• Journal of Ginseng Research
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• v.26 no.3
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• pp.111-131
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• 2002

Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.

• Journal of Intelligence and Information Systems
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• v.16 no.2
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• pp.19-32
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• 2010

Volatility plays a central role in both academic and practical applications, especially in pricing financial derivative products and trading volatility strategies. This study presents a novel mechanism based on generalized autoregressive conditional heteroskedasticity (GARCH) models that is able to enhance the performance of intelligent volatility trading systems by predicting Korean stock market volatility more accurately. In particular, we embedded the concept of the volatility asymmetry documented widely in the literature into our model. The newly developed Korean stock market volatility index of KOSPI 200, VKOSPI, is used as a volatility proxy. It is the price of a linear portfolio of the KOSPI 200 index options and measures the effect of the expectations of dealers and option traders on stock market volatility for 30 calendar days. The KOSPI 200 index options market started in 1997 and has become the most actively traded market in the world. Its trading volume is more than 10 million contracts a day and records the highest of all the stock index option markets. Therefore, analyzing the VKOSPI has great importance in understanding volatility inherent in option prices and can afford some trading ideas for futures and option dealers. Use of the VKOSPI as volatility proxy avoids statistical estimation problems associated with other measures of volatility since the VKOSPI is model-free expected volatility of market participants calculated directly from the transacted option prices. This study estimates the symmetric and asymmetric GARCH models for the KOSPI 200 index from January 2003 to December 2006 by the maximum likelihood procedure. Asymmetric GARCH models include GJR-GARCH model of Glosten, Jagannathan and Runke, exponential GARCH model of Nelson and power autoregressive conditional heteroskedasticity (ARCH) of Ding, Granger and Engle. Symmetric GARCH model indicates basic GARCH (1, 1). Tomorrow's forecasted value and change direction of stock market volatility are obtained by recursive GARCH specifications from January 2007 to December 2009 and are compared with the VKOSPI. Empirical results indicate that negative unanticipated returns increase volatility more than positive return shocks of equal magnitude decrease volatility, indicating the existence of volatility asymmetry in the Korean stock market. The point value and change direction of tomorrow VKOSPI are estimated and forecasted by GARCH models. Volatility trading system is developed using the forecasted change direction of the VKOSPI, that is, if tomorrow VKOSPI is expected to rise, a long straddle or strangle position is established. A short straddle or strangle position is taken if VKOSPI is expected to fall tomorrow. Total profit is calculated as the cumulative sum of the VKOSPI percentage change. If forecasted direction is correct, the absolute value of the VKOSPI percentage changes is added to trading profit. It is subtracted from the trading profit if forecasted direction is not correct. For the in-sample period, the power ARCH model best fits in a statistical metric, Mean Squared Prediction Error (MSPE), and the exponential GARCH model shows the highest Mean Correct Prediction (MCP). The power ARCH model best fits also for the out-of-sample period and provides the highest probability for the VKOSPI change direction tomorrow. Generally, the power ARCH model shows the best fit for the VKOSPI. All the GARCH models provide trading profits for volatility trading system and the exponential GARCH model shows the best performance, annual profit of 197.56%, during the in-sample period. The GARCH models present trading profits during the out-of-sample period except for the exponential GARCH model. During the out-of-sample period, the power ARCH model shows the largest annual trading profit of 38%. The volatility clustering and asymmetry found in this research are the reflection of volatility non-linearity. This further suggests that combining the asymmetric GARCH models and artificial neural networks can significantly enhance the performance of the suggested volatility trading system, since artificial neural networks have been shown to effectively model nonlinear relationships.

• Journal of Intelligence and Information Systems
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• v.26 no.3
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• pp.149-169
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• 2020

