• Journal of Gastric Cancer
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• v.8 no.1
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• pp.27-34
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• 2008

Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

• The Korean Journal of Air & Space Law and Policy
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• v.31 no.1
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• pp.37-62
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• 2016

Two controversial issues exist in interpretation of "Force Majeure" set forth in the Article 931 (4) of the Korean Commercial Code. Firstly, its scope of application is ambiguous. Secondly, there is a concern that the "immunity" under paragraph 1 and "Force Majeure" may overlap each other. "Force Majeure" refers an event resulted from either natural disaster or 3rd-party. Meanwhile, the latter implies relatively extensive and comprehensive meaning and its interpretation may vary depends on law enforcement. In general, the aircraft accident hardly results in damage or loss to the 3rd-party. Additionally, it is worth to review newly enacted clause and to define its applicability. When the 3rd party is suffered from damage or loss incurred by any external act, it is necessary to explicit the concept of the non-contractual liabilities with respect to 3rd party. From the perspective of protecting aviation industries, the commercial aviation operator may be entitled to immunity in respect of claim for damage incurred by the event of Force Majeure. However, this approach is directly opposite to the victim's benefit and protection by the law. Therefore, the priority of the legal protection should be considered. Although the interest of the commercial aviation operator is not negligible, the protection of the law should be favorable to the 3rd party. Otherwise, the innocent party has no right to claim for damage incurred by aviation accident. Another issue is about the possibility of overlapping of the provision set forth in the paragraph 1 and 4. The former states that the liabilities shall be exempted on account of either the unsettled political or economic situation but this clause is inconsistent with the interpretation on Force Majeure under the latter. As argued above, this may include any event resulted from either political or economic account by the external influence of the 3rd party, thus these two provisions are overlapped. Consequently, in order to develop ordinances and guidelines and to ensure an equal protection to both parties, above two issues must remain open for further discussions.

• Journal of Gastric Cancer
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• v.7 no.4
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• pp.206-212
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• 2007

Purpose: The number of laparoscopy assisted distal gastrectomies (LADG) is gradually increasing for the treatment of early gastric cancer (EGC) patients as a surgical modality for improving quality of life. However, there are few reports on laparoscopy-assisted total gastrectomy (LATG), mainly because this procedure is performed relatively infrequently, and the procedure is more complicated than LADG. This study was performed to evaluate the technical feasibility, safety, and surgical results of LATG with lymphadenectomy through a review of our experience. Materials and Methods: From July 2003 to June 2007, 77 LATG with Roux-en-Y esophagojejunostomy were performed for patients with a preoperative diagnosis of EGC. The clinicopathological features and surgical outcomes were analyzed. Results: There were 49 males and 28 females in the study with a mean age of 61 years (range $30{\sim}85$ years). The mean operation time was 210 minutes (range $100{\sim}400$ minutes) and the operation time was gradually decreased as the case numbers increased. There were 13 operative morbidities (16.9%) and no operative mortalities. The restoration of bowel motility was noted at 3.2 postoperative days; a soft diet was started at 4.4 postoperative days and the duration of hospital stay was 10 days. There were 20 mucosal lesions, 32 submucosal lesions, 15 proper muscle lesions, 7 subserosal lesions and 3 serosal lesions. A total of 20 patients were treated by D2 lymph node dissection, 55 patients were treated by D1+$\beta$ lymph node dissection, and two patients were treated by D1+$\alpha$ lymph node dissection. The mean number of retrieved lymph nodes was 42 (range $11{\sim}86$). Lymph node metastases were noted in 12 patients. Conclusion: This study indicated LATG could be applied safely and effectively for patients with EGC. However, a prospective study comparing laparoscopy-assisted versus open gastrectomy for short-term and long-term surgical outcome is needed.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.2 no.2
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• pp.151-159
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• 1997

