• Journal of Chest Surgery
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• v.32 no.9
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• pp.806-812
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• 1999

Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.

• Journal of Chest Surgery
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• v.40 no.6 s.275
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• pp.420-427
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• 2007

Background: Postpneumonectomy empyema (PPE) due to bronchopleural fistula (BPF) can be a surgical challenge for surgeons. We analyzed the follow-up outcomes after performing omentopexy and thoracoplasty for the treatment of PPE with BPF after pneumonectomy. Material and Mehod: Between December 1991 and January 2006, 9 patients underwent BPF closure using an omental pedicled flap for the treatment of PPE with BPF after pneumonectomy. There were 7 males and 2 females (mean age: $45.9{\pm}9$ years). The patients were followed up for a mean of 58 months (median: 28 months, range: $6{\sim}169$). When we performed omentopexy, the surgical procedures for empyema were thoracoplasy for 8 patients and the Clagett procedure for 1 patient. Thoracoplasty was performed for the latter patient due to recurrence of empyema, Result: For the 8 patients who were treated by omentopexy and thoracoplasty, there was 1 operation-related death due to sepsis. During follow up, 1 patient, who was treated by omentopexy and a Clagett procedure, died of acute hepatitis 40 months postoperatively. The early mortality was 11.1% (8/9). Of the 8 patients, including the 1 late death patient, successful closure of the BPF were achieved in all patients (8/9) and the empyema was cured in 7 patients (7/8). Conclusion: The BPF closure using an omental pedicled flap was an effective method for treating PPE with BPF due to 75-destroyed lung, and thoracoplasty with simultaneous omentopexy was effective and safe for removing dead space if the patient was young and in a good general condition.

• Korean Journal of Heritage: History & Science
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• v.45 no.2
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• pp.4-19
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• 2012

There remain many royal tombs of the Goryeo Dynasty in Gaeseong and Ganghwa. During the Goryeo Dynasty, these royal tombs were taken over tradition of tomb construction style from previous generation, and they completed their own inventive style. Furthermore they handed down those style to the Joseon Dynasty. The area of tomb was divided into 3 or 4 steps, and stone figures and T-shaped houses for sacrifice were arranged on each steps. It was the stone chamber of lateral opening style which had an entrance to southward, and it was formed as a rectangular box-shaped with a pile of stone walls and a flat ceiling. There was a coffin stand in the middle of floor, and traditional bricks were around them. The wall side and ceiling had been whitewashed and painted pictures. These are general characteristics for the tomb construction style of the Goryeo Dynasty. By the way, we can notice a number of features except those general things with inspection in detail. In early days, we confirmed 1step-parallel fulcrum ceiling, coffin stand of all in one stone, bier of burial artifact, and mural of plant material as a set, but they were changed as flat ceiling, Red-stone wall with rectangular stone, coffin stand set as stone pillar through the period of transitional form as of in the late 12th century. In case of several royal tombs, the fragments of king's epitaph which were confirmed from tombs could be defined owners clearly, and there were considerable timing difference between the large numbers of celadons which were excavated with the fragments of king's epitaph and recording chronologically of stone chamber structure. The reason for timing difference is that posterity artifacts were buried through repairing courses by occasion of destruction caused by robbing of the royal tombs. Meanwhile I inferred the existing hypothesis about owners of royal tombs and autonym ones in comparison the burial spot direction of hypothesis ones and outcomes of excavation. Therethrough, some hypothesis about owners of royal tombs such as Myung-neung which was assumed as tomb of the King Choongmok were not correct.

• Korean Journal of School Psychology
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• v.17 no.1
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• pp.17-38
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• 2020

This study examined the factor structure of the Child Behavior Checklist Dysregulation Profile(CBCL-DP) for school-aged children in Korea identified differences in the level of maladjustment and problematic behaviors between the clinical group which had characteristics of CBCL-DP and the control group which did not. Confirmative factor analysis was performed on three alternative models from the literature to determine which was the most appropriate factor structure for the CBCL-DP. The result showed that the bi-factor model fit the sample data better than both the one and second-factor models. To confirm that the bi-factor model was the most appropriate factor structure, regression paths with relevant variables examined. The showed that CBCL-DP with the bi-factor model was associated with executive function difficulty as reported by parents and with school adjustment and all sub-factors of strength and difficulty as reported by teachers. The results also showed that this model had a different relationship with anxiety/depression, aggressive behavior, and attention problems than the other models. The clinical group was shown to have more executive function difficulty, worse adjustment of school life and to be less likely to engage in desired behaviors than the control group. These results indicate the CBCL-DP is more related to negative outcomes than any other factor, and that the bi-factor model was found to best fit the sample data, consistent with other studies. The early discovery of CBCL-DP can be used to provide interventions for high-risk children who exhibit emotional and behavioral problems, making its detection a significant diagnostic tool. The implications of these result, the limitations of this study, and areas for future research are discussed in this paper.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.164-171
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• 2019

Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.244-253
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• 2019

Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

• Journal of the Korean earth science society
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• v.44 no.6
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• pp.578-593
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• 2023

