• Sim-seong Yeon-gu
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• v.33 no.2
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• pp.141-194
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• 2018

The article is about Yong-Ho-Bi-Gyeol(龍虎秘訣), which is one of the most important Taoist text in Korea written by Jeong-Ryum, a Taoist and alchemist in the Chosun Dynasty. The article deals with the alchemical and psychological meanings of Yong-Ho (龍虎, Dragon-Tiger), the way of nurturing cinnabar (修丹之道), the closing of the qi (閉氣), the method of alchemical breathing, the Dantian (丹田, cinnabar-field), and the Mysterious Female's One Opening (玄牝一竅), in addition to the brief introduction of the life of Jeong-Ryum and the bibliography of the book. The Yong-Ho (龍虎) meaning the dragon and tiger is the archetype of transformation in the form of their opposites, rooted in the psychoid system of the human psyche. The unified Yong-Ho makes Dan and the Dan, literally indicating cinnabar, has many alchemical connotations such as Mercurius, the rubedo state of the alchemical process, and the philosopher's stone. In the book, Jeong-Ryum emphasized the slow and subtle way of breathing in and out of Dantian to develop neidan (内丹, inner cinnabar or inner alchemy). The refining of neidan begins by the closing of the qi, which symbolizes the radical introversion and withdrawal of all the projections on the outer objects. The Dantian located at the lower part of the abdomen has been known to preserve jing (精), the vital essence of life, which can be refined into qi and spirit (神). In Jungian perspective, the Dantian is a mandala where an individual's mind can stay and focus at the center of psyche detached from ego and related to the Self. The long-nurtured introverted energy makes the Mysterious Female's One Opening (玄牝一竅), a pit or cavity in the transcendental space, through which the meditator can have a relationship with the great female principle of the universe. The current article has introduced the contents of the Yong-Ho-Bi-Gyeol in the perspective of analytical psychology. However, it has not dealth with the remaining topics including Taesik (胎息, embryonic breathing) and Juchenhwahu (周天火候, the great Celestial circuit firing), due to the lack of author's sufficient knowledge and experience. The unexplored areas of Yong-Ho-Bi-Gyeol will be studied in the future.

• Journal of the Korean Society of Radiology
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• v.83 no.2
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• pp.254-264
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• 2022

The Korean Society of Radiology and Medical Guidelines Committee amended the existing 2016 guidelines to publish the "Korean Clinical Practice Guidelines for Adverse Reactions to Iodide Contrast for Injection and Gadolinium Contrast for MRI: The Revised Clinical Consensus and Recommendations (2022 Third Edition)." Expert members recommended and approved by the Korean Society of Radiology, the Korean Academy of Asthma, Allergy and Clinical Immunology, and the Korean Nephrology Society participated together. According to the expert consensus or systematic literature review, the description of the autoinjector and connection line for the infection control while using contrast medium, the acute adverse reaction, and renal toxicity to iodized contrast medium were modified and added. We would like to introduce the revised contents.

• Journal of Intelligence and Information Systems
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• v.17 no.4
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• pp.175-191
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• 2011

