• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.483-488
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• 2005

Aortic valve-sparing procedures could reduce valve-related morbidity, but may increase operative risks; therefore, these procedures could not be performed routinely. We attempted to find out the early results while focusing on the operative risks associated with these procedures in our hospital. Material and Method: From May 1996 to July 2003, 26 patients underwent these procedures including 15 patients with Marfan syndrome and 1 patient with Behcet disease. There were 17 men and 9 women with mean age of $37.9\pm19.2$ years (range: 6 months-74 years). Ten patients had ascending aortic dissection, 18 patients had more than moderate degree of aortic valve insufficiency (AI). Two types of valve-sparing procedures were performed: valve reimplantation in 14 and root remodeling in 12 patients. Associated procedures were performed as follows: aortic valve plasty in 6, mitral valve plasty in 5, hemi-arch replacement in 4, total arch replacement in 2, coronary artery bypass surgery in 1 and Maze procedure in 1 patient(s). Result: In four patients, valve-sparing procedures were converted to Bentall procedures during operation. Including these patients, there was no operative deaths, 3 patients underwent re-operation due to bleeding, 1 patient had permanent pacemaker. The median duration of ICU stay was 45.5 hours, the median duration of hospital stay was 10.5 days. In 22 patients excluding 4 converted patients, intraoperative transesophageal echocardiogram (TEE) showed less than mild degree of AI in all except one who had not received intra-operative TEE in the beginning and showed moderate degree of AI at discharge. The mean duration of follow-up was $21.2\pm27.4$ months. All patients were alive except one who died during other departmental surgery. In 3 patients, more than moderate degree of AI was recurred, but there were no reoperation. Conclusion: Aortic valve-sparing procedures could be performed relatively safely in selected patients who had annuloaortic ectasia.

• KDI Journal of Economic Policy
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• v.32 no.2
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• pp.93-143
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• 2010

This paper estimates the impact of Japan's economic sanction on DPRK trade in the 2000s. It conceptualizes the effects of sanction on DPRK trade, econometrically tests whether such effects exist in case of Japan's sanction using currently available DPRK trade statistics, and measures the size of the effects by correcting and reconfiguring the deficiencies of the currently available DPRK trade statistics. The main findings of the paper are as follows. First, Japan's sanction can have two different effects on DPRK trade: 'Sanction Country Effect' and "Third Country Effect.' The former means that the sanction diminishes DPRK trade with Japan while the latter refers to the effects on DPRK trade with other countries as well. The third country effect can arise not simply because the DPRK changes its trade routes to circumvent the sanction, but because the sanction forces the DPRK to readjust its major trade items and patterns. Second, currently no official DPRK trade statistics are available. Thus, the so-called mirror data referring to DPRK trading partners' statistics should be employed for the analysis of the sanction effects. However, all currently available mirror data suffer from three fundamental problems: 1) they may omit the real trade partners of the DPRK; 2) they may confuse ROK trade with DPRK trade; 3) they cannot distinguish non-commercial trade from commercial trade, whereas only the latter concerns Japan's sanction. Considering those problems, we have to adopt the following method in order to reach a reasonable conclusion about the sanction effect. That is, we should repeat the same analysis using all different mirror data currently available, which include KOTRA, IMF and UN Commodity Trade Statistics, and then discuss only the common results from them. Third, currently available mirror data make the following points. 1) DPRK trade is well explained by the gravity model. 2) Japan's sanction has not only the sanction country effect but also the third country effect on DPRK trade. 3) The third country effect occurs differently on DPRK export and import. In case of export, the mirror statistics reveal positive (+) third country effects on all of the major trade partners of the DPRK, including South Korea, China and Thailand. However, on DPRK import, such third country effects are not statistically significant even for South Korea and China. 4) This suggests that Japan's sanction has greater effects on DPRK import rather than its export. Fourth, as far as DPRK export is concerned, it is possible to resolve the abovementioned fundamental problems of mirror data and thus reconstruct more accurate statistics on DPRK trade. Those reconstructed statistics lead us to following conclusions. 1) Japan's economic sanction diminished DPRK's export to Japan from 2004 to 2006 by 103 million dollars on annual average (Sanction Country Effect). It comprises around 60 percent of DPRK's export to Japan in 2003. 2) However, for the same period, the DPRK diverted its exports to other countries to cope up with Japan's sanction, and as a result its export to other countries increased by 85 million dollars on annual average (Third Country Effect). 3) This means that more than 80 per cent of the sanction country effect was made up for by the third country effect. And the actual size of impact that Japan's sanction made on DPRK export in total was merely 30 million dollars on annual average. 4) The third country effect occurred mostly in inter-Korean trade. In fact, Japan's sanction increased DPRK export to the ROK by 72 million dollars on annual average. In contrast, there was no statistically significant increase in DPRK export to China caused by Japan's sanction. 5) It means that the DPRK confronted Japan's sanction and mitigated its impact primarily by using inter-Korean trade and thus the ROK. Fifth, two things should be noted concerning the fourth results above. 1) The results capture the third country effect caused only by trade transfer. Facing Japan's sanction, the DPRK could transfer its existing trade with Japan to other countries. Also it could change its main export items and increase the export of those new items to other countries as mentioned in the first result. However, the fourth results above reflect only the former, not the latter. 2) Although Japan's sanction did not make a huge impact on DPRK export, it might not be necessarily true for DPRK import. Indeed the currently available mirror statistics suggest that Japan's sanction has greater effects on DPRK import. Hence it would not be wise to argue that Japan's sanction did not have much impact on DPRK trade in general, simply using the fourth result above.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.43-49
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• 1998