Intense convective activity and heavy precipitation inundated Seoul and its metropolitan area on July 15, 2017. This study investigated the synoptic-scale meteorological drivers of cold cloud genesis of this event. The WRF-Chem (Weather Research and Forecasting model coupled with Chemistry) model was employed to explore the intricate interplay between meteorological factors and the indirect effects of PM_2.5 aerosols originating from eastern China. The PM_2.5 aerosols' indirect effect was quantified by contrasting outcomes between the comprehensive Aerosol Radiation Interaction experiment (encompassing aerosol radiation feedback, cloud chemistry processes, and wet scavenging in the WRF-Chem model) and ACR (Aerosol Cloud Radiation interaction) experiment. The ACR experiment specifically excluded aerosol radiation feedback while incorporating only cloud chemistry processes and wet scavenging. Results indicated that in the early hours of July 15, 2017, a convergence of warm, moisture-laden airflow originating from southeast China and the East China Sea unfolded over the Yellow Sea. This convergence was driven by the juxtaposition of a low-pressure system over the Chinese mainland and Northwest Pacific high. Notably, at approximately 12 km altitude, the resultant convective clouds were characterized by the presence of ice crystals, a hallmark of continental-origin cold clouds. The WRF-Chem model simulations elucidated the role of PM_2.5 aerosols from eastern China, attributing 5.7, 10.4, and 10.8% to cloud water, ice crystal column, and liquid water column formation, respectively, within the developing cold clouds. Thus, this study presented a meteorological mechanism elucidating the formation of deep convective clouds over the Yellow Sea and the indirect effects of PM_2.5 aerosols originating from eastern China.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.18 no.4
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• pp.21-35
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• 2023

Expectations surrounding generative AI technology and its profound ramifications are sweeping across various industrial domains. Given the anticipated pivotal role of the startup ecosystem in the utilization and advancement of generative AI technology, it is imperative to cultivate a deeper comprehension of the present state and distinctive attributes characterizing venture capital (VC) investments within this domain. The current investigation delves into South Korea's landscape of VC investment deals and prognosticates the projected VC investments by juxtaposing these against the United States, the frontrunner in the generative AI industry and its associated ecosystem. For analytical purposes, a compilation of 286 investment deals originating from 117 U.S. generative AI startups spanning the period from 2008 to 2023, as well as 144 investment deals from 42 South Korean generative AI startups covering the years 2011 to 2023, was amassed to construct new datasets. The outcomes of this endeavor reveal an upward trajectory in the count of VC investment deals within both the U.S. and South Korea during recent years. Predominantly, these deals have been concentrated within the early-stage investment realm. Noteworthy disparities between the two nations have also come to light. Specifically, in the U.S., in contrast to South Korea, the quantum of recent VC deals has escalated, marking an augmentation ranging from 285% to 488% in the corresponding developmental stage. While the interval between disparate investment stages demonstrated a slight elongation in South Korea relative to the U.S., this discrepancy did not achieve statistical significance. Furthermore, the proportion of VC investments channeled into generative AI enterprises, relative to the aggregate number of deals, exhibited a higher quotient in South Korea compared to the U.S. Upon a comprehensive sectoral breakdown of generative AI, it was discerned that within the U.S., 59.2% of total deals were concentrated in the text and model sectors, whereas in South Korea, 61.9% of deals centered around the video, image, and chat sectors. Through forecasting, the anticipated VC investments in South Korea from 2023 to 2029 were derived via four distinct models, culminating in an estimated average requirement of 3.4 trillion Korean won (ranging from at least 2.408 trillion won to a maximum of 5.919 trillion won). This research bears pragmatic significance as it methodically dissects VC investments within the generative AI domain across both the U.S. and South Korea, culminating in the presentation of an estimated VC investment projection for the latter. Furthermore, its academic significance lies in laying the groundwork for prospective scholarly inquiries by dissecting the current landscape of generative AI VC investments, a sphere that has hitherto remained void of rigorous academic investigation supported by empirical data. Additionally, the study introduces two innovative methodologies for the prediction of VC investment sums. Upon broader integration, application, and refinement of these methodologies within diverse academic explorations, they stand poised to enhance the prognosticative capacity pertaining to VC investment costs.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.403-414
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• 2023

Backgrounds/Aims: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. Methods: Data were extracted from the Recurrence After Whipple's (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). Results: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6-21), group B (49 days, 39-64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-to-death (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p = 0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. Conclusions: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence.

• Korean Circulation Journal
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• v.54 no.4
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• pp.189-200
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• 2024

Background and Objectives: Concerns remain that early aspirin cessation may be associated with potential harm in subsets at high risk of ischemic events. This study aimed to assess the effects of P2Y12 inhibitor monotherapy after 3-month dual antiplatelet therapy (DAPT) vs. prolonged DAPT (12-month or longer) based on the ischemic risk stratification, the CHADS-P2A2RC, after percutaneous coronary intervention (PCI). Methods: This was a sub-study of the SMART-CHOICE trial. The effect of the randomized antiplatelet strategies was assessed across 3 CHADS-P2A2RC risk score categories. The primary outcome was a major adverse cardiac and cerebral event (MACCE), a composite of all-cause death, myocardial infarction, or stroke. Results: Up to 3 years, the high CHADS-P2A2RC risk score group had the highest incidence of MACCE (105 [12.1%], adjusted hazard ratio [HR], 2.927; 95% confidence interval [CI], 1.358-6.309; p=0.006) followed by moderate-risk (40 [1.4%], adjusted HR, 1.786; 95% CI, 0.868-3.674; p=0.115) and low-risk (9 [0.5%], reference). In secondary analyses, P2Y12 inhibitor monotherapy reduced the Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding without increasing the risk of MACCE as compared with prolonged DAPT across the 3 CHADS-P2A2RC risk strata without significant interaction term (interaction p for MACCE=0.705 and interaction p for BARC types 2, 3, or 5 bleeding=0.055). Conclusions: The CHADS-P2A2RC risk score is valuable in discriminating high-ischemic-risk patients. Even in such patients with a high risk of ischemic events, P2Y12 inhibitor monotherapy was associated with a lower incidence of bleeding without increased risk of ischemic events compared with prolonged DAPT.