With the MICE(Meeting, Incentive travel, Convention, Exhibition) industry coming into the spotlight, there has been a growing interest in the domestic exhibition industry. Accordingly, in Korea, various studies of the industry are being conducted to enhance exhibition performance as in the United States or Europe. Some studies are focusing particularly on analyzing visiting patterns of exhibition visitors using intelligent information technology in consideration of the variations in effects of watching exhibitions according to the exhibitory environment or technique, thereby understanding visitors and, furthermore, drawing the correlations between exhibiting businesses and improving exhibition performance. However, previous studies related to booth recommendation systems only discussed the accuracy of recommendation in the aspect of a system rather than determining changes in visitors' behavior or perception by recommendation. A booth recommendation system enables visitors to visit unplanned exhibition booths by recommending visitors suitable ones based on information about visitors' visits. Meanwhile, some visitors may be satisfied with their unplanned visits, while others may consider the recommending process to be cumbersome or obstructive to their free observation. In the latter case, the exhibition is likely to produce worse results compared to when visitors are allowed to freely observe the exhibition. Thus, in order to apply a booth recommendation system to exhibition halls, the factors affecting the performance of the system should be generally examined, and the effects of the system on visitors' unplanned visiting behavior should be carefully studied. As such, this study aims to determine the factors that affect the performance of a booth recommendation system by reviewing theories and literature and to examine the effects of visitors' perceived performance of the system on their satisfaction of unplanned behavior and intention to reuse the system. Toward this end, the unplanned behavior theory was adopted as the theoretical framework. Unplanned behavior can be defined as "behavior that is done by consumers without any prearranged plan". Thus far, consumers' unplanned behavior has been studied in various fields. The field of marketing, in particular, has focused on unplanned purchasing among various types of unplanned behavior, which has been often confused with impulsive purchasing. Nevertheless, the two are different from each other; while impulsive purchasing means strong, continuous urges to purchase things, unplanned purchasing is behavior with purchasing decisions that are made inside a store, not before going into one. In other words, all impulsive purchases are unplanned, but not all unplanned purchases are impulsive. Then why do consumers engage in unplanned behavior? Regarding this question, many scholars have made many suggestions, but there has been a consensus that it is because consumers have enough flexibility to change their plans in the middle instead of developing plans thoroughly. In other words, if unplanned behavior costs much, it will be difficult for consumers to change their prearranged plans. In the case of the exhibition hall examined in this study, visitors learn the programs of the hall and plan which booth to visit in advance. This is because it is practically impossible for visitors to visit all of the various booths that an exhibition operates due to their limited time. Therefore, if the booth recommendation system proposed in this study recommends visitors booths that they may like, they can change their plans and visit the recommended booths. Such visiting behavior can be regarded similarly to consumers' visit to a store or tourists' unplanned behavior in a tourist spot and can be understand in the same context as the recent increase in tourism consumers' unplanned behavior influenced by information devices. Thus, the following research model was established. This research model uses visitors' perceived performance of a booth recommendation system as the parameter, and the factors affecting the performance include trust in the system, exhibition visitors' knowledge levels, expected personalization of the system, and the system's threat to freedom. In addition, the causal relation between visitors' satisfaction of their perceived performance of the system and unplanned behavior and their intention to reuse the system was determined. While doing so, trust in the booth recommendation system consisted of 2nd order factors such as competence, benevolence, and integrity, while the other factors consisted of 1st order factors. In order to verify this model, a booth recommendation system was developed to be tested in 2011 DMC Culture Open, and 101 visitors were empirically studied and analyzed. The results are as follows. First, visitors' trust was the most important factor in the booth recommendation system, and the visitors who used the system perceived its performance as a success based on their trust. Second, visitors' knowledge levels also had significant effects on the performance of the system, which indicates that the performance of a recommendation system requires an advance understanding. In other words, visitors with higher levels of understanding of the exhibition hall learned better the usefulness of the booth recommendation system. Third, expected personalization did not have significant effects, which is a different result from previous studies' results. This is presumably because the booth recommendation system used in this study did not provide enough personalized services. Fourth, the recommendation information provided by the booth recommendation system was not considered to threaten or restrict one's freedom, which means it is valuable in terms of usefulness. Lastly, high performance of the booth recommendation system led to visitors' high satisfaction levels of unplanned behavior and intention to reuse the system. To sum up, in order to analyze the effects of a booth recommendation system on visitors' unplanned visits to a booth, empirical data were examined based on the unplanned behavior theory and, accordingly, useful suggestions for the establishment and design of future booth recommendation systems were made. In the future, further examination should be conducted through elaborate survey questions and survey objects.

• Korean Journal of Heritage: History & Science
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• v.42 no.3
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• pp.154-175
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• 2009

