description, person job, person name) and ten relations between concepts. For our knowledge base, we input individual data of 14,374 movies for each concept in contents ontology model. This movie metadata knowledge base is used to search the movie that is related to interesting metadata of user. And it can search the similar movie through relations between concepts. We also propose the architecture for movie recommendation. The proposed architecture consists of four components. The first component search candidate movies based the demographic information of the user. In this component, we decide the group of users according to demographic information to recommend the movie for each group and define the rule to decide the group of users. We generate the query that be used to search the candidate movie for recommendation in this component. The second component search candidate movies based user preference. When users choose the movie, users consider metadata such as genre, actor/actress, synopsis, keywords. Users input their preference and then in this component, system search the movie based on users preferences. The proposed system can search the similar movie through relation between concepts, unlike existing movie recommendation systems. Each metadata of recommended candidate movies have weight that will be used for deciding recommendation order. The third component the merges results of first component and second component. In this step, we calculate the weight of movies using the weight value of metadata for each movie. Then we sort movies order by the weight value. The fourth component analyzes result of third component, and then it decides level of the contribution of metadata. And we apply contribution weight to metadata. Finally, we use the result of this step as recommendation for users. We test the usability of the proposed scheme by using web application. We implement that web application for experimental process by using JSP, Java Script and prot$\acute{e}$g$\acute{e}$ API. In our experiment, we collect results of 20 men and woman, ranging in age from 20 to 29. And we use 7,418 movies with rating that is not fewer than 7.0. In order to experiment, we provide Top-5, Top-10 and Top-20 recommended movies to user, and then users choose interested movies. The result of experiment is that average number of to choose interested movie are 2.1 in Top-5, 3.35 in Top-10, 6.35 in Top-20. It is better than results that are yielded by for each metadata.

A Study on the Landscape Philosophy of Hageohwon Garden (별업 하거원(何去園) 원림에 투영된 조영사상 연구)

  • Shin, Sang-Sup;Kim, Hyun-Wuk;Kang, Hyun-Min
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.1
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    • pp.46-56
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    • 2012
  • The research results of tracing the Landscape Philosophy of Hageowon garden(何去園) in Musu-dong, Daejon of Youhwadang, Kwon, Iijin(權以鎭, 1668-1734) is as below. The ideological background of the protagonist reflected in Hageowon is the Hyoje Ideology(filial piety and brotherly love, 孝弟) of Sinjongchuwon(painstakingly caring for one's ancestors), Musil ideology(pursuing ethical diligence and truthful mind, 務實) based on sadistic tradition and ethical rationalism, Confucionist Eunil Ideology(ideology on seclusion, 隱逸) of Cheonghanjiyeon(quiet relaxation, 淸閒之燕), and the Pungryu ideology(appreciation for the arts, 風流) of Taoism in the Taoist style. Thus, by substituting these ideological values into a space called Hageowon, the Byulup gardens(別業) such as the Symbolic garden(象徵園), meaning gaeden(意園), and miniascape garden(縮景園) were able to be constructed. 2) The space organization system of Hageowon is generally classified into three phases considering the hierarchy. The first territory is the transitional space having residential features, which is an area to reach peach tree - road(Taoist world 桃經) from Youhwadang(有懷堂). The second territory is a monumental memorial space where the Yocheondae(繞千臺), Jangwoodam(丈藕潭), Hwagae(花階), and the ancestral graves take place, centering on the yards of Sumanheon(收漫軒), and the third territory is the secluded space in the eastern outer garden where the mountain stream flows from the north to south and which is the vein of the left-hand blue dragon(靑龍) of the guardian mountain of Hageowon. 3) Symbolically, the first phase has symbolized the space as a meaningful scenery by overlapping the Confucionist place of Youhwadang - Gosudae(孤秀臺) - Odeokdae(五德臺), and the mystic world of Jukcheondang(竹遷堂) - peach tree - road(桃徑). The second phase, which is the space of Sumanheon(收漫軒), Yocheondae, and Jangwoodam, the symbolical value of Sinjongchuwon(愼終追遠) and the remembrance and longing for one's parents are reflected. The third phase, which is the eastern outer garden of Hageowon and where the mountain stream flows from the north to south, is composed of the east valley(東溪) - Hwalsudam(活水潭) - Sumi Waterfall(修眉瀑布). More specifically, (1) Mongjeong symbolizes the life of gaining knowledge through studying to realize one's foolishness, (2) Hwalsudam symbolizes a transcending attitude in life refusing to pursue wealth and fame, and (3) Jangwoodam symbolizes the gateway to the fairyland to enter the world of mystic gods. 4) The rationale behind Hageowon is that the two algorithms of Confucionism and Taoist Theory appear repeatedly and in an overlapping way. The Napoji(納汚池) and Hwalsudam, which pertains to the prelude of space development, has symbolized Susimyangseong(修心養成, meditating one's mind and improving one's nature), which is based on ethical rationalism. Moreover, if the Monjeong sphere pertaining to the eastern outer garden of Hageowon takes the Confucionist value system as its theme, including moral training, studying, and researching, Jangwudam, Sumi Waterfalls, and Unwa can be understood as a taste of Cheokbyeon(滌煩, eliminating troubles) for the arts where the mystic world is substituted as a meaningful scenery. 5) The miniascape technique called artificial mountain was substituted to Hageowon to construct a mystic world like the 12 peaks of Mt. Mu(巫山). By borrowing the symbolic meaning expressed in old poems, it has been named 'Habang(1/何放), Hwabong(2, 3/和峯), Chulgun(4, 5, 6/出群), Sinwan(7/神浣), Chwhigyu(8, 9, 10/聚糾), Cheomyo(11/處杳), Giyung(12/氣融).' The representative poet reciting artificial mountain were Wangeui(汪醫), Nosamgang(魯三江), Dubo(杜甫), Hanyou(韓愈), Jeonheaseong(錢希聖), and Beomseokho(范石湖). They related themselves with literature by transcending time and space and attempted to sing about the richness of the mental world by putting the mystic world and culture of appreciating the arts they pursued in the vacation home called Hageowon.

