• Journal of Chest Surgery
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• v.29 no.11
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• pp.1212-1217
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• 1996

From Dec. 1993 to May 1995, 9 male and 5 female patients ranging in age from 25 to 65 years, were operated on for ascending aorta and/or aortic arch diseases. Six patients had acute aortic dissection, type A(ruptured in 4 cases); four had ruptured ascending aortic aneurysm; three had annuloaortic ectasia(ruptured in 1 cases); one had aortic arch aneurysm. The diagnostic procedures were echo cardiography and dynamic CT scan in all patients having acute dissection or rupture. The aortic angiography was performed in two cases. Indications for operations were rupture in five cases, acute aortic dissection in five cases, severe congestive heart failure in two cases, progressive aortic insufficiency in one case and impending rupture in one case. The emergent repair was performed in ten cases(71%). The surgical treatment consisted of 6 Cabrol operations, a Cabrol operation combined with arch replacement, a modified Bentall operation, 4 replacement of ascending aorta, a replacement of aortic arch, and a replacement of ascending aorta and aortic arch. Complications were a hypoxic encephalopathy, two atrial fibrillations, a sternal deheiscence, and a mediastinitis. Two early mortality(14%) were due to intractable bleeding and multiple organ failure, and one late mortality(7%) was due to ventricular arrhythmia. In eleven survivors, follow-up period was from 2 months to 12 months and the course was uneventful.

• Journal of Chest Surgery
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• v.25 no.5
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• pp.494-503
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• 1992

The durability of the xenograft cardiac substitute valves is of a great concern on the clinical grounds. Four groups of tc tal and consecutive patients to the end of study operated on between 1976 and 1984 were Group ISM, 291 patients of MVR, ISA, 65 patients of AVR, and ISMA, 107 patients of MVR+AVR with the standard Ionescu-Shiley bovine pericardial valve, and H, 163 patients of valve replacement with the Hancock porcine aortic vlave. Operative mortality was 5.2%[ISM], 10.8%[ISA], 7.5%[ISMA] and 6.1%[H]. Early survivors were followed up for a total of 1148.3 patient-years[pt-yrs] [ISM], 271.2 pt-yrs [ISA], 488.1 pt-yrs[ISMA] and 822.9 pt-yrs[H]. Linearized late mortality was 2.1% /pt-yr [ISM], 1.l%/pt-yr[ISA], 1.8%/pt-yr[ISMA] and 1.8% /pt-yr[H]. Thromboembolic complication was experienced at the linearized rate of 1.045% /pt-yr [ISM], 1.475%/pt-yr[ISA], 0.615%/pt-yr[ISMA] and 1.822%/pt-yr[H], and bleeding complication at the rate of 0.871% /pt-yr[ISM], 0.63% /pt-yr[ISA], 0.205% /pt-yr [ISMA] and 0.729%a /pt-yr[H], respectively. Prosthetic valve endocarditis occurred at the rate of 0.610% /pt-yr[ISM], 1.475% /pt-yr[ISA], 1.639% /pt-yr[ISMA] and 0.972% /pt-yr[H]. The linearized annual incidence of primary tissue failure was 1.655%/pt-yr[ISM], l. 475%/pt-yr[ISA], 1.639% /pt-yr[ISMA], 2.187% /pt-yr[H] and 1.785% /pt-yr[Group HM : MVR with Hancock valve]. The incidence of tissue failure was significantly high in the patients younger than 30 years of age compared with the older patients. The actuarial survival was 87.7$\pm$2.5% at 10 years[ISM], 94.3$\pm$3.2% at 11 years[ISA], 89.6$\pm$3.4% at 10 years[ISMA] and 81.3$\pm$6.6% at 12 years[HM], The freedom from thromboembolism was 93.2$\pm$2.0% at 10 years[ISM], 90.6$\pm$4.6% at 11 years[ISA], 95.8$\pm$2.6% at 10 years[ISMA] and 80.9$\pm$11.1% at 12 years[HM], And, the freedom from primary tissue failure was 84.2$\pm$3.8% and 28.1$\pm$23.0% at 9 and 10 years[ISM], 60.4$\pm$16.9% at 11 years[ISA], 62.3$\pm$12.7 at 10 years[ISMA] and 65.6$\pm$9.8% at 12 years[HM]. In conclusion, the standard Ionescu-Shiley and the Hancock bioprosthetic valves are excellent in their antithrombogenicity and long-term survival. However, the features of the structural failure with the prolonged follow-up beyond 10 years appear to be guarding, and the clinical indications of these bioprostheses seem to be quite limited.

