• Journal of Intelligence and Information Systems
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• v.26 no.1
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• pp.47-73
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• 2020

KTX rolling stocks are a system consisting of several machines, electrical devices, and components. The maintenance of the rolling stocks requires considerable expertise and experience of maintenance workers. In the event of a rolling stock failure, the knowledge and experience of the maintainer will result in a difference in the quality of the time and work to solve the problem. So, the resulting availability of the vehicle will vary. Although problem solving is generally based on fault manuals, experienced and skilled professionals can quickly diagnose and take actions by applying personal know-how. Since this knowledge exists in a tacit form, it is difficult to pass it on completely to a successor, and there have been studies that have developed a case-based rolling stock expert system to turn it into a data-driven one. Nonetheless, research on the most commonly used KTX rolling stock on the main-line or the development of a system that extracts text meanings and searches for similar cases is still lacking. Therefore, this study proposes an intelligence supporting system that provides an action guide for emerging failures by using the know-how of these rolling stocks maintenance experts as an example of problem solving. For this purpose, the case base was constructed by collecting the rolling stocks failure data generated from 2015 to 2017, and the integrated dictionary was constructed separately through the case base to include the essential terminology and failure codes in consideration of the specialty of the railway rolling stock sector. Based on a deployed case base, a new failure was retrieved from past cases and the top three most similar failure cases were extracted to propose the actual actions of these cases as a diagnostic guide. In this study, various dimensionality reduction measures were applied to calculate similarity by taking into account the meaningful relationship of failure details in order to compensate for the limitations of the method of searching cases by keyword matching in rolling stock failure expert system studies using case-based reasoning in the precedent case-based expert system studies, and their usefulness was verified through experiments. Among the various dimensionality reduction techniques, similar cases were retrieved by applying three algorithms: Non-negative Matrix Factorization(NMF), Latent Semantic Analysis(LSA), and Doc2Vec to extract the characteristics of the failure and measure the cosine distance between the vectors. The precision, recall, and F-measure methods were used to assess the performance of the proposed actions. To compare the performance of dimensionality reduction techniques, the analysis of variance confirmed that the performance differences of the five algorithms were statistically significant, with a comparison between the algorithm that randomly extracts failure cases with identical failure codes and the algorithm that applies cosine similarity directly based on words. In addition, optimal techniques were derived for practical application by verifying differences in performance depending on the number of dimensions for dimensionality reduction. The analysis showed that the performance of the cosine similarity was higher than that of the dimension using Non-negative Matrix Factorization(NMF) and Latent Semantic Analysis(LSA) and the performance of algorithm using Doc2Vec was the highest. Furthermore, in terms of dimensionality reduction techniques, the larger the number of dimensions at the appropriate level, the better the performance was found. Through this study, we confirmed the usefulness of effective methods of extracting characteristics of data and converting unstructured data when applying case-based reasoning based on which most of the attributes are texted in the special field of KTX rolling stock. Text mining is a trend where studies are being conducted for use in many areas, but studies using such text data are still lacking in an environment where there are a number of specialized terms and limited access to data, such as the one we want to use in this study. In this regard, it is significant that the study first presented an intelligent diagnostic system that suggested action by searching for a case by applying text mining techniques to extract the characteristics of the failure to complement keyword-based case searches. It is expected that this will provide implications as basic study for developing diagnostic systems that can be used immediately on the site.

• Journal of Gastric Cancer
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• v.5 no.2
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• pp.89-94
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• 2005

Purpose: Early gastric cancer (EGC) has an excellent prognosis compared to advanced gastric cancer. The 5-year survival rate for EGC now exceeds $90\%$, and EGC is recognized as a curable malignancy. The important prognostic factor in EGC is the status of lymph-node metastasis. Despite conserving surgery being suggested for EGC at present, it is of vital importance to select a surgical method appropriate to each individual case. This retrospective study was undertaken to clarify clinicopathologic features and factors related to lymph-node metastasis in submucosal gastric cancer in order to determine an appropriate therapy. Materials and Methods: This study analyzed the clinicopathologic features for 279 patients with a submucosal gastric carcinoma (Group I) and compared with those of patients with mucosal (Group II) or muscularis proprial gastric carcinoma (Group III). All patients were operated on from 1981 to 1999 at Chonnam University Hospital. There were no statistically significant differences among the groups with respect to age, gender, tumor location, hepatic metastasis, or peritoneal dissemination. Results: Positive lymph node metastasis was found in 47 ($16.8\%$) of the 279 patients with a submucosal gastric carcinoma. The incidence of lymph-node metastasis was significantly higher in patients with a submucosal gastric carcinoma than in patients with a mucosal gastric carcinoma ($16.8\%\;vs.\;3.9\%\;$; P<0.01). Therefore, depth of invasion was a significant factor affecting in lymph-node metastasis. The 5-year survival rates were $88.6\%$ for patients in Group I, $95.2\%$ for patients in Group II, and $72.7\%$ for patients in Group III (P<0.01 for Group I vs. Group II; Group I vs. Group III). In patients with a submucosal gastric carcinoma, the survival rate with positive lymph nodes was significantly poorer than that of patients without lymph-node metastasis ($87.3\%\;vs.\;94.2\%$; P<0.01). Conclusion: Gastrectomy with D2 lymph node dissection is an appropriate operative procedure for patients with a submucosal gastric carcinoma.