Clinical Outcomes of Corrective Surgical Treatment for Esophageal Cancer (식도암의 외과적 근치 절제술에 대한 임상적 고찰)

  • Ryu Se Min;Jo Won Min;Mok Young Jae;Kim Hyun Koo;Cho Yang Hyun;Sohn Young-sang;Kim Hark Jei;Choi Young Ho
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.157-163
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    • 2005
  • Background: Clinical outcomes of esophageal cancer have not been satisfactory in spite of the development of surgical skills and protocols of adjuvant therapy. We analyzed the results of corrective surgical patients for esophageal cancer from January 1992 to July 2002. Material and Method: Among 129 patients with esophageal cancer, this study was performed in 68 patients who received corrective surgery. The ratio of sex was 59 : 9 (male : female) and mean age was $61.07\pm7.36$ years old. Chief complaints of this patients were dysphagia, epigastric pain and weight loss, etc. The locations of esophageal cancer were 4 in upper esophagus, 36 in middle, 20 in lower, 8 in esophagogastric junction. 60 patients had squamous cell cancer and 7 had adenocarcinoma, and 1 had malignant melanoma. Five patients had neoadjuvant chemotherapy. Result: The postoperative stage I, IIA, IIB, III, IV patients were 7, 25, 12, 17 and 7, respectively. The conduit for replacement of esophagus were stomach (62 patients) and colon (6 patients). The neck anastomosis was performed in 28 patients and intrathoracic anastomosis in 40 patients. The technique of anastomosis were hand sewing method (44 patients) and stapling method (24 patients). One of the early complications was anastomosis leakage (3 patients) which had only radiologic leakage that recovered spontaneously. The anastomosis technique had no correlation with postoperative leakage, which stapling method (2 patients) and hand sewing method (1 patient). There were 3 respiratory failures, 6 pneumonia, 1 fulminant hepatitis, 1 bleeding and 1 sepsis. The 2 early postoperative deaths were fulminant hepatitis and sepsis. Among 68 patients, 23 patients had postoperative adjuvant therapy and 55 paitents were followed up. The follow up period was $23.73\pm22.18$ months ($1\~76$ month). There were 5 patients in stage I, 21 in stage 2A, 9 in stage IIB, 15 in stage III and 5 in stage IV. The 1, 3, 5 year survival rates of the patients who could be followed up completely was $58.43\pm6.5\%,\;35.48\pm7.5\%\;and\;18.81\pm7.7\%$, respectively. Statistical analysis showed that long-term survival difference was associated with a stage, T stage, and N stage (p<0.05) but not associated with histology, sex, anastomosis location, tumor location, and pre and postoperative adjuvant therapy. Conclusion: The early diagnosis, aggressive operative resection, and adequate postoperative treatment may have contributed to the observed increase in survival for esophageal cancer patients.