• Journal of Chest Surgery
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• v.44 no.5
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• pp.332-337
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• 2011

Background: The optimal timing of surgery for infective endocarditis complicated by embolic stroke is unclear. We compared early versus delayed surgery in these patients. Materials and Methods: Between 1992 and 2007, 56 consecutive patients underwent open cardiac surgery for the treatment of infective endocarditis complicated by acute septic embolic stroke, 34 within 2 weeks (early group) and 22 more than 2 weeks (delayed group) after the onset of stroke. Results: The mean age at time of surgery was $45.7{\pm}14.8$ years. Stroke was ischemic in 42 patients and hemorrhagic in 14. Patients in the early group were more likely to have highly mobile, large (>1 cm in diameter) vegetation and less likely to have hemorrhagic infarction than those in the delayed group. There were two (3.7%) intraoperative deaths, both in the early group and attributed to neurologic aggravation. Among the 54 survivors, 4 (7.1%), that is, 2 in each group, showed neurologic aggravation. During a median follow-up of 61.7 months (range, 0.4~170.4 months), there were 5 late deaths. Overall 5-year neurologic aggravation-free survival rates were $79.1{\pm}7.0%$ in the early group and $90.9{\pm}6.1%$ in the delayed group (p=0.113). Conclusion: Outcomes of early operation for infective endocarditis in stroke patients were similar to those of the conventional approach. Early surgical intervention may be preferable for patients at high risk of life-threatening septic embolism.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.325-331
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• 1991

Treatment results of 28 patients with Wilms' tumor who received radiation therapy at the Department of Therapeutic Radiology, Seoul National University Hospital from 1979 to 1988 were analyzed. The median follow-up period for the survivors was 40 months. The local control and overall survival rate at 3 years were 78.1$\%$ and 67.4$\%$, respectively. The local control was not affected by age. The local control rates for favorable histology (FH) and unfavorable histology (UH) were 83.3$\%$ and 62.5$\%$, respectively. In FH, the local control rates of stage II and III were not different ($83.3\%\;vs\;100.0\%$). In UH, the control rates of stage I/II and stage III were 83.3$\%$ and 0$\%$, respectively. Poor local control was correlated with involvement of lymph node ($50.0\%\;vs\;87.5\%$). Radiotherapy delayed 10 or more days after operation resulted in poorer local control than that without delay (p<0.05). Thus radiotherapy contributed to reduction of local recurrence in patients with high risk factor without increased severe complication. It is suggested that bulky unresectable mass might need a more intensified treatment.

• Asia pacific journal of information systems
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• v.23 no.2
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• pp.67-86
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• 2013

This study first provides a stylized model that captures the essential features of the SC (Social Commerce) business and the competition process. The model focuses on the relationship between key decision issues such as marketing inputs and market value. As more SCs join the industry, they are inevitably faced with fierce competition, which may lead to sharp increase in the total marketing and advertising expenditure. This type of competition may lead the industry away from its optimal development path, and at worst, toward a disruption of the entire industry ecosystem. Such being the case, another goal of this study is to examine the possibility that the ToC (Tragedy of the Commons) may occur in the SC industry. We build game models, each of which assumes homogeneity and heterogeneity of SC providers, respectively, and derive explicit equilibrium solutions from both models. Our basic analysis presents Nash equilibria in both models and shows that SC providers are inevitably faced with fierce competition, which may lead to sharp increase in the total marketing expenses. We also compare the game outcomes with one with a hypothetical social planner who determines the total marketing level that optimizes the entire market value. Then, ToC can be defined to describe the situation where the total marketing efforts exceed the socially optimal level of marketing efforts. In both models, we examine the possibility of the ecosystem disruption and specify the conditions under which ToC may occur. However, the chance of avoiding ToC is higher with heterogeneous players than with homogeneous players. To supplement our analytical results, we develop a simulation model which incorporates a market dynamics based on the gap between actual marketing efforts and socially optimal marketing level. Simulation experiments present some lessons and insights which also confirm out findings from equilibrium analysis. For example, heterogeneity in SC providers alleviates the severity of ToC and makes it faster for survivors to escape from the ToC trap. As a result, the degree of industrial concentration tends to increase, which also explains the 'rich-get-richer' phenomenon observed in some empirical studies on the SC industry. Lastly, based on our analytical and experimental results, we come up with some measures to avoid ToC and overcome the shortcomings intrinsic to the current business model. And further discussions provide strategic implications and policy directions to overcome the possible trap of ToC in this ecosystem, and eventually help the industry to sustainably develop itself toward the next level. To name a few examples of policy measures, regulations on the marketing activities so that the overall marketing expenses cannot go beyond the socially optimal level; institutional guidelines and rules to straightening up the distortions in the way that SC providers view the marketing costs (the current marketing costs are underestimated, thereby encouraging SC providers to increase marketing expenditure); and so on.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.31 no.4
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• pp.560-566
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• 1998