Benthic respiration and chemical fluxes were measured at the sediment-water interface underlying the marine fish cages floating on the open coastal waters off Tong-Young, the South Coast of Korea. The effects of cage farming on coastal benthic environment and on mass balance of organic carbon in the benthic boundary layer under the marine fish cages are addressed. In a growing season of caged fishes of June, 1995, benthic chambers and sediment traps were deployed on the sediment-water interfaces of the two sites chosen for this study: 1) Cage Site, directly underlying the fish cages of the farm at 18 m water depth, and 2) Control Site, about 100 m away from the farm at 32 m water depth. Benthic respiration rates and chemical fluxes were calculated from the evolution of dissolved oxygen and chemicals in the chamber water, and mass balance of organic carbon in the benthic boundary layer was constructed based on the vertical flux of particulate organic matter (POM) and chemical fluxes out of the sediment. High organic dumping (6400 mg C $m^{-2}d^{-1}$) and high benthic respiration (230 mmol $O_2\;m^{-2}d^{-1}$) were observed at the Cage Site. Equivalent to 40% of vertical flux of organic carbon into the Cage Site seemed to be decomposed concurrently and released back to overlying waters (2400 mg C $m^{-2}d^{-1}$). Consequently, up to 4000 mg C $m^{-2}d^{-1}$ of organic carbon could be buried into the farm sediment (equivalent to 60% of organic carbon flux into the Cage Site). At the Control Site, relatively less input of organic carbon (4000 mg C $m^{-2}d^{-1}$) and low benthic respiration rate (75 mmol $O_2\;m^{-2}d^{-1}$) were observed despite short distance away from the cages. The influence of cage farming on benthic chemical fluxes might be restricted and concentrated in the sea bottom just below the fish cages in spite of massive organic dumping and high current regime around the fish cage farm.

• Journal of Chest Surgery
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• v.35 no.7
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• pp.517-522
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• 2002

Background: Congenital heart surgery may lead to myocardial swelling and hemodynamic instability. Delayed sternal closure may be beneficial in this setting. The purpose of this study was to assess mortality and mediastinal infection rate associated with delayed sternal closure after congenital heart surgery and to evaluate the risk factors which affect mortality and mediastinal infection rate. Material and Method: We retrospectively reviewed 40 patients who underwent delayed sternal closure after repair of congenital heart disease at Yonsei Cardiovascular Hospital, from January 1994 to May 2001. In these patients, we assessed the mortality and mediastinal infection rate, and evaluated their risk factors including operation time, bypass time, aortic cross clamp time, duration to sternal closure and postoperative artificial ventilation time. Mediastinal infection was defined to have positive culture in mediastinum. Result: Hemodynamic instability was the most common indication for delayed sternal closure(n=36) and other indications included postoperative bleeding(n=2) and conduit compression(n=2). The median age at operation was $14.4{\pm}33.4$months old(range, 2days-12years). The patients with postoperative bleeding and conduit compression were much older than the others. The sternum was left open for $4.5{\pm}3.4$ days(range, 1-20days). Overall mortality was 25%(10/40) and mediastinal infection occured in 24.3%(9/37) (3 patients were excluded in mediastinal infection for early death). In risk factor analyses, only aortic cross clamp time had statistical significance for mortality in univariate analyses. However, multivariate analyses revealed that there were no significant predictors for risk of mortality and mediastinal infection. Conclusion: Delayed sternal closure after repair of congenital cardiac disease had relatively high mortality and mediastinal infection rate. But, in patients with hemodynamic instability, postoperative bleeding and conduit compression after repair of congenital cardiac disease, delayed sternal closure may be an effective life saving method.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.354-362
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• 1994