"The Urban Renewal New Deal project", one of the government's major national projects, is about developing underdeveloped areas by investing 50 trillion won in 100 locations on the first year and 500 over the next four years. This project is drawing keen attention from the media and local governments. However, the project model which fails to reflect the original characteristics of the area as it divides project area into five categories: "Our Neighborhood Restoration, Housing Maintenance Support Type, General Neighborhood Type, Central Urban Type, and Economic Base Type," According to keywords for successful urban regeneration in Korea, "resident participation," "regional specialization," "ministerial cooperation" and "public-private cooperation", when local governments propose urban regeneration projects to the government, they can see that it is most important to accurately understand the characteristics of the city and push ahead with the projects in a way that suits the characteristics of the city with the help of local residents and private companies. In addition, considering the gentrification problem, which is one of the side effects of urban regeneration projects, it is important to select and implement urban regeneration types suitable for the characteristics of the area. In order to supplement the limitations of the 'Urban Regeneration New Deal Project' methodology, this study aims to propose a system that recommends urban regeneration types suitable for urban regeneration sites by utilizing various machine learning algorithms, referring to the urban regeneration types of the '2025 Seoul Metropolitan Government Urban Regeneration Strategy Plan' promoted based on regional characteristics. There are four types of urban regeneration in Seoul: "Low-use Low-Level Development, Abandonment, Deteriorated Housing, and Specialization of Historical and Cultural Resources" (Shon and Park, 2017). In order to identify regional characteristics, approximately 100,000 text data were collected for 22 regions where the project was carried out for a total of four types of urban regeneration. Using the collected data, we drew key keywords for each region according to the type of urban regeneration and conducted topic modeling to explore whether there were differences between types. As a result, it was confirmed that a number of topics related to real estate and economy appeared in old residential areas, and in the case of declining and underdeveloped areas, topics reflecting the characteristics of areas where industrial activities were active in the past appeared. In the case of the historical and cultural resource area, since it is an area that contains traces of the past, many keywords related to the government appeared. Therefore, it was possible to confirm political topics and cultural topics resulting from various events. Finally, in the case of low-use and under-developed areas, many topics on real estate and accessibility are emerging, so accessibility is good. It mainly had the characteristics of a region where development is planned or is likely to be developed. Furthermore, a model was implemented that proposes urban regeneration types tailored to regional characteristics for regions other than Seoul. Machine learning technology was used to implement the model, and training data and test data were randomly extracted at an 8:2 ratio and used. In order to compare the performance between various models, the input variables are set in two ways: Count Vector and TF-IDF Vector, and as Classifier, there are 5 types of SVM (Support Vector Machine), Decision Tree, Random Forest, Logistic Regression, and Gradient Boosting. By applying it, performance comparison for a total of 10 models was conducted. The model with the highest performance was the Gradient Boosting method using TF-IDF Vector input data, and the accuracy was 97%. Therefore, the recommendation system proposed in this study is expected to recommend urban regeneration types based on the regional characteristics of new business sites in the process of carrying out urban regeneration projects."

• Journal of Intelligence and Information Systems
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• v.26 no.3
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• pp.91-108
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• 2020

Korea's famous soccer players are steadily performing well in international leagues, which led to higher interests of Korean fans in the international leagues. Reflecting the growing social phenomenon of rising interests on international leagues by Korean fans, the study examined the overall consumer perception in the consumption of uniform by domestic soccer fans and compared the changes in perception following the transfers of the players. Among others, the paper examined the consumer perception and purchase factors of soccer fans shown in social media, focusing on periods before and after the recruitment of Heung-Min Son to English Premier League's Tottenham Football Club. To this end, the EPL uniform is the collection keyword the paper utilized and collected consumer postings from domestic website and social media via Python 3.7, and analyzed them using Ucinet 6, NodeXL 1.0.1, and SPSS 25.0 programs. The results of this study can be summarized as follows. First, the uniform of the club that consistently topped the league, has been gaining attention as a popular uniform, and the players' performance, and the players' position have been identified as key factors in the purchase and search of professional football uniforms. In the case of the club, the actual ranking and whether the league won are shown to be important factors in the purchase and search of professional soccer uniforms. The club's emblem and the sponsor logo that will be attached to the uniform are also factors of interest to consumers. In addition, in the decision making process of purchase of a uniform by professional soccer fan, uniform's form, marking, authenticity, and sponsors are found to be more important than price, design, size, and logo. The official online store has emerged as a major purchasing channel, followed by gifts for friends or requests from acquaintances when someone travels to the United Kingdom. Second, a classification of key control categories through the convergence of iteration correlation analysis and Clauset-Newman-Moore clustering algorithm shows differences in the classification of individual groups, but groups that include the EPL's club and player keywords are identified as the key topics in relation to professional football uniforms. Third, between 2002 and 2006, the central theme for professional football uniforms was World Cup and English Premier League, but from 2012 to 2015, the focus has shifted to more interest of domestic and international players in the English Premier League. The subject has changed to the uniform itself from this time on. In this context, the paper can confirm that the major issues regarding the uniforms of professional soccer players have changed since Ji-Sung Park's transfer to Manchester United, and Sung-Yong Ki, Chung-Yong Lee, and Heung-Min Son's good performances in these leagues. The paper also identified that the uniforms of the clubs to which the players have transferred to are of interest. Fourth, both male and female consumers are showing increasing interest in Son's league, the English Premier League, which Tottenham FC belongs to. In particular, the increasing interest in Son has shown a tendency to increase interest in football uniforms for female consumers. This study presents a variety of researches on sports consumption and has value as a consumer study by identifying unique consumption patterns. It is meaningful in that the accuracy of the interpretation has been enhanced by using a cluster analysis via convergence of iteration correlation analysis and Clauset-Newman-Moore clustering algorithm to identify the main topics. Based on the results of this study, the clubs will be able to maximize its profits and maintain good relationships with fans by identifying key drivers of consumer awareness and purchasing for professional soccer fans and establishing an effective marketing strategy.

