• Journal of Chest Surgery
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• v.25 no.3
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• pp.220-231
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• 1992

We have performed 28 single lung transplantation in mongrel dogs transplanting the left lung exclusively from November 1989 to September 1991, in the department of thoracic surgery of Seoul National University Hospital. In the donor dogs, the main pulmonary artery was divided proximal to its bifurcation, and the left atrium was incised freeing the left veins with a generous atrial cuff. We used cold saline in the first 7 transplantations and Euro-Collins or modified Euro-Collins solution in the remaining 17 transplantations as a lung preservatives. The bronchus was divided at two cartilage rings proximal to the upper lobe bronchus take off. In the recipient procedure, we used a Fogarty catheter as a bronchus block. Left atrial anastomosis was performed first using 5-O prolene and the pulmonary artery was anastomosed using 6-O prolene. The bronchus was anastomosed next with 4-O vicryl interruptedly and covered with a greater omentum which had been prepared previously. All dogs received cyclosporin A and azathioprine as immunosuppressants and were divided into two group. In the 10 Group I dogs, they survived within 6 days, mean survival time was 66.8$\pm$53.4 hours. In remainder 14 Group lI dogs, they survived above 6 days, mean survival time was 9. 5$\pm$5.6 days. The cause of death were as follows: 2 cases of sacrifice, 2 cases of respiratory insufficiency during operation, 2 cases of arrhythmia immediate postoperatively, 2 cases of bleeding, others in Group I, and 6 cases of sacrifice, 4 cases of sepsis, 3 cases of bleeding, others in Group lI. Results of bronchoscopic findings were obstruction above 50% in 12 cases of 16 performance cases within 5th day. Early chest radiologic haziness were showed, and total lung perfusion defect was frequently showed in both group within 7th day. Main autopsy findings were left atrial and pulmonary arterial thrombi and bronchial obstruction The major histologic findings of Group I were pleural exudate, hemorrhagic infarct, pulmonary congestion, and interesting histologic findings of Group II were 3 cases of perivascular or peribronchial lymphocyte infiltration, 3 cases of hemorrhage infarct, 2 cases of interstitial pneumonitis. The structual change of bronchioles, suggesting bronchiolitis obliterans was not observed due to improper preparation of proximal pulmonary tissue and short term survival times.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2903-2908
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• 2015

Background: Head and neck cancer (HNC) is the eighth most common cancer as estimated from worldwide data. The incidence of HNC in Peninsular Malaysia was reported as 8.5 per 100,000 population. This study was aimed to determine the treatment outcomes for HNC patients treated in the Oncology Unit of University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with squamous cell carcinoma of head and neck (HNSCC) referred for treatment to the Oncology Unit at UMMC from 2003-2010 were retrospectively analyzed. Treatment outcomes were 5-year overall survival (OS), cause specific survival (CSS), loco-regional control (LRC) and radiotherapy (RT) related side effects. Kaplan-Meier and log rank analyses were used to determine survival outcomes, stratified according to American Joint Committee on Cancer (AJCC) stage. Results: A total of 130 cases were analysed. Most cases (81.5%) were at late stage (AJCC III-IVB) at presentation. The 5-year OS for the whole study population was 34.4% with a median follow up of 24 months. The 5-year OS according to AJCC stage was 100%, 48.2%, 41.4% and 22.0% for stage I, II, III and IVA-B, respectively. The 5-year overall CSS and LCR were 45.4% and 55.4%, respectively. Late effects of RT were documented in 41.4% of patients. The most common late effect was xerostomia. Conclusions: The treatment outcome of HNSCC at our centre is lagging behind those of developed nations. Efforts to increase the number of patients presenting in earlier stages, increase in the use of combined modality treatment, especially concurrent chemoradiotherapy and implementation of intensity modulated radiotherapy, may lead to better outcomes for our HNC patients.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.157-164
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• 2016