• The Korean Journal of Air & Space Law and Policy
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• v.29 no.2
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• pp.109-134
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• 2014

Regulation (EC) No 261/2004 of the European Parliament and of the Council of 11 February 2004 establishing common rules on compensation of assistance to passengers in the event of denied boarding and of cancellation or long delay of flights (Regulation No 261/2004) provides extra protection to air passengers in circumstances of denied boarding, cancellation and long-delay. The Regulation intends to provide a high level of protection to air passengers by imposing obligations on air carriers and, at the same time, offering extensive rights to air passengers. If denied boarding, cancellation and long-delay are caused by reasons other than extraordinary circumstances, passengers are entitled for compensation under Article 7 of Regulation No 261/2004. In Wallentin-Hermann v Alitalia-Linee Aeree Italiane SpA(Case C-549/07, [2008] ECR I-11061), the Court did, however, emphasize that this does not mean that it is never possible for technical problems to constitute extraordinary circumstances. It cited specific examples of where: an aircraft manufacturer or competent authority revealed that there was a hidden manufacturing defect on an aircraft which impacts on safety; or damage was caused to an aircraft as a result of an act of sabotage or terrorism. Such events are not inherent in the normal exercise of the activity of the air carrier concerned and is beyond the actual control of that carrier on account of its nature or origin. One further point arising out of the court's decision is worth mentioning. It is not just necessary to satisfy the extraordinary circumstances test for the airline to be excused from paying compensation. It must also show that the circumstances could not have been avoided even if all reasonable measures had been taken. It is clear from the language of the Court's decision that this is a tough test to meet: the airline will have to establish that, even if it had deployed all its resources in terms of staff or equipment and the financial means at its disposal, it would clearly not have been able - unless it had made intolerable sacrifices in the light of the capacities of its undertaking at the relevant time - to prevent the extraordinary circumstances with which it was confronted from leading to the cancellation of the flight.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.32 no.4
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• pp.14-23
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• 2014

The purpose of this study is to contribute in building credibility of the methodology of the appearance of the traditional colors and the interpretation of the meaning of those appearances by analyzing the spatial construction and configuration and the traditional colors that appear in spatial elements about the scenery component that appear in Seyeonjeong. We conducted a literature research about the traditional colors, the background of the creation of Seyeonjeong, and etc. For the contents for the empirical analysis, we took the scenery and space elements in the poems, such as Eobusasisa and O-u-ga, and the contents of poems related to ojeongsaek (five Korean traditional colors) based on the Yin-Yang and the Five Elements ideology Particularly, after dividing the spatial elements appearing in Seyoenjeong into visual, synesthetic, symbolic/cognitive spatial element, we further distinguished the visual space into positions and directions of the of the spaces and the scenery of the season; the synesthetic space into seasons, time and five senses; and the symbolic/cognitive space into chiljeong (or the seven passions) and sadan (or the four clues). Then we carried out the study by analyzing the correlation between the intention of the garden creation and the meaning of the spaces, through the analysis of ojeongsaek system for each spatial element. Firstly, spatial structure and format that appear in Seyeonjeong can be divided into two directional axes of southeast and northwest according to the flat form of the Seyeongjeong's rectangular palace, with Seyeongjoeng as the center. Secondly, in spatial component element, the frequencies of appearance of the traditional colors of Seyoenjeong are 33.2% for white, 20.8% for blue, 20.8% for black, 18.7% for red and 6.3% for yellow. Thirdly, based on the analysis of the traditional colors the most frequent appearance of 'white' left a room for interpretation like the creation of Seyeonjeong was to enjoy secular living without lingering political feelings so that the high mountains remain clear and clean. Also, the predominant frequency of appearance of blue, similar frequency of appearance of black and red, and the least frequent appearance of yellow is in agreement with or can be at least interpreted related to Yun Seon-do's intention for creating Seyeonjeong not for political rank or power but as a place to enjoy nature, through which he can build on his knowledge, and to lead rest of his life as a noble being through plays, like dancing and writing poems. Fourthly, these interpretations of the analysis of the frequency of appearance of the traditional colors of Seyeongjong shows the reliability, validity, and consistency of the methodology of the analysis of the frequency of appearance of the traditional colors and the interpretation of the meanings in the context that the color white appears most frequently in Soswewon as well and that the background life of the Soswewon's creator Yangsanbo can be interpreted in a similarly way. Above all, this study is significant from the fact that we proposed a theory about the method of analysis and interpretation of the traditional colors in a traditional landscape space. Moreover, there is a great significance of discovering that traditional colors appear in traditional spaces and this can be used as a methodological framework to interpret things like, intention for creation of (buildings/architectures).