At the present state, studies on Gyeongbok palace are being done with history of architecture, records, and art. However, these studies have limits that they can only depend on existing buildings and record, which make it hard to research whole aspect of palaces. The foundation remains(Jeoksim) of Gyeongbok palace in the ground gives important clues that can fill the gaps of these studies. Thus I analysed jeoksim of Gyeongbok palace, assorted them by type, scale, material, and construction method. I examined jeoksim used by various types of building, and looked at changes by periods. Jeoksims are classified in 21 types. The foundation(jeoksim) varies according to types of buildings, building types and material of jeoksim also varies along the periods, and the fact proves certain peroid of time has its own jeoksim style in fashion. Jeoksims of Gyeongbok palace are divided into round-shape(I), rounded square-shape(II), rectangular-shape(III), square-shape(IV), and whole foundation of building(V) by the plane shape. They can be divided again into 21 types by construction techniques and materials used. During early Joseon(I), only three types of jeoksim; round-shape riprap jeoksim(1-1), II-1(rounded square-shape), II-2a(rounded square-shape riprap+roofingingtile brick), had been built, but as 19th century begun, all 21 types of jeoksim had built. In 19th century during Emperor Gojong, different types of jeoksim by periods were built, and especially different materials were used. During Gojong year 2(1865)~year 5(1868), in which Gyeongbok palace were rebuilt, 7 out of 10 types of jeoksim used piece of roofinging tile and brick mixture, in contrast, during Gojong year 10(1873)~13(1876), or 25(1888), 3 out of 5 types of jeoksim used sandy soil with mixture of plaster. Meanwhile palace buildings have different names by the class of owner and use such as Jeon, Dang, Hap, Gak, Jae, Heon, Nu, and Jeong, which were classified by types and buildings were built according to each level. With an analysis of jeoksim by its building types, I ascertained that jeoksim were built differently in accordance to building types(Jeon, Dang, Hap, Gak, Jae, Heon, Nu, and Jeong). By the limitation of present document, only some types of buildings such as Jeon, Dang, Gak, Bang were confirmed, as for Jeon and Gak, square-shape(IV) built with rectangular parallelepiped stone, and for Dang and Bang, rounded square-shape(IV) built with roofinginginging tile and riprap were commonly used. From the fact that other jeoksim with uncertain building names, were mostly built in early Joseon, we learn that round-shape riprap jeoksim(1-1) were commonly built. Therefore, the class of building was higher if the owner was in higher class, jeoksim is also considered to be built with the strongest and best material. And for Dang and Bang, rounded square-shape jeoksim were used, Dang has lots of II-2a (riprap + piece of roofing tile and brick rounded square-shape) type which mainly used riprap and piece of roofing tile and brick, but Bang has lots of II-2b (piece of roofing tile and brick+(riprap+piece of roofing tile and brick rounded square-shape), which paved piece of roofing tile and brick by 15~20cm above. These jeoksim by building types were confirmed to have changed its construction type by period. As for Jeon and Gak, they were built with round-shape riprap jeoksim(1-1) in early Joseon(14~15c), but in late Joseon(19c), various types of Jeoksim were built, especially square-shape(IV) were commonly built. For Dang, only changes in later Joseon were confirmed, jeoksim built in Gojong year 4(1867) mostly used mixture of riprap and piece of roofing tile and brick. In Gojong year 13(1876) or year 25(1888), unique type of plaster with sand and coal and soil layered jeoksim were built that are not found in any other building types. Through this study, I learned that various construction types of jeoksim and material were developed in later Joseon compare to early Joseon. This states that construction technique of building foundation of palace has upgraded. Above all, I learned jeoksim types are all different for various kinds of buildings. This tells us that when they constructed foundation of building, they used pre-calculated construction technique.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.34 no.1
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• pp.83-96
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• 2016

Through the research and analysis on the vegetation environment, flora of habitats through documentary and field studies over 14 habitats of Euryale ferox Salisbury within Jeollabukdo, with the objective of acquiring the basic data for forming an environment based on plantation of reservoirs that are composed with Euryale ferox, the following results were obtained. 1. The entire flora of the 14 habitats appeared to be 79 families, 211 genus, 298 species, two subspecies, 30 varieties and six forma, thus, a total of 336 taxa was confirmed. Among these, emergent water plants appeared to compose 17 taxa, floating-leaved plants to compose seven taxa including Euryale ferox floating plants to compose five taxa and submerged water plants to compose two taxa. As a result of analyzing the similarity only over the water plants. The lowest similarity rate appeared between Gamdong Reservoir and Aedang Reservoir, as the similarity rate between the two regions appeared to be 0% as a result of the analysis. Floating-leaved plants, lotuses and caltrops, appeared to be equally inhabiting in Hanseongji at Jeongeup and Seoknam Reservoir at Gochang, which showed the highest similarity rate, in addition to Euryale ferox. 2. When examining the appearance frequency of aquatic plants per growth type, Actinostemma lobatum and Phragmites communis, in addition to Euryale ferox each appeared 11 times, showing a high frequency of 78.6% and Trapa japonica, which is a floating-leaved water plant, appeared ten times(71.4%) and Zizania latifolia appeared eight times(57.1%). In addition, the appearance rate appeared to be high in the order of Persicaria thunbergii, Leersia sayanuka, Ceratophyllum demersum, Echinochloa crusgalli var. oryzicola, Scirpus maritimus, and Nelumbo nucifera. 3. The rare plants discovered in the Euryale ferox habitats pursuant to the IUCN evaluation standards was confirmed to be composed of five taxa, with three taxa including the least concerned species(LC), Melothria japonica at Yanggok Reservoir, Hydrocharis dubia at Myeongdeokji and Ottelia alismoides at Daewi Reservoir, in addition to vulnerable species(VU), Utricularia vulgaris at Sangpyeong Reservoir, along with Euryale ferox. 4. Most of the group or community types of the natural habitats of Euryale ferox appeared to be the Euryale ferix community' and the Daewi Reservoir of Gunsan was defined as caltrop + Euryale ferox + Nymphoides indica community. The green coverage ratio of Euryale ferox per natural habitats showed a considerably huge deviation from 0.03 to 36.50 and as the average green coverage ratio was appropriated as 9.8, it can be considered that maintaining the green coverage ratio of Euryale ferox in a 10% level would be advisable when forming a reservoir with Euryale ferox as the key composition species. 5. The vegetation community nearby the natural habitats of Euryale ferox per research subject area appeared to be composed of three Leersia japonica communities, two communities each for Zizania latifolia community and Trapa japonica community and one community each for Nelumbo nucifera community, Nymphoides peltata + Typha orientalis community, Trapa japonica + Nelumbo nucifera community, Hydrocharis dubia community, Leersia japnica + Paspalum distichum var. indutum community and Euryale ferox + Trapa japonica community, showing a slight difference depending on the location conditions of each reservoir. Thus, this result may be suggested as a guideline to apply when allocating the vegetation ratio and the types of floating-leaved plants upon planting plants in reservoirs with Euryale ferox as the main companion species.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.32 no.2
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• pp.27-41
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• 2014

