• Journal of Chest Surgery
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• v.42 no.5
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• pp.657-661
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• 2009

Intramural esophageal dissection is a rare disorder that's characterized by a lengthy laceration between the mucosal and submucosal layers of the esophageal wall, and the esophageal wall is without perforation. The three different types of acute esophageal injury are a mucosal tear (Mallory-Weiss syndrome), full-thickness rupture (Boerhaave's syndrome) and intramural esophageal dissection. Most intramural esophageal dissections respond to conservative management with a very good prognosis. This rare condition should be considered in patients who present with acute chest pain, dysphagia or odynophagia, and particularly in the presence of a bleeding disorder or where there has been recent administration of antiplatelet medication, anticoagulantsorthrombolyticsto avoid inappropriate treatment with surgery. We present here a rare case of intramural dissection of the esophagus that occurred when the patient was taking anti platelet medication.

• Journal of Korean Neurosurgical Society
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• v.56 no.4
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• pp.310-314
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• 2014

Objective : To analyze the clinical courses and outcomes after anterior lumbar interbody fusion (ALIF) for the treatment of postoperative spondylodiscitis. Methods : A total of 13 consecutive patients with postoperative spondylodiscitis treated with ALIF at our institute from January, 1994 to August, 2013 were included (92.3% male, mean age 54.5 years old). The outcome data including inflammatory markers (leukocyte count, C-reactive protein, erythrocyte sedimentation rate), the Oswestry Disability Index (ODI), the modified Visual Analogue Scale (VAS), and bony fusion rate using spine X-ray were obtained before and 6 months after ALIF. Results : All of the cases were effectively treated with combination of systemic antibiotics and ALIF with normalization of the inflammatory markers. The mean VAS for back and leg pain before ALIF was $6.8{\pm}1.1$, which improved to $3.2{\pm}2.2$ at 6 months after ALIF. The mean ODI score before ALIF was $70.0{\pm}14.8$, which improved to $34.2{\pm}27.0$ at 6 months after ALIF. Successful bony fusion rate was 84.6% (11/13) and the remaining two patients were also asymptomatic. Conclusion : Our results suggest that ALIF is an effective treatment option for postoperative spondylodiscitis.

• Ocean and Polar Research
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• v.27 no.2
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• pp.115-123
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• 2005

Recently, it has been observed in the East Sea that temperature increases below the thermocline, and dissolved oxygen increase in the intermediate layer but decrease below it. The layer of minimum dissolved oxygen deepens and the bottom homogeneous layer in oxygen becomes thinner. It emerges very probably that these changes are induced by the mode change of deep water formation associated with global warming. To further support this hypothesis, a one-dimensional model experiment is performed. First, a thermal profile is obtained by injecting a cold and high oxygen deep water into the bottom layer, say the bottom mode. Then, two thermal profiles are obtained from the bottom mode profile by assuming that either all the deep water introduce into the intermediate layer has been initiated, say the intermediate mode, or that only a part of the deep water has been initiated into the intermediate layer, say the intermediate-bottom mode. The results, from the intermediate-bottom mode experiment are closest to the observed results. They show quite well the tendency for oxygen to increase in the intermediate layer and the simultaneous thinning of the bottom homogeneous layer in oxygen. Therefore, it can be said that the recently observed slow variation of the thermal structure might be associated with changes in the deep water formation from the bottom mode to the intermediate-bottom mode.

• Ocean and Polar Research
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• v.28 no.3
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• pp.245-258
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• 2006

We investigated seasonal variations of the upper ocean temperature and the mixed layer depth (MLD) in an eddy-permitting global ocean general circulation model (OGCM) to assess the OGCM perfermance. The OGCM is based on the GFDL MOM3 which has a horizontal resolution of 0.5 degree and 30 vertical levels. The OGCM was integrated for 68 years using a monthly-mean climatological wind stress forcing. The model sea surface temperature (SST) and sea surface salinity were restored to the Levitus climatology with a time scale of 30 days. Annual-mean model SST shows a cold bias $(<\;-2^{\circ}C)$ in the summer hemisphere and a warm bias $(>\;1^{\circ}C)$ in the winter hemisphere mainly due to the restoring boundary condition of temperature. The model MLD captures well the observed features in most areas, with a slightly deep bias. However, in the Ross Sea and Weddell Sea, the model shows significantly deeper MLD than the climatology-mainly due to weak salinity stratifications in the model. For amplitude of seasonal variation, the model SST is smaller $(1{\sim}3^{\circ}C)$ than the observation largely due to the restoring surface boundary condition while the model MLD has larger seasonal variation $({\sim}50m)$. It is suggested that for more realistic simulation of the upper ocean structure in the present eddy-permitting ocean model, more refinements in the surface boundary condition for the thermohaline forcing and parameterization for vertical mixing are required, together with the incorporation of a sea-ice model.