The bacteriocin produced by Lactobacillus sp. GM7311 showed strong inhibitory activity against the growth of three Gram positive bacteria, Listeria monocytogenes, Bacillus subtilis, and Staphylococcus aureus. When the bacteriocin was added to the culture at different phases, viable cells of all of the tested strains were decreased, although the most inhibited phase was different. Thereby, when the bacteriocin $(100\;Bu/m{\ell})$ was added to exponential and stationary phase of L. monocytogenes, the rapid reduction of viable cell counts occured. And, in the case of B. subtilis, the highest inhibitory effect occured at lag phase and mid-exponential phase by the addition of the bacteriocin under same condition as mentioned above. Also, we can observe the accelerated reduction of survivors counts for the all of the phase except stationary phase in the S. auresus. Transmission electron microscopic observation of L. monocrogenes and B. subtilis treated with bacteriocin revealed apparent Iysis of the cell wall and excretion of the cell contents, indicating bacteriolysis. Also, the amino acids and fatty acids compositions were different from controls. However, the Iysis of cell wall didn't occur in S. aureus, though the cytoplasmic materials were reduced. This result indicates that the bacteriocin inhibits the synthesis of nuclear materials such as DNA, RNA and proteins.

• Journal of Trauma and Injury
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• v.28 no.2
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• pp.60-66
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• 2015

Purpose: Cultivator accidents are frequent and often lead to abdomino-perineal organ injury and, if severe, to death. This study presents the clinical characteristics, outcomes, and factors associated with mortality in patients who sustained an abdomino-perineal organ injury in cultivator accidents. Methods: We retrospectively analyzed the records of 53 patients who visited the emergency department of a tertiary hospital with abdomino-perineal organ injuries caused in cultivator accidents from April 2005 to March 2010. Results: All 53 patients had visited other medical institutions before visiting our hospital. Their mean age was $64.0{\pm}11.1$ (range, 20-80) years and 32 (60.4%) patients were 65 or older. The male-to-female ratio was 46:7. The chief complaint was abdominal pain (38 cases, 71.7%). The 53 patients included 41 cultivator operators (77.4%), 11 passengers (20.8%), and 1 passerby (1.9%). The causes of the injuries included a direct impact of the handlebar in 20 cases (37.7%), a rollover in 21 cases (39.6%), a fall in 10 cases (18.9%), and a wheel in two cases (3.8%). Several of the 53 patients had injuries to multiple abdomino-perineal organs, and the injured organs included the liver (23 cases, 26.4%), spleen (16 cases, 18.4%), pancreas (7 cases, 8.0%), small bowel (7 cases, 8.0%), mesentery (6 cases, 6.9%), adrenal gland (5 cases, 5.8%), and other organs. According to the abbreviated injury scale (AIS) dictionary, a thoracic injury was the most frequent co-injury (33 of 53 cases, 62.3%). Abdomino-perineal surgery was performed in 31 cases (58.8%) and angio-embolization was performed for six liver and two kidney injuries. Thirteen patients died (24.5%); all were males. The Injury Severity Scale (ISS) was lower in the survivors ($17.8{\pm}8.5$ vs. $27.0{\pm}16.0$; p=0.010). Conclusion: With the aging of agricultural workers, safety education programs should be implemented. Furthermore, the patient transfer system in agricultural areas must be improved.