Purpose : Carcinomas arising in the gall bladder(GB) or extrahepatic biliary ducts are uncommon and generally have a poor prognosis. The overall 5-year survival rates are less than $10\%$. Early experiences with the external radiation therapy demonstrated a good palliation with occasional long-term survival. The present report describes our experience over the past decade with irradiation of primary carcinomas of the gallbladder and extrahepatic biliary duct. Materials and Methods : From Feb. 1984 to Nov. 1995, thirty-three patients with carcinoma of the GB and extrahepatic biliary duct were treated with external beam radiotherapy with curative intent at our institution. All patients were treated with 4-MV linear accelerator and radiation dose ranged from 31.44Gy to 54.87Gy(median 44.25Gy), and three Patients received additional intraluminal brachytherapy(range, 25Gy to 30Gy). Twenty-seven Patients received postoperative radiation. Among 27 patients, Sixteen patients underwent radical operation with curative aim and the rest of the patients either had bypass surgery or biopsy alone. In seventeen patients, adjuvant chemotherapy was used and eleven patients were treated with 5-FU, mitomycin and leucovorin. Results : Median follow up period was 8.5 months(range 2-97 months). The overall 2-year and 5-year survival rates in all patients were $29.9\%$ and $13.3\%$ respectively. In patients with GB and extrahepatic biliary duct carcinomas, the 2-year survival rates were $34.5\%$ and $27.8\%$ respectively. Patients who underwent radical operation showed better 2-year survival rates than those who underwent palliative operation($43.8\%\;vs.\;20.7\%$), albeit statistically insignificant(p>0.05). The 2-year survival rates in Stage I and II were higher than in Stage III and IV with statistical significance(p<0.05). Patients with good performance status in the beginning showed significantly better survival rates than those with worse status(p<0.05). The 2-year survival rates in combined chemotherapy group and radiation group were $40.5\%$ and $22.0\%$ respectively. There was no statistical differences in two groups (p>0.05). Conclusion : The survival of patients with relatively lower stage and/or initial good performance was significantly superior to that of others. We found an statistically insignificant trend toward better survival in patients with radical operation and/or chemotherapy, More radical treatment strategies, such as total resection with intensive radiation and/or chemotherapy may offer a better chance for cure in selective patients with carcinoma of gall bladder and extrahepatic biliary ducts.