Background: Heart-lung transplantation (HLT) has provided hope to patients with end-stage lung disease and irreversible heart dysfunction. We reviewed the clinical outcomes of 10 patients who underwent heart-lung transplantation at Asan Medical Center. Methods: Between July 2010 and August 2014, a total of 11 patients underwent HLT at Asan Medical Center. After excluding one patient who underwent concomitant liver transplantation, 10 patients were enrolled in our study. We reviewed the demographics of the donors and the recipients' baseline information, survival rate, cause of death, and postoperative complications. All patients underwent follow-up, with a mean duration of $26.1{\pm}16.7months$. Results: Early death occurred in two patients (20%) due to septic shock. Late death occurred in three patients (38%) due to bronchiolitis obliterans (n=2) and septic shock (n=1), although these patients survived for 22, 28, and 42 months, respectively. The actuarial survival rates at one year, two years, and three years after HLT were 80%, 67%, and 53%, respectively. Conclusion: HLT is a procedure that is rarely performed in Korea, even in medical centers with large heart and lung transplant programs. In order to achieve acceptable clinical outcomes, it is critical to carefully choose the donor and the recipient and to be certain that all aspects of the transplant procedure are planned in advance with the greatest care.

• 대한예방의학회:학술대회논문집
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• 1994.02b
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• pp.206-233
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• 1994

The Medical Research Council has for some years encouraged collaborative clinical trials in leukaemia and other cancers, reporting the results in the medical literature. One unreported result which deserves such publication is the development of the expertise to design and analyse such trials. This report was prepared by a group of British and American statisticians, but it is intended for people without any statistical expertise. Part!, which appears in this issue, discusses the design of such trials; Part II, which will appear separately in the January 1977 issue of the Journal, gives full instructions for the statistical analysis of such trials by means of life tables and the logrank test, including a worked example, and discusses the interpretation of trial results, including brief reports of particular trials. Both parts of this report are relevant to all clinical trials which study time to death, and would be equally relevant to clinical trials which study time to other particular classes of untoward event: first stroke, perhaps, or first relapse, metastasis, disease recurrence, thrombosis, transplant rejection, or death from a particular cause. Part I, in this issue, collects together ideas that have mostly already appeared in the medical literature, but Part II, next month, is the first simple account yet published for non-statistical physicians of how to analyse efficiently data from clinical trials of survival duration. Such trials include the majority of all clinical trials of cancer therapy; in cancer trials, however, it may be preferable to use these statistical methods to study time to local recurrence of tumour, or to study time to detectable metastatic spread, in addition to studying total survival. Solid tumours can be staged at diagnosis; if this, or any other available information in some other disease is an important determinant of outcome, it can be used to make the overall logrank test for the whole heterogeneous trial population more sensitive, and more intuitively satisfactory, for it will then only be necessary to compare like with like, and not, by chance, Stage I with Stage III.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.40-45
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• 1998

Backgroud and Objectives: Major salivary gland tumor is a rare disease with a largely unknown origin. And also corresponding to the diversity of histopathologic characteristics is an equally wide distribution of clinical behavior that makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guidline of management. Materials and Methods : We studied clinical manifestations and treatment results of 104 patients who were diagnosed as major salivary gland tumors. Tumor site, patient age and sex of the patients were analysed. Histopathologic diagnosis, treatment modality, lymph nodes metastasis, recurrence rate and 5-year survival rate were studied on malignant tumors. Results: 1) 48 patients were male and 56 patients were female. 2) Benign tumors were 79 cases. They consisted of 57 cases(72%) of parotid tumor, 22 cases(27%) of submandibular tumor. And pleomorphic adenoma was the most common benign tumor. 3) Malignant tumors were 25 cases and were consisted of 19 cases(76%) of parotid tumor, 4 cases(l6%) of submandibular tumor and 2 cases(8%) of sublingual gland tumor with high-grade mucoepidermoid carcinoma as the most common cause. 4) In the malignant tumors, the number of stage I, II tumors was 14 and that of stage III, IV tumors was 11. Neck node metastasis was noted in 8 cases. 5) 8 cases of malignant tumor were died and all of them had high-grade malignancy. And they were dead before 17 months from the time of diagnosis. 6) Mean survival duration in the malignant salivary gland tumor was 56 months. 7) High-grade malignancy had a 5-year survival rate of 57.9%. A 5-year survival rate of TI, T2 patients was 92.9% and that of T3, T4 patients was 36.4%. That of patients who had neck node metastasis was 37.5% and that of those who had tree neck was 82.4%. Conclusion: The results of this study suggest that the survival rate is dependent on the tumor size, lymph node matastasis and histologic grade. And also the early diagnosis and radical surgery result in the increased survival rate and are effective for prevention of the tumor recurrance.

