Purpose : The incidence of esophageal carcinoma is increasing. Radical surgery is the treatment of choice, but large proportion of the esophageal cancer patients are with unresectable disease at the time of initial diagnosis, so radiation therapy has been the major treatment modality. We carried out retrospective analysis to see the outcome and prognostic factors of radiation therapy alone for esophageal carcinoma. Methods and Materials : From June of 1979 through December 1992, 289 patients with esophageal carcinoma were treated with radiation therapy alone at Department of Therapeutic Radiology, Seoul National University Hospital. Of these patients, 84 patients were excluded as they were ineligible for the current analyses. Twenty-two patients had distant metastasis other than supraclavicular lymph node metastasis, 52 patients received less than 45 Gy, and 10 patient were lost from follow-up. Therefore 205 patients constituted the base population of this study. According to AJCC s1aging system, there were 2 patients with stage 1, 104 with stage IIA, 26 with stage IIB, 48 with stage III, and 25 with stage IV Radiation dose ranged from 4500 cGy to 6980 cGy with median dose of 5940 cGy. Follow-up period of the alive patients ranged from 77 to 180 months. Results : The Median survival period of all the patients was II months and the 2-, 5-, and 10-year overall survival rates were 22.4$\%$, 10.2$\%$ and 5.3$\%$, respectively. Most of the failures were local recurrences. Of 169 failures, 134 had local failure as a component and 111 had local recurrence only. The Lymph node was most common distant metastatic site and the next was the lung. The stage, T-stage, N-stage, functional status, tumor size, and aim of treatment were statistically significant prognostic factors for survival by univariate analyses. But only tumor size and N-stage were significant by multivariate analyses. Conclusion : We could get 10.2$\%$ of 5 year survival rate and 5.3$\%$ of 10 year survival rate with radiation therapy alone. The size of tumor and N-stage were statistically significant prognostic factors for survival on multivariate analyses.
Lee Hyun Joo;Suh Hyun Suk;Kim Jun Hee;Kim Chul Soo;Kim Sung Rok;Kim Re Hwe
Radiation Oncology Journal
/
v.14
no.1
/
pp.17-23
/
1996
Purpose : To evaluate the role of combination therapy of external radio-therapy and chemotherapy in the management of advanced esophageal cancer as a primary treatment compared with radiation therapy alone. Materials and Methods : A retrospective review of evaluable 55 esophageal cancer patients referred to the Department of Therapeutic Radiology, Paik Hospital for the external radiotherapy between Jul, 1983 and Dec. 1994 was undertaken. Combined therapy patients (A group) were 30 and radiation alone patients (B group) were 25. Median age was 60 years old in A group (ranges : 42-81) and 65 years old in B group (ranges : 50-81). The male patients were 53. The fifty patients had squamous cell carcinomas. Radiation doses of 2520-6480c0y were delivered over a period of 4-7weeks, using 4MV LINAC. Chemotherapy was administered in bolus injection before, after, or during the course of external radiotherapy. The local control rate and patterns of failure according to both treatment modalities and 1, 2 year survival rates according to prognostic factors (stage, tumor length, radiation dose etc.) were analysed. Resuts : Median follow up Period was 7 months (range : 2-73 months). Median survival was 7.5 months (20 days-29 months) in A group and 5 months (20 days-73 months) in B group. The 1, 2 YSRs were $26.7\%$, $8.9\%$ in A group, $12.7\%$, $4.3\%$ in B group (p>0.05), respectively. The 1, 2 YSRs according to stage(II/III), tumor length (5cm more or less). radiation dose (5000cGymore or less) of A and B group were analyzed and the differences of survival rates of both treatments were not statistically significant. But among group B, patients who received 5000cGy or more showed significant survival benefits (p<0.05). The treatment response rates of A and B group were $43.8\%$. $25.0\%$, respectively. Complete response rate of $25.0\%$ in A and $8.3\%$ in B were achieved. The local failure and distant metastsis were $52.4\%$. $23.8\%$ in A group, $64.3\%$, $14.3\%$ in 8 group, respectively. The combination therapy revealed more frequent leukopenia and nausea/vomiting than radiation alone group, but degree of side effects was only mild to moderate. Conclusion : The combined external radiotherapy and chemotherapy for advanced esophageal cancer appears to improve the response rate, local control rate and survival rate, but the improvement was not statistically significant. The side effects of combined modalities were mild to moderate without significant morbidity. Therefore it may be worthwhile to continue the present combined external radiotherapy and chemotherapy in the management of advanced esophageal cancer to confirm our result.
