• Journal of Chest Surgery
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• v.36 no.5
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• pp.335-342
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• 2003

Background: The aortic arch replacement in an acute aortic dissection is technically demanding procedure that has a lot of postoperative morbidity and high mortality The authors have applied several techniques of aortic arch replacement to overcome the risks of the procedure. Therefore we analysed the results of these techniques. Material and Method: From March of 1996 to July of 2002, we performed 31 cases of the aortic arch replacement in the Stanford type A acute aortic dissection. There were 12 male and 19 female patient's with 59.6$\pm$9.4 years of mean age. Among them 18 cases were treated with the hemiarch replacement and 13 cases with the total arch replacement. We approached the aortic arch through median sternotomy in all but 3 cases of Clamshell incision and applied the deep hypothermic circulatory arrest with retrograde cerebral perfusion. The associated procedures were 2 Bentall's procedures, an axillobifemoral bypass, a femorofemoral bypass and a carotid artery bypass. Result: The postoperative morbidities were 8 acute renal failures, 3 CNS complications, 2 low cardiac output syndromes, 2 malpefusion syndromes, and 2 deep wound infections. There were 4 cases of early hospital mortality which were from an acute renal failure a postoperative bleeding, a low cardiac output syndrome, and a reperfusion syndrome. There were 3 cases of late hospital mortality which were from an acute renal failure, and 2 multiorgan failures. So the total mortality rate was 22.5%. There were 4 cases of late mortality after the discharge, which were form 2 cases of distal anastomotic rupture and 2 cases of intracranial hemorrhage. Conclusion: The hemiarch replacement has relatively shorter operative time and lower hospital mortality but higher late mortality than the total arch replacement. The total arch replacement needs more technically demanding procedure.

• Journal of Soil and Groundwater Environment
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• v.12 no.1
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• pp.73-86
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• 2007

Risk-based remediation strategy (RBRS) is a consistent decision-making process for the assessment and response to chemical release based on protecting human health and the environment. The decision-making process described integrates exposure and risk assessment practices with site assessment activities and remedial action selection to ensure that the chosen actions are protective of human health and the environment. The general sequences of events in Tier 1 is as follows: initial site assessment, development of conceptual site model with all exposure pathways, data collection on pollutants and receptors, and identification of risk-based screening level (RBSL). If site conditions do not meet RBSL, it needs further site-specific tier evaluation, Tier 2. In most cases, only limited number of exposure pathways, exposure scenarios, and chemicals of concern are considered the Tier 2 evaluation since many are eliminated from consideration during the Tier 1 evaluation. In spite of uncertainties due to the conservatism applied to risk calculations, limitation in site-specific data collections, and variables affecting the selection of target risk levels and exposure factors, RBRS provides us time- and cost-effectiveness of the remedial action. To ensure reliance of the results, the development team should consider land and resource use, cumulative risks, and additive effects. In addition, it is necessary to develop appropriate site assessment guideline and reliable toxicity assessment method, and to study on site-specific parameters and exposure parameters in Korea.

• Radiation Oncology Journal
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• v.22 no.2
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• pp.77-90
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• 2004

Purpose: The purpose of this review Is to provide an update on novel radiation treatments for head and neck cancer Recent Findings: Despite the remarkable advances In chemotherapy and radiotherapy techniques, the management of advanced head and neck cancer remains challenging. Epidermal growth factor receptor (EGFR) Is an appealing target for novel therapies In head and neck cancer because not only EGFR activation stimulates many important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Furthermore, EGFR overexpression Is known to be portended for a worse outcome in patients with advanced head and neck cancer. Two categories of compounds designed to abrogate EGFR signaling, such as monoclonal antibodies (Cetuxlmab) and tyrosine kinase inhibitors (ZD1839 and 051-774) have been assessed and have been most extensively studied In preclinical models and clinical trials. Additional TKIs In clinical trials include a reversible agent, Cl-1033, which blocks activation of all erbB receptors. Encouraging preclinical data for head and neck cancers resulted In rapid translation Into the clinic. Results from Initial clinical trials show rather surprisingly that only minority of patients benefited from EGFR inhibition as monotherapy or In combination with chemotherapy. In this review, we begin with a brief summary of erbB- mediated signal transduction. Subsequently, we present data on prognostic-predictive value of erbB receptor expression in HNC followed by preclinlcal and clinical data on the role of EGFR antagonists alone or in combination with radiation In the treatment of HNC. Finally, we discuss the emerging thoughts on resistance to EGFR biockade and efforts In the development of multiple-targeted therapy for combination with chemotherapy or radiation. Current challenges for investigators are to determine (1 ) who will benefit from targeted agents and which agents are most appropriate to combine with radiation and/or chemotherapy, (2) how to sequence these agents with radiation and/or cytotoxlc compounds, (3) reliable markers for patient selection and verification of effective blockade of signaling in vivo, and (4) mechanisms behind intrinsic or acquired resistance to targeted agents to facilitate rational development of multi-targeted therapy, Other molecuiar-targeted approaches In head and neck cancer were briefly described, Including angloenesis Inhibitors, farnesyl transferase inhibitors, cell cycle regulators, and gene therapy Summary: Novel targeted theraples are highly appealing in advanced head and neck cancer, and the most premising strategy to use them Is a matter of intense Investigation.