• The Korean Journal of Air & Space Law and Policy
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• v.30 no.2
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• pp.469-497
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• 2015

In 2009 Iridium 33, a satellite owned by the American Iridium Communications Inc. and Kosmos-2251, a satellite owned by the Russian Space Forces, collided at a speed of 42,120 km/h and an altitude of 789 kilometers above the Taymyr Peninsula in Siberia. NASA estimated that the satellite collision had created approximately 1,000 pieces of debris larger than 10 centimeters, in addition to many smaller ones. By July 2011, the U.S. Space Surveillance Network(SSN) had catalogued over 2,000 large debris fragments. On January 11, 2007 China conducted a test on its anti-satellite missile. A Chinese weather satellite, the FY-1C polar orbit satellite, was destroyed by the missile that was launched using a multistage solid-fuel. The test was unprecedented for having created a record amount of debris. At least 2,317 pieces of trackable size (i.e. of golf ball size or larger) and an estimated 150,000 particles were generated as a result. As far as the Space Treaties such as 1967 Outer Space Treaty, 1968 Rescue Agreement, 1972 Liability Convention, 1975 Registration Convention and 1979 Moon Agreement are concerned, few provisions addressing the space environment and debris in space can be found. In the early years of space exploration dating back to the late 1950s, the focus of international law was on the establishment of a basic set of rules on the activities undertaken by various states in outer space.. Consequently environmental issues, including those of space debris, did not receive the priority they deserve when international space law was originally drafted. As shown in the case of the 1978 "Cosmos 954 Incident" between Canada and USSR, the two parties settled it by the memorandum between two nations not by the Space Treaties to which they are parties. In 1994 the 66th conference of International Law Association(ILA) adopted "International Instrument on the Protection of the Environment from Damage Caused by Space Debris". The Inter-Agency Space Debris Coordination Committee(IADC) issued some guidelines for the space debris which were the basis of "the UN Space Debris Mitigation Guidelines" which had been approved by the Committee on the Peaceful Uses of Outer Space(COPUOS) in its 527th meeting. On December 21 2007 this guideline was approved by UNGA Resolution 62/217. The EU has proposed an "International Code of Conduct for Outer Space Activities" as a transparency and confidence-building measure. It was only in 2010 that the Scientific and Technical Subcommittee began considering as an agenda item the long-term sustainability of outer space. A Working Group on the Long-term Sustainability of Outer Space Activities was established, the objectives of which include identifying areas of concern for the long-term sustainability of outer space activities, proposing measures that could enhance sustainability, and producing voluntary guidelines to reduce risks to long-term sustainability. By this effort "Guidelines on the Long-term Sustainability of Outer Space Activities" are being under consideration. In the case of "Declaration of Legal Principles Governing the Activities of States in the Exp1oration and Use of Outer Space" adopted by UNGA Resolution 1962(XVIII), December 13 1963, the 9 principles proclaimed in that Declaration, although all of them incorporated in the Space Treaties, could be regarded as customary international law binding all states considering the time and opinio juris by the responses of the world. Although the soft law such as resolutions, guidelines are not binding law, there are some provisions which have a fundamentally norm-creating character and customary international law. In November 12 1974 UN General Assembly recalled through a Resolution 3232(XXIX) "Review of the role of International Court of Justice" that the development of international law may be reflected, inter alia, by the declarations and resolutions of the General Assembly which may to that extend be taken into consideration by the judgements of the International Court of Justice. We are expecting COPUOS which gave birth 5 Space Treaties that it could give us binding space debris mitigation measures to be implemented based on space debris mitigation soft law in the near future.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.38 no.1
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• pp.115-131
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• 2020