• Journal of Pharmaceutical Investigation
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• v.36 no.1
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• pp.1-9
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• 2006

Human solid tumors exhibit a multicellular resistance (MCR) resulting from limited drug penetration and decreased sensitivity of tumor cells when interacting with their microenvironments. Multicellular cultures represent solid tumor condition in vivo and provide clinically relevant data. There is little data on antitumor effect of paclitaxel (PTX) in multicellular cultures although its MCR has been demonstrated. In the present study, we evaluated antiproliferative effects of PTX in multicellular layers (MCL) of DLD-1 human colorectal carcinoma cells. BrdU labeling index (LI), thickness of MCL, cell cycle distribution and cellular uptake of calcein were measured before and after exposure to PTX at 0.1 to 50 ${\mu}M$ for 24, 48 and 72 hrs. BrdU LI and thickness of MCL showed a concentration- and time-dependent decrease and the changes in both parameters were similar, i.e., 34.2% and 40.6% decrease in BrdU LI and thickness, respectively, when exposed to $50\;{\mu}M$ for 72 hr. The DLD-1 cells grown in MCL showed increase in $%G_{0}/G_{1}$ and resistance to cell cycle arrest and apoptosis compared to monolayers. Calcein uptake in MCL did not change upon PTX exposure, indicating technical problems in multicellular system. Overall, these data indicate that antitumor activity of PTX may be limited in human solid tumors (a multicellular system) and MCL may be an appropriate model to study further pharmacodynamics of PTX.

• Radiation Oncology Journal
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• v.11 no.1
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• pp.133-141
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• 1993

From Jan.1982 to Dec.1990, 77 patients with rectal cancer were treated with curative surgical resection followed by postoperative adjuvant irradiation alone or combined with chemotherapy at the Department of Radiation Oncology, Korea University Hospital (KUH). Fifty-four (54/77, $70.1{\%}$) patients underwent abdominoperineal resection , 20 (20/77, $26{\%}$) patients underwent low anterior resection, and 3 (3/77, $3.9{\%}$,) patients had wide excision only. Thirty-nine (39/77, $50.5{\%}$) received sequential chemotherapy (2 cycles to 12 cycles). The 5-year survival rate for the entire group was $43{\%}:\;78.2{\%}$ in B2+B3, $39.4{\%}$ in stage C1+C2+C3. Survival rates decreased with increasing penetration of the bowel wall by tumor and the presence of regional lymph node metastasis. Those patients survival who underwent an abdominoperineal resection also experienced a significant decrease in compared to low anterior resection ($23.1{\%}$ vs. $63.8{\%}$ in 5-year survival, p <0.05). Local failure occurred in 15 ($19.5{\%}$) out of the 77 patients overall, 1($5.3{\%}$) of 19 in stage B2+B3, and 14 ($24.1{\%}$,) of 58 in stage C1+C2+C3. Presacral area was most common site of local failufre (8/17, $47.1{\%}$). Distant failure occurred in 13 ($16.9{\%}$) of 77 patients. The most frequent site of distant failure was the lung followed by the liver, the bone, and the brain. Combined locoregional and distant failure occurred in 2 ($2.6{\%}$) of 77 patients. Pathological confirmation of perirectal fat and/or regional lymph node involvement resulted in a singificant decrease in survival and local control.

• Journal of the korean society of oceanography
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• v.38 no.4
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• pp.173-184
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• 2003