• Journal of Korean Institute of Fire Investigation
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• v.9 no.1
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• pp.103-121
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• 2006

We are living in more comfortable circumstances with the social developments and the improvement of the standard of living, but, on the other hand, we are exposed to an increase of the occurrences of tires on account of large-sized, higher stories, deeper underground building and the use of various energy resources. The materials of the floor in a residence modern society have been going through various alterations in accordance with the uses of a residence and are now used as final goods in interioring the bottom of apartments, houses and shops. There are so many kinds of materials you usually come in contact with, but in the first place, we need to make an experiment on the spread of the fire with the hypocaust used as the floors of apartments, etc. and the floor covers you usually can get easily. We, scientific investigators, can get in contact with the accidents caused by incendiarism or an accidental fire closely connected with petroleum stuffs on the floor materials that give rise to lots of problems. on this account, I'd like to propose that we conduct an experiment on fire shapes by each petroleum stuff and that discriminate an accidental tire from incendiarism. In an investigation, it seems that finding a live coal could be an essential part of clearing up the cause of a tire but it could not be the cause of a fire itself. And besides, all sorts of tire cases or fire accidents have some kind of legislation and standard to minimize and at an early stage cope with the damage by tires. That is to say, we are supposed to install each kind of electric apparatus, automatic alarm equipment, automatic fire extinguisher in order to protect ourselves from the danger of fires and check them at any time and also escape urgently in case of fire-outbreaking or build a tire-proof construction to prevent flames from proliferating to the neighboring areas. Namely, you should take several factors into consideration to investigate a cause of a case or an accident related to fire. That means it's not in reason for one investigator or one investigative team to make clear of the starting part and the cause of a tire. accordingly, in this thesis, explanations would be given set limits to the judgement and verification on the cause of a fire and the concrete tire-spreading part through investigation on the very spot that a fire broke out. The fire-discernment would also be focused on the early stage fire-spreading part fire-outbreaking resources, and I think the realities of police tire investigations and the problems are still a matter of debate. The cause of a fire must be examined into by logical judgement on the basis of abundant scientific knowledge and experience covering the whole of fire phenomena. The judgement of the cause should be made with fire-spreading situation at the spot as the central figure and in case of verifying, you are supposed to prove by the situational proof from the traces of the tire-spreading to the fire-outbreaking sources. The causal relation on a fire-outbreak should not be proved by arbitrary opinion far from concrete facts, and also there is much chance of making mistakes if you draw deduction from a coincidence. It is absolutely necessary you observe in an objective attitude and grasp the situation of a tire in the investigation of the cause. Having a look at the spot with a prejudice is not allowed. The source of tire-outbreak itself is likely to be considered as the cause of a tire and that makes us doubt about the results according to interests of the independent investigators. So to speak, they set about investigations, the police investigation in the hope of it not being incendiarism, the fire department in the hope of it not being problems in installments or equipments, insurance companies in the hope of it being any incendiarism, electric fields in the hope of it not being electric defects, the gas-related in the hope of it not being gas problems. You could not look forward to more fair investigation and break off their misgivings. It is because the firing source itself is known as the cause of a fire and civil or criminal responsibilities are respected to the firing source itself. On this occasion, investigating the cause of a fire should be conducted with research, investigation, emotion independent, and finally you should clear up the cause with the results put together.

• Journal of the Korean Geographical Society
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• v.29 no.2
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• pp.166-182
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• 1994