This study aims to investigate the history, cultural values prototype through literature analysis, characteristics of construction, location, space structure and landscape characteristics by Arc-GIS on the Munam pavilion(聞巖亭) in Changnyeong. The results were as follows. First, Shin-cho((辛礎, 1549~1618) is the builder of the Munam pavilion and builder's view of nature is to go back to nature. The period of formation of Munam pavilion is between 1608-1618 as referred from document of retire from politics and build a pavilion. Secondly, Munam pavilion is surrounded by mountains and located at the top of steep slope. Pavilion was known as scenic site of the area. But damaged in a past landscape is caused by near the bridge, agricultural facilities, town, the Kye-sung stream of masonry and beams. Thirdly, Munam pavilion is divided into the main space, which is located on the pavilion, space in located on the pavilion east and west and the orient space, which is located on the Youngjeonggak. Of these, original form of Munam pavilion is a simple structure composed of pavilion and Munam rock, thus at the time of the composition seems to be a direct entry is possible, unlike the current entrance. Fourth, Spatial composition of Munam pavilion is divided into vegetation such as Lagerstroemia indica trees in Sa-ri in Changnyeong, ornament such as letters carved on the rocks and pavilion containing structure. The vegetation around the building is classified as precincts and outside of the premises. Planting of precincts was limited. Outside of area consists of front on the pavilion, which is covered with Lagerstroemia Indica forest and Pinus densiflora forest at the back of the pavilion. Ofthese,LargeLagerstroemiaIndicaforestcorrespondstothenaturalheritageasHistoricalrecordsofrarespeciesresourcesthatareassociated withbuilder. Letterscarvedontherocksrepresenttheboundaryof space, which is close to the location of the Munam pavilion and those associated with the builder as ornaments. Letters carved on the rocks front on the pavilion are rare cases that are made sequentially with a constant direction and rules as act of record for families to honor the achievements. Fifth, 'The eight famous spots of Munam' is divided into landscape elements that have nothing to do with bearing 4 places and landscape elements that have to do with bearing 4 places. Unrelated bearings of landscape elements are Lagerstroemia indica trees in Sa-ri in Changnyeong, Pinus densiflora forest at the back of the pavilion, Okcheon valley, Gwanryongsa temple and Daeheungsa temple. Bearing that related element of absolute orientation, which is corresponding to the elements are Daeheungsa temple, Hwawangsan mountain, Kye-sung stream and Yeongchwisan mountain. Relative bearing is Gwanryongsa temple, Yeongchwisan mountain and Kye-sung stream Gongjigi hill. At Lagerstroemia indica trees in Sa-ri in Changnyeong, Pinus densiflora forest at the back of the pavilion, Kye-sung stream and Okcheon valley, elements are exsting. Currently, it is difficult to confirm the rest of the landscape elements. Because, it is a generic element that reliable estimate of the target and locations are impossible for element. Munam pavilion is made for turn to nature by Shin-cho(辛礎). That was remained a record such as Munamzip(聞巖集) and Munamchungueirok(聞巖忠義錄) that is relating to construction of pavilion. Munam pavilion located in a unique form, archival culture through the letters carved on the rocks and Large Lagerstroemia indica forest and through eight famous spots, cultural landscape elements can be assumed that those elements are remained.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.37 no.3
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• pp.62-82
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• 2019