• Journal of Korean Society for Quality Management
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• v.33 no.3
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• pp.19-30
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• 2005

Recently many organization to become survival in changing marketplace, they must commit to implementing tools, systems, and quality management techniques. In this paper we develop process method of Team's problem-solving to reduce in failure costs. This paper suggest the step process how to measure quality cost reasonably that works in all types organizations. Or what is continuous improvement? Continuous improvement can be described as the continuous reduction of variation. Variation has many sources(machines, methods, materials, measurements, people, and environments) and cause(special & common in organization). As quality cost are not the answer to every organization financial, or quality-related problem, it's real results are designing & implementing quality cost system might be the answer.

• Proceedings of the Korean Operations and Management Science Society Conference
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• 2006.11a
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• pp.17-20
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• 2006

Inside the global management environment that is going through sudden changes, businesses are concentrating on putting in much hard work to establish the most competitive management strategy for its survival. As a executing tool and following the strategy establishment, BSC is being introduced and used by many businesses and public institutions, but instead of being used as a tool with the proper purpose of executing strategies, in reality, it is mainly being used to measure and evaluate outcomes. Of the several reasons why this is so, one important issue and its fundamental cause is that although BSC had been developed as a strategy executing tool, it is diffcult to understand the degree of execution of strategies because the overall measurement of the KPI includes all the strategic and operational parts. Through case study, this article acts on presenting the methodology of measuring the degree of execution of strategies that apply the BSC and PM frameworks.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.936-943
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• 1989

We underwent 21 cases of orthotopic heart transplantation in the mongrel dogs from May, 1988, to April, 1989. The preoperative hematologic and hemodynamic results were similar to those of the previous reports except glucose and albumin. The exposure of operative field was excellent under the median sternotomy. All the cases died within 48 hours and the mean survival time excluding 4 operative deaths was 11.23*9.36 hours [\ulcorner.D., range 0.3-35.5 hours] We speculated the main cause of death was low cardiac output due to the myocardial failure. At autopsy, there was feature of intramyocardial hemorrhage and coagulation necrosis suggesting poor myocardial protection. Now our team is ready to do heart transplantation in man but we need more precise experiences, especially on the immunosuppression and myocardial protection. Recently we continue further experiments with improving results.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.995-1001
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• 1994

The CarboMedics valve prosthesis is a relatively new. low profile bileaflet prosthesis. During a 6 year period from Aug. 1988 to July 1994. 158 patients had CarboMedics prostheses implanted in the mitral [n=94], aortic [n=25], or aortic and mitral [n=39] in National Medical Center. Hospital mortality was 9.4% and the main cause of death was low output syndrome. Follow up was 96% complete, with 365.4 patient-years and a mean follow up of 30 months [ range 1 to 72 months ] . The overall actuarial 6 year survival rate was 91.61 3.47% and actuarial 6year freedom from all valve related complications was 73.9 7.67%. The linearized incidence of vavle related complications was as follows: thromboembolism 1.37%/patient-year ; valve thrombosis 0.82%/ patient-year ; anticoagulant related hemorrhage 0.85%/patient-year ; perivalvular leakage 0.55%/paitent-year: prosthetic valve endocarditis 0.82%/patient-year ; reoperation 1.37%/patient-year. There were no instances of structural failure. We conclude that the Carbomedics valve has a low rate of complications that further improves the quality of life in patients with heart valve prostheses.

• Research in Plant Disease
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• v.25 no.2
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• pp.89-93
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• 2019

Fire blight disease caused by the bacterium, Erwinia amylovora, was observed in apple and pear orchards in Korea in 2015. Since then, it has spread, sometimes over long distances to other orchards. Therefore, we examined the ability of E. amylovora to survive in soils and on the surfaces of common materials such as T-shirts, wrist bands, pruning shears, and rubber boots by both conventional PCR (cPCR) and quantitative PCR (qPCR) methods. E. amylovora was detected in all materials tested in this study and survived for sufficiently long periods to cause fire blight disease in new sites. Thus, based on the results of this study, sanitation protocols must be applied to equipment during orchard work.