Kyonggi Province in the late Chosun dynasty was a center of superior government offices including 'Han' River water-road transportation and was located in the middle of an 'X'-shaped arterial road network. Because of these reasons, Kyonggi Province had a faster inflow of commodities, informations and technics compared with the other province. At this period of time, every local 'Eup' (name of administrative district) had not been affected by their above administrative districts and had their own autonomy. For this reason, every 'Eup' could be developed as a town, even if its size was small when it had sufficient internal growing conditions. Moreover, the markets ('Si-Jon') in big towns and periodical markets which were spread over the Kyonggi Province played role of commercial functions of town. And because military bases for the defence of the royal capital in Kyonggi Province also took parts of a non-agricultural city role, Xyonggi Provinc had much more possibilities of growing as a town rather than the other provinces. The towns of the late Chosun Dynasty were, except the capital and superior administrative districts which were governed by the 'You-Su', small towns which had only about 3, 000-5, 000 people. Most of the town dewellers were local officials, nobles, merchants, craftmen and slaves. And the farmers who lived near town became a pseudo-towner through suburb agriculture. Among these people, the merchants were leaders of townization. The downtowns were affected by the landform and traffic roads. The most fundamental function of towns were administrative. The opcial's grade, which was dispatched to the local administrative district ('Kun' or 'Hyun'), was decided by the size of population and agricultural land of each county. Large county which was governed by a high ranking opcial had more possibilities to develop as a large town. Because they supervised other opcials of lower rank and obtained more land and population for the town. The phonomena of farm abandonment after the Japanese Invasion of Korea in 1592-1598 stimulated the development of towns for commercial function. The commercial functions of towns were evident in the Si-Jon or Nan-Jon (names of markets) in the big cities such as Hansung and Kaesung, meanffwhile in the local areas it was emerged in the shape of periodical market networks as allied with near markets (which were called as Jang-Si) or permanent markets which were grown up from periodical markets. These facts of commercial development induced the birth of commercial town. Kyonggi Province showed the weak points of its defense system during both wars (Japanese Invasion in 1592 and Manchu's Invasion in 1636). The government reinforced its defense system by adding 4 'You-Su-Bus' and several military bases. Each local districts ('Eup'), where Geo-Jins were established, were stimulated to be a town while Jin-Kwan system were, adjusted and enforced. Among Dok-Jins(name of solitary military bases), Youngjongjin was grown up as a large garrison town which only played a role of defense. The number of towns that took roles of non-agricultural functions in Kyonggi Province was 52. Among these towns, 29 were developed as big towns which had above 3, 000 people and most of these towns were located on the northwest-southeast axes of 'X'-shaped arterial trafic network in the Chosn Dynasty, This fact points out that the traffic road is one of the important causes of the development of towns. When we make hierarchy of the towns of Kyonggi Province according to its population and how many functions it had, we can make it as 6 grades. The virst grade town 'Hansung' was the biggest central town of administration, commerce and defdnse. The 2nd grade town includes 'Kaesung' which had historical inertia that it had been the capital of the Koryo Dynesty. The 3rd grade towns include some 'You- Su-Bus' such as Soowon, Kanghwa, Kwangju and also include Mapo, Yongsan and from this we can imagine that the commercial development in the late Chosun Dynasty extremely affected the townization. The 4th-6th grade towns had smiliar population but it can be discriminated by how many town functions it had. So the 4th grade towns were the core of administration, commerce and defense function. 5th grade towns had administrative functions and one of commercial and defense functions. 6th grade towns had only one of these functions. When we research and town conditions of each grades as the ratio of non-agricultural population, we can find out that the towns from the 1st grade to 4th grade show difference by degree of townization but from the 4th grade to 6th grade towns do not show big difference in general.

• Journal of the Korean Geographical Society
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• v.38 no.2
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• pp.312-323
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• 2003