Through literature research and field investigation, this paper attempts to study the distribution, morphology and the typification of the visual and perceptual stone inscription in Wuyi-Gugok of China. The results are as follows: First, there are 350 stone inscriptions in total from the 1^st Gok to 9^th Gok in Wuyi-Gugok. Second, according to the analysis of the stone inscription distribution, 74(21.2%) stone inscriptions in the 5^th Gok, 67(19.2%) in the 6^th Gok, 65(18.6%) in the 1^st Gok, 60(17.2%) in the 2^nd Gok and 53(15.2%) in the 4^th Gok are confirmed. The above five Goks contain 319(91.1%) stone inscriptions, so they have rich cultural landscape. Third, according to the survey, the number of the stone inscriptions existed in the Sugwangseok of the 1^st Gok are 41(22.6%), in the Homagan of Cheonyubong of the 6^th Gok are 29(8.3%), in the Jesiam of the 4^th Gok are 23(6.6%), in the Nyeongam of the 2^nd Gok are 22(6.3%), in the Hyangseongam of the 6^th Gok are 21(6%), in the Unwa of the 5^th Gok are 19(5.4%), in the Bokhoam of the 5^th Gok are 18(5.1%), in the Eunbyeongbong of the 5^th Gok are 17(4.9%), in the Daejangbong of the 4^th Gok are 14(4%), in the Daewangbong of the 1^st Gok and the Geumgokam of the 4^th Gok are 12(3.4%). Thus, a total of 228 (65.1%) stone inscriptions are concentrated in these 11 sites, which represent the popularity and cultural value of these rocks. Fourth, the stone inscription of Wuyi-Gugok, praising the landform and topographical geological landscape of Mount Wuyi, mainly describe the scenic name of each Gok related to Zhu Xi's Gugok culture, appreciate Zhu Xi's tracks and the stone inscription in the sacred land of Neo-Confucianism culture, and also record the Confucian edification of mencius thoughts, Muigun(武夷君) and the myths and legends related to the site names of Wuyi mountain, which can remind people of the worldview of the celestial paradise where the gods live and the fairyland of the land of peach blossoms. In addition, it indicates that the historical and cultural landscape, which is full of colorful history and myths and legends, including allusions related to Confucian, buddhist and Taoist celebrities and the ancestor ancient things related to traditional culture of China is very diverse. Fifth, the results of the classification, based on the content of the stone inscription in Wuyi-Gugok, are classified as the scenery name inscription, the praise scene inscription, the recording travel inscription, the recording event inscription, the philosophy inscription, the expressing emotion inscription, the religion inscription, the inscription for auspiciousness, the slogan and expressing ambition inscription and the official document notice inscription, among which there are 102(29.1%) praise scene inscriptions, 93(26.6%) scenery name inscriptions and 61(17.4%) recording travel inscriptions. The stone inscriptions of Wuyi-Gugok have the characteristics of the special emphasis on scenery names, landscape praise and commemorative tours. Sixth, the analysis of the intertext between the 「Figure of Wuyi-Gugok」 and Wuyi-Gugok rock letters, in the study found that the method of propagation between media was mostly the method of propagation of quotations and maintained intermedia through extension, repetition, extension, and compression.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.297-316
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• 2006

The increasing tendency of medical disputes is one of the remarkable social phenomena. Especially we must not overlook the phenomenon that production and circulation of information related to medical accidents is increasing rapidly through the internet. In this research, we evaluated the web sites which provide the information related to medical accidents using the keyword "medical accidents" in March 2006, and classified the 28 web sites according to the kinds of establishers. We also analyzed the contents of the sites, and checked and compared the current status of the web sites and problems that have to be improved. Finally, we suggested the possible solutions to prevent medical accidents. The detailed results were listed below. 1. Medical practitioners, general public, and lawyers were all familiar with and prefer the term "medical accidents" mainly. 2. In the number of sites searched by the keyword "medical accidents", lawyer had the most sites and medical practitioners had the least ones. 3. Many sites by general public and lawyers had their own medical record analysts but there was little professional analysts for dentistry. 4. General public were more interested in the prevention of medical accidents but the lawyers were more interested in the process after medical accidents. The sites by medical practitioners dealt with the least remedies of medical accidents, compared with other sites. 5. General public wanted the third party such as government intervention into the disputes including the medical dispute arbitration law or/and the establishment of independent medical dispute judgment institution. 6. In the comparison among the establishers of web sites, medical practitioners dealt with the least examples of medical accidents. 7. The suggestion of cases in counseling articles related to dental accidents were considered less importantly than the reality. 8. Whereas there were many articles about domestic cases related to the bloody dental treatment, in the open counseling articles the number of dental treatment regarding to non insurance treatment was large. 9. In comparing offered information of medical accidents based on the establishers, general public offered vocabularies, lawyers offered related laws and medical practitioners offered medical knowledge relatively. 10. They all cited the news pressed by the media to offer the current status of domestic medical accidents. Especially among the web sites by general public, NGOs provided the plentiful statistical data related to medical accidents. 11. The web sites that collect the medical accidents were only two. As a result of our research, we found out that, in the flood of information, medical disputes can be occurred by the wrong information from third party, and the medical practitioners have the most passive attitudes on the medical accidents. Thus, it is crucial to have the mutual interchange and exchange of information between lawyer, patients and medical practitioners, so that based on clear mutual comprehension we can solve the accidents and disputes more positively and actively.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.30 no.2
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• pp.263-278
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• 2004