Objectives and Methods : The presence of aneuploidy or high proliferative activity in cytologic specimens is considered as complementary for the diagnosis of malignancy. To evaluate the diagnostic usefulness of DNA ploidy and cell cycle analysis in lung cancer, we compared the diagnostic yielding rates of DNA ploidy test by brushing specimens using flow cytometry with bronchoscopic forceps biopsy and brushing cytology. Results : Of the seventy-six cases, 55 cases proved to have malignant diseases(squamous cell cancer: 27, adenocarcinoma: 7, large cell cancer: 1, undifferentiated: 4 and small cell cancer: 16). The incidence of aneuploidy in lung cancer patients was 32.7%(18/55), as opposed to no cases in benign disease. And the proportion of high proliferative activity(S+G2M>22%) in lung cancer patients was 42.9%(15/35), but none in benign diseases. In fifty-six of 75 cases(74.7%), cytology of brushing specimens and DNA analysis(either aneuploidy or high proliferative activity vs. diploidy and low proliferative activity) were in concordance. The sensitivity with only brushing cytology was 41.8%(23/55), but with the addition of DNA analysis, it was increased to 56.4%(31/55), without decreasing the specificity(100%). And there was a case whose clue for malignancy was absent except aneuploidy, and he was confirmed to have squamous cell cancer following open thoracotomy. There were no differences in the frequency of aneuploidy or high proliferative activity between histologic subtypes of bronchogenic malignancy. Conclusions : The diagnostic detection rate of lung cancer was improved with the addition of DNA ploidy and cell cycle analysis, and the presence of aneuploidy or high proliferative activity was a relatively specific indicator of malignant disease. It would be useful to test DNA ploidy and cell cycle analysis with brushing specimen for the diagnosis of bronchogenic malignancy particularly in patients whose biopsy specimen could not be obtainable.

• Journal of Korean Society of Environmental Engineers
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• v.29 no.6
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• pp.647-653
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• 2007

The ultimate objective of this study is to develop a reliable oxygen-enriched combustion techniques especially for the case of the flue gas recycling in order to reduce the $CO_2$ emissions from practical industrial boilers. To this end a systematic numerical investigation has been performed, as a first step, for the resolution of the combusting flame characteristics of lab-scale LNG combustor. One of the important parameters considered in this study is the level of flue gas recycling calculated in oxygen enriched environment. As a summary of flame characteristics, for the condition of 100% pure $O_2$ as oxidizer without any flue gas recycling, the flame appears as long and thin laminar-like shape with relatively high flame temperature. The feature of high peak of flame temperature is explained by the absence of dilution and heat loss effects due to the presence of $N_2$ inert gas. The same reasoning is also applicable to the laminarized thin flame one, which is attributed to the decrease of the turbulent mixing. These results are physically acceptable and consistent and further generally in good agreement with experimental results appeared in open literature. As the level of $CO_2$ recycling increases in the mixture of $O_2/CO_2$, the peak flame temperature moves near the burner region due to the enhanced turbulent mixing by the increased amount of flow rate of oxidizer stream. However, as might be expected, the flue gas temperature decreases due to presence of $CO_2$ gas together with the inherent feature of large specific heat of this gas. If the recycling ratio more than 80%, gas temperatures drop so significantly that a steady combustion flame can no longer sustain within the furnace. However, combustion in the condition of 30% $O_2/70% $ $CO_2$ can produce similar gas temperature profiles to those of conventional combustion in air oxidizer. An indepth analyses have been made for the change of flame characteristics in the aspect of turbulent intensity and heat balance.

• Journal of the Korean Society for Marine Environment & Energy
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• v.12 no.1
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• pp.35-46
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• 2009