• Acute and Critical Care
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• v.33 no.4
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• pp.246-251
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• 2018

Background: Target temperature management (TTM) improves neurological outcomes for comatose survivors of out-of-hospital cardiac arrest. We compared the efficacy and safety of a gel pad cooling device (GP) and a water blanket (WB) during TTM. Methods: We performed a retrospective analysis in a single hospital, wherein we measured the time to target temperature ($<34^{\circ}C$) after initiation of cooling to evaluate the effectiveness of the cooling method. The temperature farthest from $33^{\circ}C$ was selected every hour during maintenance. Generalized estimation equation analysis was used to compare the absolute temperature differences from $33^{\circ}C$ during the maintenance period. If the selected temperature was not between $32^{\circ}C$ and $34^{\circ}C$, the hour was considered a deviation from the target. We compared the deviation rates during hypothermia maintenance to evaluate the safety of the different methods. Results: A GP was used for 23 patients among of 53 patients, and a WB was used for the remaining. There was no difference in baseline temperature at the start of cooling between the two patient groups (GP, $35.7^{\circ}C$ vs. WB, $35.6^{\circ}C$; P=0.741). The time to target temperature (134.2 minutes vs. 233.4 minutes, P=0.056) was shorter in the GP patient group. Deviation from maintenance temperature (2.0% vs. 23.7%, P<0.001) occurred significantly more frequently in the WB group. The mean absolute temperature difference from $33^{\circ}C$ during the maintenance period was $0.19^{\circ}C$ (95% confidence interval [CI], $0.17^{\circ}C$ to $0.21^{\circ}C$) in the GP group and $0.76^{\circ}C$ (95% CI, $0.71^{\circ}C$ to $0.80^{\circ}C$) in the WB group. GP significantly decreased this difference by $0.59^{\circ}C$ (95% CI, $0.44^{\circ}C$ to $0.75^{\circ}C$; P<0.001). Conclusions: The GP was superior to the WB for strict temperature control during TTM.

• Korean Journal of Social Welfare Studies
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• v.49 no.1
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• pp.109-132
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• 2018

This study investigated the impact of the secondary trauma stress experienced by workers who support sexual violence victims on occupational stress level, and verified the moderating effect of the job education from support facilities in this relationship. The data analyzed in this study were sampled from "The Primary Study on The Development of Training Program to Cultivate Professional Workers of Support Organizations for Sexual Violence Survivors" as a secondary data and 482 nationwide workers were selected. By applying SPSS PROCESS macro, the moderation model was analyzed. The analysis results are as follows. First, sexual violence victim support workers' secondary trauma stress has a significantly influence on occupational stress level of workers. Second, the job education from support agencies themselves moderates the relationship between the secondary trauma stress and occupational stress level of support agents. It also showed that the higher level of job education participates, the less the experience of being stressed on the job. Thus, on the basis of the result, the theoretical discussion on the secondary trauma stress and occupational stress level of sexual violence victim support worker was drawn out and the empirical implication on the direction of the education for job related was suggested.

• Clinical and Experimental Reproductive Medicine
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• v.45 no.3
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• pp.143-148
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• 2018

Objective: The favored method of preserving fertility in young female cancer survivors is cryopreservation and autotransplantation of ovarian tissue. Reducing hypoxia until angiogenesis takes place is essential for the survival of transplanted ovarian tissue. The aim of this study was to investigate the role of angiopoietin-1 (Angpt-1), angiopoietin-2 (Angpt-2), and vascular endothelial growth factor (VEGF) in ovarian tissue grafts that were cryopreserved using two methods. Methods: Ovarian tissues harvested from ICR mice were divided into three groups: group I (control), no cryopreservation; group II, vitrification in EFS (ethylene-glycol, ficoll, and sucrose solution)-40; and group III, slow freezing in dimethyl sulfoxide. We extracted mRNA for VEGF, Angpt-1, and Angpt-2 from ovarian tissue 1 week following cryopreservation and again 2 weeks after autotransplantation. We used reverse transcriptase-polymerase chain reaction to quantify the levels of VEGF, Angpt-1, and Angpt-2 in the tissue. Results: Angpt-1 and Angpt-2 expression decreased after cryopreservation in groups II and III. After autotransplantation, Angpt-1 and Angpt-2 expression in ovarian tissue showed different trends. Angpt-1 expression in groups II and III was lower than in group I, but Angpt-2 in groups II and III showed no significant difference from group I. The vitrified ovarian tissues had higher expression of VEGF and Angpt-2 than the slow-frozen ovarian tissues, but the difference was not statistically significant. Conclusion: Our results indicate that Angpt-2 may play an important role in ovarian tissue transplantation after cryopreservation although further studies are needed to understand its exact function.