• Management & Information Systems Review
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• v.34 no.3
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• pp.17-39
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• 2015

This study examined the structural changes and volatility in the global stock markets using a Markov Regime Switching ARCH model developed by the Hamilton and Susmel (1994). Firstly, the US, Italy and Ireland showed that variance in the high volatility regime was more than five times that in the low volatility, while Korea, Russia, India, and Greece exhibited that variance in the high volatility regime was increased more than eight times that in the low. On average, a jump from regime 1 to regime 2 implied roughly three times increased in risk, while the risk during regime 3 was up to almost thirteen times than during regime 1 over the study period. And Korea, the US, India, Italy showed ARCH(1) and ARCH(2) effects, leverage and asymmetric effects. Secondly, 278 days were estimated in the persistence of low volatility regime, indicating that the mean transition probability between volatilities exhibited the highest long-term persistence in Korea. Thirdly, the coefficients appeared to be unstable structural changes and volatility for the stock markets in Chow tests during the Asian, Global and European financial crisis. In addition, 1-Step prediction error tests showed that stock markets were unstable during the Asian crisis of 1997-1998 except for Russia, and the Global crisis of 2007-2008 except for Korea and the European crisis of 2010-2011 except for Korea, the US, Russia and India. N-Step tests exhibited that most of stock markets were unstable during the Asian and Global crisis. There was little change in the Asian crisis in CUSUM tests, while stock markets were stable until the late 2000s except for some countries. Also there were stable and unstable stock markets mixed across countries in CUSUMSQ test during the crises. Fourthly, I confirmed a close relevance of the volatility between Korea and other countries in the stock markets through the likelihood ratio tests. Accordingly, I have identified the episode or events that generated the high volatility in the stock markets for the financial crisis, and for all seven stock markets the significant switch between the volatility regimes implied a considerable change in the market risk. It appeared that the high stock market volatility was related with business recession at the beginning in 1990s. By closely examining the history of political and economical events in the global countries, I found that the results of Lamoureux and Lastrapes (1990) were consistent with those of this paper, indicating there were the structural changes and volatility during the crises and specificly every high volatility regime in SWARCH-L(3,2) student t-model was accompanied by some important policy changes or financial crises in countries or other critical events in the international economy. The sophisticated nonlinear models are needed to further analysis.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.222-228
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• 2008

Purpose: Various treatment techniques have been attempted for the radiotherapy of anal cancer because of acute side effects such as perineal skin reactions. This study was performed to investigate an optimal radiotherapy technique in anal cancer. Materials and Methods: The study subjects included 35 patients who underwent definitive concurrent chemoradiotherapy for anal cancer in Yonsei Cancer Center between 1990 and 2007. The patients' clinical data, including irradiation technique, were reviewed retrospectively. The primary lesion, regional lymph nodes, and both inguinal lymph nodes were irradiated by $41.4{\sim}45\;Gy$ with a conventional schedule, followed by a boost does to the primary lesion or metastatic lymph nodes. The radiotherapy technique was classified into four categories according to the irradiation field and number of portals. In turn, acute skin reactions associated with the treatment interruption period were investigated according to each of the four techniques. Results: 28 patients (80.0%) had grade 2 radiation dermatitis or greater, whereas 10 patients (28.6%) had grade 3 radiation dermatitis or greater during radiotherapy. Radiation dermatitis and the treatment interruption period were relatively lower in patients belonging to the posterior-right-left 3 x-ray field with inguinal electron boost and in patients belonging to electron thunderbird techniques. The interruption periods were $8.2{\pm}10.2$ and $5.7{\pm}7.7$ for the two technique groups, respectively. Twenty-seven patients (77.1%) went into complete remission at 1 month after radiotherapy and the overall 5 year survival rates were 67.7%. Conclusion: Field size and beam arrangement can affect patients' compliance in anal cancer radiotherapy, whereas a small x-ray field for the perineum seems to be helpful by decreasing severe radiation dermatitis.