Ursolic acid (UA) and Oleanolic acid (ONA), known as urson, micromerol and malol, are pentacyclic triterpenoid compounds which naturally occur in a large number of vegetarian foods, medicinal herbs, and plants. They may occur in their free acid form or as aglycones for triterpenoid saponins, which are comprised of a triterpenoid aglycone, linked to one or more sugar moieties. Therefore UA and ONA are similar in pharmacological activity. Lately scientific research, which led to the identification of UA and ONA, revealed that several pharmacological effects, such as antitumor, hepato-protective, anti-inflammatory, anticarcinogenic, antimicrobial, and anti-hyperlipidemic could be attributed to UA and ONA. Here, we introduced the effect of UA and ONA on acutely barrier disrupted and normal hairless mouse skin. To evaluate the effects of UA and ONA on epidermal permeability barrier recovery, both flanks of 8-12 week-old hairless mice were topically treated with either 0.01-0.1mg/mL UA or 0.1-1mg/mL ONA after tape stripping, and TEWL (transepidermal water loss) was measured. The recovery rate increased in those UA or ONA treated groups (0.1mg/mL UA and 0.5mg/mL ONA) at 6h more than 20% compared to vehicle treated group (p < 0.05). Here, we introduced the effects of UA and ONA on acute barrier disruption and normal epidermal permeability barrier function. For verifying the effects of UA and ONA on normal epidermal barrier, hydration and TEWL were measured for 1 and 3 weeks after UA and ONA applications (2mg/mL per day). We also investigated the features of epidermis and dermis using electron microscopy (EM) and light microscopy (LM). Both samples increased hydration compared to vehicle group from 1 week without TEWL alteration (p < 0.005). EM examination using RuO4 and OsO4 fixation revealed that secretion and numbers of lamellar bodies and complete formation of lipid bilayers were most prominent (ONA=UA > vehicle). LM finding showed that thickness of stratum corneum (SC) was slightly increased and especially epidermal thickening and flattening was observed (UA > ONA > vehicle). We also observed that UA and ONA stimulate epidermal keratinocyte differentiation via PPAR Protein expression of involucrin, loricrin, and filaggrin increased at least 2 and 3 fold in HaCaT cells treated with either ONA (10${\mu}$M) or UA (10${\mu}$M) for 24 h respectively. This result suggested that the UA and ONA can improve epidermal permeability barrier function and induce the epidermal keratinocyte differentiation via PPAR Using Masson-trichrome and elastic fiber staining, we observed collagen thickening and elastic fiber elongation by UA and ONA treatments. In vitro results of collagen and elastin synthesis and elastase inhibitory activity measurements were also confirmed in vivo findings. These data suggested that the effects of UA and ONA related to not only epidermal permeability barrier functions but also dermal collagen and elastic fiber synthesis. Taken together, UA and ONA can be relevant candidates to improve epidermal and dermal functions and pertinent agents for cosmeseutical applications.