Major differences between wind speeds from atmospheric pressure maps (Na wind) and near­surface wind speeds derived from satellite scatterometer (NSCAT) observations over the East (Japan) Sea have been examined. The root­mean­square errors of Na wind and NSCAT wind speeds collocated with Japanese Meteorological Agency (JMA) buoy winds are about $3.84\;ms^{-1}\;and\;1.53\;ms^{-1}$, respectively. Time series of NSCAT wind speeds showed a high coherency of 0.92 with the real buoy measurements and contained higher spectral energy at low frequencies (>3 days) than the Na wind. The magnitudes of monthly Na winds are lower than NSCAT winds by up to 45%, particularly in September 1996. The spatial structures between the two are mostly coherent on basin­wide large scales； however, significant differences and energy loss are found on a spatial scale of less than 100 km. This was evidenced by the temporal EOFs (Empirical Orthogonal Functions) of the two wind speed data sets and by their two­dimensional spectra. Since the Na wind was based on the atmospheric pressures on the weather map, it overlooked small­scale features of less than 100 km. The center of the cold­air outbreak through Vladivostok, expressed by the Na wind in January 1997, was shifted towards the North Korean coast when compared with that of the NSCAT wind, whereas NSCAT winds revealed its temporal evolution as well as spatial distribution.

• 한국해양학회지
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• v.18 no.1
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• pp.73-83
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• 1983

To serch the origin of the cold water mass along the east coast of Korea its characteristics are inrestigated based upon Cooperative Study of Kuroahio and Fisheries Research and Development Agency data. In the southwestern part of the Japan Sea the North Korean Cold Water sinks at the front and flows southwards on top of the Japan Sea Proper Water. it is found that the sunken North Korean Cold Water il high in the content of dissolved oxygen and less saline compared with the Japan Sea Proper Water. It is highly likely that the cold water mass off the Jugbyeon-Chuksan coast in summer il the North Koreah Cold Water and not upwelled Japan Sea Proper Water. It os shown that the Notth Korean cold Water Flows strongly in summer and its scuthern limit is generally off Chuksan-Janggigab and occasionally off Gampo as observed in 1973.

• Biomolecules & Therapeutics
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• v.14 no.2
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• pp.90-95
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• 2006

CKD-602 exerts its antitumor effect via inhibition of topoisomerase I in cancer cells. Multicellular spheroid (MCS) and Multicellular layers (MCLs) are known as in vitro 3-dimensional models which closely represent tumor conditions in vivo. In order to investigate the potential of CKD-602 against human colorectal tumors, we evaluated the anti-proliferative activity and penetration ability of CKD-602 in MCS and MCL cultures of DLD-l human colorectal cancer cells, respectively. The maximum effects($E_{max}$) induced by CKD-602 were significantly lower in MCS compared to monolayers (48% vs 92%). With prolonged drug exposure, the $IC_{50's}$ of CKD-602 decreased to $23.5{\pm}1.0nM$ in monolayers after 24 h exposure and $42.3{\pm}1.7nM$ in MCS after 6 days, respectively. However, no further increase in effect was observed for exposure time longer than growth doubling time (Td) in both cultures. Activity of CKD-602 was significantly reduced after penetration through MCL and also with cell-free insert membrane. In conclusion, CKD-602 showed significantly decreased anti-proliferative activity in 3D cultures (MCS) of human colorectal cancer cells. Tumor penetration of CKD-602 could not be determined due to loss of activity after penetration through cell free insert membrane, which warrants further evaluation using a modified model.

• Journal of Chest Surgery
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• v.47 no.1
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• pp.20-25
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• 2014

Background: Symptomatic or asymptomatic patients with significant carotid artery stenosis (range, 70% to 99%) generally undergo either carotid artery endarterectomy (CEA) or carotid artery stenting (CAS) to prevent stroke. In this study, we evaluated the cost effectiveness of these two treatment modalities. Methods: A total of 47 patients (mean age, $67.1{\pm}9.1$ years; male, 87.2%) undergoing either CEA (n=28) or CAS (n=19) for the treatment of significant carotid artery stenosis were enrolled in this study. Hospitalization costs were subdivided into three parts, namely pre-procedure, procedure and resource, and post-procedure costs. Results: Total hospitalization costs were similar in both groups of CEA and CAS (6,377 thousand won [TW] vs. 6,703 TW, p=0.255); however, the total cost minus the pre-procedure cost was higher in the CAS group than in the CEA group (4,948 TW vs. 5,941 TW, p<0.0001). The pre-procedure cost of the CEA group was higher than that of the CAS group (1,429 TW vs. 762 TW, p<0.0001). However, the procedure and resource cost was higher in the CAS group because the resource cost was approximately three times higher in the CAS group than in the CEA group. The post-procedure cost was higher in the CEA group because hospital stays were approximately two times longer. Conclusion: The total hospitalization cost was not different between the CEA and the CAS groups. The pre-procedure cost was high in the CEA group, but the cost from procedure onset to discharge, including the resource cost, was significantly lower in this group.