• Clinical and Experimental Pediatrics
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• v.45 no.5
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• pp.588-595
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• 2002

Purpose : The incidence of obesity has increased in Korea recently. Obesity leads to higher risks of hypertension, hyperlipidemia and insulin resistance. It also leads to risks of respiratory complications. This study was performed to see the effects of obesity on children's pulmonary functions and on developed bronchospasm after exercise loading according to their obesity degrees. Methods : 257 obese children and 150 non-obese children were enrolled. Obese children were divided into 3 groups by the obesity degrees. Pre- and post-exercise loading $FEV_1$(forced expiratory volume at one second), FVC(forced vital capacity) and PEFR(peak expiratory flow rate) were checked in all subjects. The percent predicted values of each parameter was compared according to obesity degrees and the differences between pre-exercise and post-exercise values. Results : The percent predicted value of $FEV_1$, FVC decreased only in the severe obesity group compared with those in the control group. However percent predicted PEFR declined according to obesity degrees. The percent predicted value of $FEV_1$, FVC and PEFR after exercise loading were much lower than those before exercise loading in all groups. Conclusion : As the degree of obesity was higher, the percent predicted value of pulmonary function was lower. And after exercise loading, as the degree of obesity was higher, the reduction of percent predicted value of pulmonary function was larger. Therefore the pulmonary function in obese children must be observed carefully. Further studies on the effects of pulmonary functions in obese children are necessary.

• 한국지구과학회:학술대회논문집
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• 2010.04a
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• pp.108-109
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• 2010