This writer absolutely agrees with the government that regional disequilibrium is severe enough to consider moving the administrative capital. Pursuing this course solely to establish a balanced development, however, is not a convincing enough reason. The capital city is directly related to not only the social and economic situation but, much more importantly, to the domestic political situation as well. In the mid-1970s, the proposal by the Third Republic to move the capital city temporarily was based completely on security reasons. At e time, the then opposition leader Kim, Dae-jung said that establishing a safe distance from the demilitarized zone(DMZ) reflected a typically military decision. His view was that retaining the capital city close to the DMZ would show more consideration for the will of the people to defend their own country. In fact, independent Pakistan moved its capital city from Karachi to Islamabad, situated dose to Kashmir the subject of hot territorial dispute with India. It is regrettable that no consideration has been given to the urgent political situation in the Korean peninsula, which is presently enveloped in a dense nuclear fog. As a person requires health to pursue his/her dream, a country must have security to implement a balanced territorial development. According to current urban theories, the fate of a country depends on its major cities. A negligently guarded capital city runs the risk of becoming hostage and bringing ruin to the whole country. In this vein, North Koreas undoubted main target of attack in the armed communist reunification of Korea is Seoul. For the preservation of our state, therefore, it is only right that Seoul must be shielded to prevent becoming hostage to North Korea. The location of the US Armed Forces to the north of the capital city is based on the judgment that defense of Seoul is of absolute importance. At the same time, regardless of their different standpoints, South and North Korea agree that division of the Korean people into two separate countries is abnormal. Reunification, which so far has defied all predictions, may be realized earlier than anyone expects. The day of reunification seems to be the best day for the relocation of the capital city. Building a proper capital city would take at least twenty years, and a capital city cannot be dragged from one place to another. On the day of a free and democratic reunification, a national agreement will be reached naturally to find a nationally symbolic city as in Brazil or Australia. Even if security does not pose a problem, the governments way of thinking would not greatly contribute to the balanced development of the country. The Chungcheon region, which is earmarked as the new location of the capital city, has been the greatest beneficiary of its proximity to the capital region. Not being a disadvantaged region, locating the capital city there would not help alleviate regional disparity. If it is absolutely necessary to find a candidate region at present, considering security, balanced regional development and post-reunification scenario of the future, Cheolwon area located in the middle of the Korean peninsula may be a plausible choice. Even if the transfer of capital is delayed in consideration of the present political conflict between the South and the North Koreas, there is a definite shortcut to realizing a balanced regional development. It can be found not in the geographical dispersal of the central government, but in the decentralization of power to the provinces. If the government has surplus money to build a new symbolic capital city, it is only right that it should improve, for instance, the quality of drinking water which now everyone eschews, and to help the regional subway authority whose chronic deficit state resoled in a recent disastrous accident. And it is proper to time the transfer of capital city to coincide with that of the reunification of Korea whenever Providence intends.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.472-480
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• 1998

We reviewed the surgical results of intracardiac lateral tunnel Fontan procedure for the repair of functional single ventricles. Between 1990 and 1996, 104 patients underwent total cavopulmonary anastomosis. Patients' age and body weight averaged 35.9(range 10 to 173) months and 12.8(range 6.5 to 37.8) kg. Preoperative diagnoses included 18 tricuspid atresias and 53 double inlet ventricles with univentricular atrioventricular connection and 33 other complex lesions. Previous palliative operations were performed in 50 of these patients, including 37 systemic to pulmonary artery shunts, 13 pulmonary artery bandings, 15 surgical atrial septectomies, 2 arterial switch procedures, 2 resections of subaortic conus, 2 repairs of total anomalous pulmonary venous connection and 1 Damus-Stansel-Kaye procedure. In 19 patients bidirectional cavopulmonary shunt operation was performed before the Fontan procedure and in 1 patient a Kawashima procedure was required. Preoperative hemodynamics revealed a mean pulmonary artery pressure of 14.6(range 5 to 28) mmHg, a mean pulmonary vascular resistance of 2.2(range 0.4 to 6.9) wood-unit, a mean pulmonary to systemic flow ratio of 0.9(range 0.3 to 3.0), a mean ventricular end-diastolic pressure of 9.0 (range 3.0 to 21.0) mmHg, and a mean arterial oxygen saturation of 76.0(range 45.6 to 88.0)%. The operative procedure consisted of a longitudinal right atriotomy 2cm lateral to the terminal crest up to the right atrial auricle, followed by the creation of a lateral tunnel connecting the orifices of either the superior caval vein or the right atrial auricle to the inferior caval vein, using a Gore-Tex vascular graft with or without a fenestration. Concomitant procedures at the time of Fontan procedure included 22 pulmonary artery angioplasties, 21 atrial septectomies, 4 atrioventricular valve replacements or repairs, 4 corrections of anomalous pulmonary venous connection, and 3 permanent pacemaker implantations. In 31, a fenestration was created, and in 1 an adjustable communication was made in the lateral tunnel pathway. One lateral tunnel conversion was performed in a patient with recurrent intractable tachyarrhythmia 4 years after the initial atriopulmonary connection. Post-extubation hemodynamic data revealed a mean pulmonary artery pressure of 12.7(range 8 to 21) mmHg, a mean ventricular end-diastolic pressure of 7.6(range 4 to 12) mmHg, and a mean room-air arterial oxygen saturation of 89.9(range 68 to 100) %. The follow-up duration was, on average, 27(range 1 to 85) months. Post-Fontan complications included 11 prolonged pleural effusions, 8 arrhythmias, 9 chylothoraces, 5 of damage to the central nervous system, 5 infectious complications, and 4 of acute renal failure. Seven early(6.7%) and 5 late(4.8%) deaths occured. These results proved that the lateral tunnel Fontan procedure provided excellent hemodynamic improvements with acceptable mortality and morbidity for hearts with various types of functional single ventricle.

• 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.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.275-286
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• 2001

Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.