Taking the three Wuyi-Gugok Drawings, 『A Picture Showing the Boundary Between Mountains and Rivers: A』, 『Landscape of the Jiuqu River in the Wuyi Mountain: B』 and 『Eighteen Sceneries of Wuyi Mountain: C』, which were produced in the mid-Qing Dynasty as the research objects and after investigating the names recorded in the paintings, this paper tries to analyze the scenic spots, scene types and images in the literature survey. Also, based on the number of Scenic type and the number of Scenic name in each Gok, landscape richness(LR) and landscape similarity(LS) of the Gugok scenic spots, the cognitive characteristics of the landscape in the 18th century were carefully observed. The results are as follows. Firstly, according to the description statistics of scenic spot types in Wuyi Mountain Chronicle, there were 41 descriptions of scenery names in the three paintings, among which rock, peak and stone accounted for the majority. According to the data, the number of rocks, peaks and stones in Wuyi-Gugok landscape accounted for more than half, which reflected the characteristics of geological landscape such as Danxia landform in Wuyi-Gugok landscape. Secondly, the landscape of Gugok Stream(九曲溪) was diverse and full of images. The 1^st Gok Daewangbong(大王峰) and Manjeongbong(幔亭峰), the 2^nd Gok Oknyeobong(玉女峰), the 3^rd Gok Sojangbong(小藏峰), the 4^th Gok Daejangbong(大藏峰), the 5^th Gok Daeeunbyeong(大隱屛) and Muijeongsa(武夷精舍), the 6^th Gok Seonjangbong(仙掌峰) and Cheonyubong(天游峰) all had outstanding landscape in each Gok. However, the landscape features of the 7^th~9^th Gok were relatively low. Thirdly, according to the landscape image survey of each Gok, the image formation of Gugok cultural landscape originates from the specificity of the myths and legends related to Wuyi Mountain, and the landscape is highly well-known. Due to the specificity, the landscape recognition was very high. In particular, the 1^st Gok and the 5^th Gok closely related to the Taoist culture based on Muigun, the Stone Carving culture and the Boat Tour culture related to neo-confucianism culture of Zhu Xi. Fourthly, according to the analysis results of landscape similarity of 41 landscape types shown in the figure, the similarity of A and C was very high. The morphological description and the relationship of distant and near performance was very similar. Therefore, it could be judged that this was obviously influenced by one painting. As a whole, the names of the scenes depicted in the three paintings were formed at least in the first half of 18^th century through a long history of inheritance, accumulated myths and legends, and the names of the scenes. The order of the scenery names in three Drawings had some differences. But among the scenery names appearing in all three Drawings, there were 21 stones, 20 rocks and 17 peaks. Stones, rocks and peaks guided the landscape of Gugok Streams in Wuyi Mountain. Fifthly, Seonjodae(仙釣臺) in A and C was described in the 4^th Gok, but what deserved attention was that it was known as the scenery name of the 3^rd Gok in Korean. In addition, Seungjindong(升眞洞) in the 1^st Gok and Seokdangsa(石堂寺) in the 7^th Gok were not described in Drawings A, B and C. This is a special point that needs to be studied in the future.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.34 no.3
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• pp.78-97
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• 2016