IMPACT Silver 주식회사는 Zacualpan 프로젝트의 Royal Mines(이하 로얄 광산)을 인수했다. $124.5\;km^2$에 해당하는 지역의 소유권은 두 개의 멕시코 사기업으로부터 가행중인 광산의 채굴권 구입과 운영 중인 기반시설의 임대를 조건으로 한다. 프로젝트 지역은 멕시코시티로부터 남서방향으로 100 km와 Taxco Silver 광산으로부터 북서방향으로 25 km 떨어진 지점에 위치한다. 기반시설은 비포장 도로, 충분한 전력과 물의 공급 및 숙련공들을 갖추어 우수한 평가를 받고 있다. 소유권은 멕시코인의 개인소유 하에서 무한한 매장량 혹은 자원량을 갖고 운영된 채광과 가공시설을 인수하는 것이다. 소유권 지역을 대상으로 한 IMPACT Silver사의 주 탐사목적은 이미 알려진 광화대의 확장을 위한 잠재성 평가와 다른 지역에서 신규 광상의 유망지역을 발견하는 것이다. Zacualpan 프로젝트의 로얄 광산은 남동 Guerrero terrane의 북부에 위치한다. Teloloapan subterrane은 주로 저변성 녹색편암상으로 구성된 쥬라기 후기에서 백악기 초기의 화산성 퇴적층으로 구성된다. 대부분의 유망지역은 Lower Villa de Ayala층의 중성 내지 염기성 화산성 쇄설암을 모암으로 한다. 다상의 변성작용은 지역 전반에 걸쳐 나타나고, Zacualpan 광산지역에서 수반되는 광화작용을 규제한다. Zacualpan 광산지역은 Sierra Madre del Sur로 알려진 유망 광화대에 해당한다. 이 지역은 화산성 괴상 황화광상과 천열수 맥상광상이 우세하다. 대부분의 천열수 광화작용은 3.2-3.8억 년 전 마그마의 생성이 활발한 판구조 체제 동안 발생하였다. 역사적으로 가장 주요한 지역은 Lipton Vein이다. 현재 Zacualpan 지구에서 채광량은 은 200-500 g/t 정도로 보고되고 있다. 일부 지역은 고품위 은 광화작용(은 1,000 g/t 이상)을 수반하고 있으며, 이는 탐사의 주 타겟이 되고 있다. Zacualpan에서 은 광화작용은 은이 부화된 중유황 천열수 맥상광상으로 상당히 유명하다. Fresnillo, Pachuca 및 Taxco 광산을 포함한 멕시코 소유의 대규모의 잘 알려진 광산들이 이에 해당한다. 이러한 광산들은 부산물로서 금, 아연, 연이 생산된다. 이러한 광상들은 맥상과 각력상 및 산점상 또는 망상세맥의 형태로 산출된다. 광화작용은 석영과 탄산염 맥 내에 주로 황철석과 다양한 섬아연석, 방연석, 은 혹은 금 광물들을 수반한다. 경제성을 갖는 광화작용의 수직적인 연장은 평균적으로 대략 300 m이고, 멕시코 중부에 위치한 Fresnillo의 광화작용은 100 m에서 960 m의 연장을 갖는 것으로 알려져 있다. 아주 오랫동안 Zacualpan에서 광산관계자의 관측과 IMPACT Silver에서 최근 작업의 결과를 토대로, Zacualpan 광산지역의 탐사모델은 새로운 광상의 탐사를 위한 가이드로서 개발되었다. Zacualpan 광산지역에서 가장 높은 경제성을 갖는 광화작용은 북서와 남북방향의 맥 구조를 따라 수반된다. 이러한 맥 구조들은 종종 이 지역을 가로질러 수 km까지 추적되지만, 경제성을 갖는 광화작용은 맥 구조를 따라서 구조적으로 유리한 지역에서 부광대를 형성한다. 부광대를 형성하기 위한 가장 유리한 구조적 지역은 북서와 남북방향으로 발달한 맥 구조들이 교차하는 지역이다. 지난 30년간 채광된 주요 부광대는 폭이 2-6 m 이고 수평연장은 30-150 m 그리고 수직연장은 230-300 m에 이른다. 가장 높은 생산량을 보이는 부광대는 남북방향의 이차 맥들이 Guadalupe 광산의 Lipton 맥을 가로지르는 지역에서 발달한다. 남동쪽으로 현재 Compadres 광산의 Silver Shoot No. 1으로부터 고품위 은을 생산하는 지역은 북서방향의 San Agustin 맥이 북향의 Cometa Navideno 맥에 의해 절단되는 지역에서 산출한다. 모암은 광화작용을 규제하는 또 다른 중요한 요소이다. 광산지역에서 경제성을 갖는 모든 광화작용은 중성 내지 염기성 화산암 특히 안산암과 관련 모암에 배태된다. 부광대가 셰일 혹은 편암으로 전이되는 지역에서, 맥들은 소규모의 세맥으로 나뉘어 진다. Zacualpan의 전형적인 천열수 광상에서 부광대는 상부로 가면서 은의 함량이 증가하고, 하부로 가면서 연 아연의 함량이 증가하는 수직적 대상을 보인다. 금의 함량 변화는 보다 예측이 어려우나 상당히 중요하다. Zacualpan 광산지역의 탐사모델에 사용된 토양 채취, 정밀지도제작, 트렌치 및 시추탐광은 현재 IMPACT Silver사가 이 지역을 대상으로 한 가장 효율적인 탐사방법으로 입증되었다. Zacualpan 프로젝트의 로얄 광산은 하루 500 톤을 제련하는 기반시설과 수반된 채굴권을 갖는 가행 광산들을 포함한다. 현재 IMPACT Silver사는 두 곳의 타겟 지역에서 정밀지도제작, 토양 및 암석 채취, 12공 총 1866 m의 시추탐광에 의한 사전조사로 구성된 4 단계 탐사를 수행했다. 암석 1,953개, 토양 1,631 개, 389 개의 시추코어 시료가 채집되고 분석되었다. 이러한 작업은 추가탐사를 요구하는 수많은 유망 광화대를 규명했다. Compadres 광산에서 현재 가행중인 지하갱 시료는 레벨 1에서 0.9 m의 폭을 갖는 광체에서 은 680 g/t과 금 0.3 g/t, 레벨 3에서 1.67 m의 폭을 갖는 광체에서 은 12,591 g/t과 금 12.07 g/t의 품위를 갖는 것으로 나타났다. 레벨 1에서 3까지 2-3 m의 폭과 30-40 m 연장으로 채광되었다. 시추탐광은 고품위를 갖는 몇몇의 중첩된 맥을 발견했다. Compadres 광산에서 남동방향으로 200 m지점에 위치한 Soledad 지역에서 5 개의 시추공으로부터 동일 맥 시스템이 발견되었고, 고품위 부광대의 상부로 간주되는 몇몇 중요 지점이 발견되었다. 초기 단계의 탐사는 유망 시추탐광 지역인 중간정도 내지 고품위 유망 광화대를 규명했다.