In order to investigate spatial and temporal distributional characteristics of major water qualities in the Saemangeum area during the Saemangeum dike construction, salinity, COD, dissolved nutrients(DIN, Silicate) and heavy metals were analyzed from the surface water collected in April, May, August and November 2002. The overall value of Salinity, COD, DIN, and silicate in surface waters were in the range of $13.08{\sim}31.96\;psu$, $0.12{\sim}3.43\;mg/L$, $0.001{\sim}2.638\;mg/L$, and $0.010{\sim}3.181\;mg/L$, respectively. The COD and DIN in each survey showed the highest concentration at the mouth of Mangyeong river estuary(St. 1) where freshwater flow into the Saemangeum area. The concentrations of nutrients were high in the inner part of the Saemangeum dike with low-salinity, and low nutrients in the outer part of the dike with high-salinity, which strongly indicated that concentrations were adjusted by physical mixing. The ranges of dissolved metals and acid-soluble Hg in surface seawater were $0.006{\sim}0.115{\mu}g/L$ for Co, $0.26{\sim}0.114{\mu}g/L$ for Ni, $0.14{\sim}0.93{\mu}g/L$ for Cu, $0.04{\sim}0.53{\mu}g/L$ for Zn, $0.010{\sim}0.043{\mu}g/L$ for Cd, $0.010{\sim}0.795{\mu}g/L$ for Pb, and $0.25{\sim}4.16{\mu}g/L$ for Hg. The highest concentrations of some metals except for Cd were found at the estuary(Sts. 1 or 3). In most cases, a decreasing order of metal concentrations towards open sea(low-salinity$\rightarrow$high-salinity) was observed and showed positive relationship with DIN and silicate caused by land base pollutants input. On the other hand, due to Cd desorption from suspended solids in saline water, dissolved Cd concentrations were high in high-salinity area and low in low-salinity. In November, Co, Zn, Cu and Pb were relatively high in the northern area of the outer-side of Saemangeum, which was only influenced by the Geum river discharge. The concentrations of most dissolved metals of this study were lower than those of the past data in this area, but higher than those in Lena river estuary under the pristine environment.

• Korean Journal of Organic Agriculture
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• v.14 no.1
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• pp.55-67
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• 2006

A survey of 31 organic farmers were conducted to investigate the actual conditions of organic matter application. The amounts of organic matter application in the fields were higher in order of fruit, vegetable and rice farm. The average was 50 ton/ha in vegetable farms. In the green vegetable farms saw dust and animal manure were mainly utilized to make compost. Rice straw, wood chip, and forest bushes were also used for composting. In the fruit vegetable farms materials relatively lower in nitrogen content such as rice straw and cattle manure were used in vegetative period and materials higher in nitrogen content such as oil cake and wild grass were used in reproductive phase. Nutrient balance investigated in the farm in Icheon region who produce lettuce, angelica, and kale continuously in one cropping year indicated surplus in three major nutrients. Nitrogen and phosphorous were in excess by 29 and 10 kg respectively in the organic rice farm in yang-pyoung region. While soil chemical properties in the organic farms are within the adequate range in open field, it is much higher than the limits in the greenhouse soils. Overall application of organic matter is in an oversupply state. This results suggested that the organic matter management should be based on the soil conditions for sustainable cultivation. Chemical composition of organic matters and soil test reports should be considered prior to the application of organic matter.

• Journal of Gifted/Talented Education
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• v.24 no.6
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• pp.1001-1024
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• 2014

The purpose of the study is to explore the experiences and meaning of the AP (Advanced Placement) at the specialized school for the highly gifted through the in-depth interview with 39 college students who had graduated from the specialized schools with the AP experiences. It is expected that the AP will be expanded to the students at the Science High Schools from the year of 2015, however, there has been no study to examine the realities of the AP in-depth especially through the voices of the AP participants. Students have taken 8 required and/or selective courses as AP in average. Students usually start to take AP from the second year of the specialized school for the highly gifted, but some start from the first year through the placement test. Numbers of available AP courses vary by subjects, but relatively more courses open in the areas of math and physics. Students' opinions regarding the AP were quite positive. Specifically, the high quality of the AP class and energetic interaction between student and teacher compared to the college classes were preferred by the students. However, it was controversial whether C+ is enough for the pass condition of the AP. Students were using the shortened time by AP in diverse ways, such as early graduation, double majors, exchange students, individual researches, and so on. Most of all, they tried to search for their career interests through the AP experiences. In closing, the present study provides some advices and future directions for the better AP management, including the improvement of administrative system between schools for the gifted and the universities, and the expansion of the number of university which approves the AP system.