The objectives of this study are to examine the context of the establishment of Suhoe Gugok, Byeokgye Gugok Vally, and Nosan Palkyung, which have been established in Seojong-myeon of Yangpyeong-gun, by literature review and site investigations, and to determine the sceneries of Byeokgye scenic site as enjoyed and managed during the period of Hwaseo Lee, Hang-ro(華西 李恒老). The results of the study are as follows. First, Byeokgye Gugok Vally(黃蘗九曲) and Nosan Palkyung(蘆山八景), which have been established after the period of Hwaseo and theorized to have been established around key scenic areas associated with Hwaseo's activities, the analysis results showed that they were collecting sceneries of modern times. The extensive overlap between Byeokgye Gugok Vally and concentrated scenic elements of Suhoe Gugok(水回九曲), and the artificial configuration from the end point of Suhoe Gugok to the beginning point of Nosan Palkyung, reveal the pattern of space conflict and hegemony between Byeokgyes of Suip-ri and Nomun-ri. This is likely to be caused by the conflict between the historicity of the group that enjoyed Byeokgye prior to Hwaso's period and the strong territoriality of the space filled with the image of Hwaseo. Second, Byeokgye Gugok Vally was the secondary spatial system created by selecting the most scenic sites in Suip-ri while expanding the area of Nosan Palkyung. After establishment of Byeokgye Gugok Vally, the spatial identity of the entire Byeokgyecheon area was effectively established. This was a "Hwaseo-oriented" move, including the complete exclusion of the scenic sites from the pre-Hwaseo period such as Cheongseo Gujang and Suhoe Gugok's Letters Carved on the Rock. Consequently, the entire Byeokgyecheon area was reorganized into a cultural scenic site with Heoseo's influence. Third, Fifth, creations of Gugok(九曲) to determine the lineage of the Hwaseo School from Juja(朱子) to Yulgok(栗谷) to Uam(尤庵) to Hwaseo is likely to be an opportunity of birth and external motivation of the establishment of new Gugok Palkyung. In other words, Nosan Palkyung and Byeokgye Gugok Vally are likely to have been created as a reaction to the change of the center of the Hwaseo School to Okgyedong, and with strategic orientation based on the motivation and needs such as creation of the connecting space between Mui Gugok, Gosan Gugok, and Okgye Gugok, and the elevation of Hwaseo's status. Fourth, from the Hwaseo's Li-centric point of view, all revered sites in Beokwon(蘗園) that he managed existed as the spatial creative work to experience the existence of "li" through the objects in the landscape and the boundary of the spirit of emptiness of the aesthetic self. This clearly shows how Byeokgye Gugok Vally or Nosan Palkyung must be defined, and furthermore, appreciated and approached, prior to discussing it as the space associated with Hwaseo. Fifth, Nosan Palkyung was composed of cultural scenic landscapes of Gokjungkyung(曲中景) with eight scenic sites where Hwaseo gave his teachings and spend time around, in the Byeokgye of Nomun-ri area of Byeokgye Gugok Vally. The sceneries is, however, collected by depending on Hwaseo's Letters Carved on the Rock and poetry. Consequently, an inner exuberance of Nosan Palkyung is satisfied beside Byeokgye Gugok Vally, but its conceptual adequacy leaves room for questions.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.289-297
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• 2006

Background: Surgery for Stanford type A aortic dissection shows a high operative mortality rate and frequent postoperative brain injury. This study was designed to find out the risk factors leading to operative mortality and brain injury after surgical repair in patients with type A aortic dissection. Material and Method: One hundred and eleven patients with type A aortic dissection who underwent surgical repair between February, 1995 and January 2005 were reviewed retrospectively. There were 99 acute dissections and 12 chronic dissections. Univariate and multivariate analysis were performed to identify risk factors of operative mortality and brain injury. Resuit: Hospital mortality occurred in 6 patients (5.4%). Permanent neurologic deficit occurred in 8 patients (7.2%) and transient neurologic deficit in 4 (3.6%). Overall 1, 5, 7 year survival rate was 94.4, 86.3, and 81.5%, respectively. Univariate analysis revealed 4 risk factors to be statistically significant as predictors of mortality: previous chronic type III dissection, emergency operation, intimal tear in aortic arch, and deep hypothemic circulatory arrest (DHCA) for more than 45 minutes. Multivariate analysis revealed previous chronic type III aortic dissection (odds ratio (OR) 52.2), and DHCA for more than 45 minutes (OR 12.0) as risk factors of operative mortality. Pathological obesity (OR 12.9) and total arch replacement (OR 8.5) were statistically significant risk factors of brain injury in multivariate analysis. Conclusion: The result of surgical repair for Stanford type A aortic dissection was good when we took into account the mortality rate, the incidence of neurologic injury, and the long-term survival rate. Surgery of type A aortic dissection in patients with a history of chronic type III dissection may increase the risk of operative mortality. Special care should be taken and efforts to reduce the hypothermic circulatory arrest time should alway: be kept in mind. Surgeons who are planning to operate on patients with pathological obesity, or total arch replacement should be seriously consider for there is a higher risk of brain injury.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.17-25
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• 1998

Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.