• Journal of the Korean GEO-environmental Society
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• v.18 no.7
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• pp.37-47
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• 2017

In this study, a series of full-scale field tests on prebored and precast steel pipe piles and the corresponding numerical analysis have been conducted in order to study the characteristics of pile load-settlement relations and shear stress transfer at the pile-soil interface. Dynamic pile load tests (EOID and restrike) have been performed on the piles and the estimated design pile loads from EOID and restrike tests were analysed. Class-A type numerical analyses conducted prior to the pile loading tests were 56~105%, 65~121% and 38~142% respectively of those obtained from static load tests. In addition, design loads estimated from the restrike tests indicate increases of 12~60% compared to those estimated in the EOID tests. The EOID tests show large end bearing capacity while the restrike tests demonstrate increased skin friction. When impact energy is insufficient during the restrike tests, the end bearing capacity may be underestimated. It has been found that total pile capacity would be reasonably estimated if skin friction from the restrike tests and end bearing capacity from the EOID are combined. The load-settlement relation measured from the static pile load tests and estimated from the numerical modelling is in general agreement until yielding occurs, after which results from the numerical analyses substantially deviated away from those obtained from the static load tests. The measured pile behaviour from the static load tests shows somewhat similar behaviour of perfectly-elastic plastic materials after yielding with a small increase in the pile load, while the numerical analyses demonstrates a gradual increase in the pile load associated with strain hardening approaching ultimate pile load. It has been discussed that the load-settlement relation mainly depends upon the stiffness of the ground, whilst the shear transfer mechanism depends on shear strength parameters.

• Tuberculosis and Respiratory Diseases
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• v.40 no.4
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• pp.384-389
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• 1993

Background: Pulmonary sclerosing hemangioma is rare, but still the second most common benign lung tumor, occurring most1y in middle-aged women. Methods: From January 1985 through April 1993, we experienced eight cases of solitary pulmonary sclerosing hemangioma. Results: Subjects studied were 7 female and 1 male patients. They ranged from 14 to 63 years of age(mean age, 43.8 years) at the time of operation. The patients were frequently asymptomatic and the tumor was often shown to be a large lobulated mass on radiographic examination. The tumor can usually be diagnosed on operation because of its subtle clinical and radiographic presentation. All eight cases were diagnosed intraoperatively. The mean interval between initial radiographic detection and operation was 7.9 months. Out of 8 cases, preoperative impression of benign tumor was made in 4 cases, whereas malignant tumor was suspected in the remaining 4 cases. Enucleation, wedge resection or lobectomy was performed which appropriate in each patient. Conclusion: Surgical removal of the tumor preserving as much lung parenchyma as possible is indicated for proper diagnosis and treatment of this condition.

• Tuberculosis and Respiratory Diseases
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• v.49 no.5
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• pp.614-623
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• 2000

Background : Diffuse alveolar hemorrhage (DAH) is rare but often fatal. To determine the clinical manifestations of DAH, its etiology, clinical course and prognosis were studied. Method : A retrospective analysis was performed in 21 patients that were diagnosed as DAH. Diagnosis of DAH was based on the presence of the "classical triad" of hemoptysis, anemia, and rapidly progressive infiltrates on chest X-ray and a finding of bronchoalveolar lavage or lung biopsy. Results : Thirteen patients (61.9%) had collagen vascular diseases (CVDs) as underlying disease and 10 patients had systemic lupus erythematosus. Females were more prevalent in CVD than in non-collagen vascular disease (NCVD). Otherwise, there were no significant differences between the two groups in terms of clinical manifestations. Dyspnea (95.2%), cough (76.2%), hemoptysis (61.9%), and fever (33.0%) were frequent symptoms. The initial creatinine level was higher in CVD than in NCVD ($3.27{\pm}3.15$ mg/dl vs. $1.19{\pm}0.94$ mg/dl, p=0.030). The corresponding drop in hemoglobin level was $2.69{\pm}1.26$ g/dl. Maximal drop in hemoglobin preceded the progression of infiltrates on the chest radiograph by $1.38{\pm}4.22$ days. The mortality rate was higher in the patients with NCVD than in those with CVD (50.0% vs. 23.1%). Conclusion : The DAH can occur not only in patients with CVD but also in those with NCVD. Higher creatinine level CVD in patients is associated with renal involvement in conjunction with DAH. The maximal drop in hemoglobin preceeding the progression of infiltrates on the chest radiograph suggests that the drop in hemoglobin is important for diagnosing DAH.