• Journal of Intelligence and Information Systems
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• v.26 no.2
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• pp.1-25
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• 2020

In this paper, we suggest an application system architecture which provides accurate, fast and efficient automatic gasometer reading function. The system captures gasometer image using mobile device camera, transmits the image to a cloud server on top of private LTE network, and analyzes the image to extract character information of device ID and gas usage amount by selective optical character recognition based on deep learning technology. In general, there are many types of character in an image and optical character recognition technology extracts all character information in an image. But some applications need to ignore non-of-interest types of character and only have to focus on some specific types of characters. For an example of the application, automatic gasometer reading system only need to extract device ID and gas usage amount character information from gasometer images to send bill to users. Non-of-interest character strings, such as device type, manufacturer, manufacturing date, specification and etc., are not valuable information to the application. Thus, the application have to analyze point of interest region and specific types of characters to extract valuable information only. We adopted CNN (Convolutional Neural Network) based object detection and CRNN (Convolutional Recurrent Neural Network) technology for selective optical character recognition which only analyze point of interest region for selective character information extraction. We build up 3 neural networks for the application system. The first is a convolutional neural network which detects point of interest region of gas usage amount and device ID information character strings, the second is another convolutional neural network which transforms spatial information of point of interest region to spatial sequential feature vectors, and the third is bi-directional long short term memory network which converts spatial sequential information to character strings using time-series analysis mapping from feature vectors to character strings. In this research, point of interest character strings are device ID and gas usage amount. Device ID consists of 12 arabic character strings and gas usage amount consists of 4 ~ 5 arabic character strings. All system components are implemented in Amazon Web Service Cloud with Intel Zeon E5-2686 v4 CPU and NVidia TESLA V100 GPU. The system architecture adopts master-lave processing structure for efficient and fast parallel processing coping with about 700,000 requests per day. Mobile device captures gasometer image and transmits to master process in AWS cloud. Master process runs on Intel Zeon CPU and pushes reading request from mobile device to an input queue with FIFO (First In First Out) structure. Slave process consists of 3 types of deep neural networks which conduct character recognition process and runs on NVidia GPU module. Slave process is always polling the input queue to get recognition request. If there are some requests from master process in the input queue, slave process converts the image in the input queue to device ID character string, gas usage amount character string and position information of the strings, returns the information to output queue, and switch to idle mode to poll the input queue. Master process gets final information form the output queue and delivers the information to the mobile device. We used total 27,120 gasometer images for training, validation and testing of 3 types of deep neural network. 22,985 images were used for training and validation, 4,135 images were used for testing. We randomly splitted 22,985 images with 8:2 ratio for training and validation respectively for each training epoch. 4,135 test image were categorized into 5 types (Normal, noise, reflex, scale and slant). Normal data is clean image data, noise means image with noise signal, relfex means image with light reflection in gasometer region, scale means images with small object size due to long-distance capturing and slant means images which is not horizontally flat. Final character string recognition accuracies for device ID and gas usage amount of normal data are 0.960 and 0.864 respectively.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.269-274
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• 2006

Background: Tetralogy of Fallot (TOF) with pulmonary atresia and major aortopulmonary collateral arteries (MAPCAS) is complex lesion with marked heterogeneity of pulmonary blood supply and arborization anomalies. Patients with TOF with PA and MAPCAS have traditionally required multiple staged unifocalization of pulmonary blood supply before undergoing complete repair. In this report, we describe recent change of strategy and the results in our institution. Material and Method: We established surgical stratagies: early correction, central mediastinal approach, initial RV-PA conduit interposition, and aggressive intervention. Between July 1998 and August 2004, 23 patients were surgically treated at our institution. We divided them into 3 groups by initial operation method; group I: one stage total correction, group II: RV-PA conduit and unifocalization, group III: RV-PA conduit interposition only. Result: Mean ages at initial operation in each group were $13.9{\pm}16.0$ months (group 1), $10.4{\pm}15.6$ months (group II), and $7.9{\pm}7.7$ months (group III). True pulmonary arteries were not present in f patient and the pulmonary arteries were confluent in 22 patients. The balloon angioplasty was done in average 1.3 times (range: $1{\sim}6$). There were 4 early deaths relating initial operation, and 1 late death due to incracranial hemorrhage after definitive repair. The operative mortalities of initial procedures in each group were 25.0% (1/4: group I), 20.0% (2/10: group II), and 12.2% (1/9: group III). The causes of operative mortality were hypoxia (2), low cardiac output (1) and sudden cardiac arrest (1). Definitive repair rates in each group were 75% (3/4) in group I, 20% (2/10, fenestration: 2) in group II, and 55.0% (5/9, fenestration: 1) in group III. Conclusion: In patients of TOF with PA and MAPCAS, RV-PA connection as a initial procedure could be performed with relatively low risk, and high rate of definitive repair can be obtained in the help of balloon pulmonary angioplasty. One stage RV-PA connection and unifocalization appeared to be successful in selected patients.