After the first opening of the KTX in April 2004, travel time between major cities has been dramatically reduced. The reduction rates range from 32% to 47%. Considering travel time reduction between major cities, this study concerned about the intercity travel impact of the KTX operation. This study aimed to analyze intercity mode choice behavior of Daegu Citizens according to the first opening of the KTX. This study takes place in two sections. These are (i) the section of KTX between Daegu and Seoul, and (ii) the section of KTX between Daegu and Daejeon. This study estimated empirical models for analyzing intercity mode choice behavior according to the first opening of the KTX. This study makes use of the data from travel survey from Daegu metropolitan area. The main part of the survey was carried out in the KTX Dong-Daegu station. The survey data includes the information on travel from Daegu to Daejeon and from Daegu to Seoul. In order to analyze intercity choice behavior according to the frist opening of the KTX, multinomial model structure is used. For the model specification, a variety of behavioral assumptions about the factors which affect the mode choice, were considered. From the empirical model estimation, it is found that OVTT(Out-of-Vehicle Travel Time), OVTC(Out-of-Vehicle Travel Cost), IVTT(In-Vehicle Travel Time), IVTC(In-Vehicle Travel Cost), travel frequency, travel purpose, sex, age, occupation. household income, individual income are significant in choosing intercity travel mode. However, it is found that the intercity nde choice behavior is different between (i) the section of KTX between Daegu and Seoul, and (ii) the section of KTX between Daegu and Daejeon. Furthermore, some policy implications are discussed in conclusion.
Journal of The Korean Society of Grassland and Forage Science
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v.11
no.4
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pp.252-257
/
1991
In a two-year's field experiment, the effectiveness of magnesium-and boron-enriched complex fertilizer (CF, N-P$_2$O$_{5}$-K$_2$O-MgO-B$_2$O$_3$: 14-10-12-3-0.2) on the maintenance and management of hilly pasture was studied. The effects of CF and some straight fertilizers (SF) on forage yields, yield components, and chemical compositions were compared in a mixed grass-clover (orchardgrass, tall fescue, kentucky bluegrass, and ladino clover) and a pure grass (orchardgrass) swards. The results are summarized as follows: 1. Considerably higher average dry matter yields were obtained in the CF plots than in the SF plots. In the mixed sward, the yields of whole mixed forages were inclosed by 10.8-14.5%, grasses by 11%, and legume by 21.5-31.0% by the use of the CF over the use of SF. In the pure grass sward, the yield of grasses was increased by 7.0-21.8%. 2. The rates of yield increase due to the application of CF were dependent on such factors as types of sward (pure or mixed), application rates of NPK, and forage species. The increase of forage yields due to the CF was greater at the normal rate of NPK application than at lower application rate, and in legume forage than in grass forage. 3. The crude fiber, crude fat and NFE contents of forages were not significantly changed by different treatments. However, the forage of CF plot at the normal application rate of NPK contained relatively higher amount of crude protein and crude fat compared with the forages of other plots. 4. There were no significant differences in the contents of mineral nutrients in forages among the different treatments. In spite of the application of Mg-enriched CF, the contents of Mg in soils and forages were below the optimum level.
Park, Yeon-Jeong;Lee, Hae-Jin;Seo, Jung-Kwan;Tak, Bo-Mi;Jeong, Hyun-Gi;Lee, Jae-Kwan
Korean Journal of Environmental Biology
/
v.29
no.4
/
pp.296-304
/
2011
This study was carried out to investigate the relation between water quality and structure of the aquatic ecosystem in the Lake Gachang from February to December in 2010. The annual mean COD (Chemical Oxygen Demand) in Lake Gachang was 3.5 mg $L^{-1}$, indicating, level II of environmental standards and the trophic state was mesotrophic. The seasonal succession of phytoplankton showed that Bacillariophyceae was mostly dominant species throughout the year except August. In case of zooplankton, rotifers dominate in the most seasons, but copepod (Nauplii) in August. The macrophyte plants showed diverse species composition consisted of 9 varieties, 77 species, 64 genera, 34 families and 24 orders. Surveyed species of macroinvertebrates were classified into 1 phyla, 2 classes, 4 orders, 7 families, 9 species. The macroinvertebrates showed FFG (Functional Feeding Groups) such as GC (Gathering-Collector) and SH (Shedder). A total of 42 species of fish was collected including $Zacco$$koreanus$ and $Coreoperca$$herzi$. In this study, we investigated environmental factors including pollutant source, load, water quality and distribution characteristics of biota such as phytoplankton, zooplankton, macrophyte plants, macroinvertebrates, fish.
The precise role of radiotherapy for low grade gliomas including the optimal radiation dose and timing of treatment remains unclear. The information given by a retrosepctive analysis may be useful in the design of prospective randomized studies looking at radiation dose and time of surgical and radiotherapeutic treatment. The records of 56 patients (M:F = 29:27) with histologically verified cerebral low grade gliomas (47 cases of grade 1 or 2 astrocytomas and 9 oligodendrogliomas) diagnosed between 1979 and 1989 were retrospectively reviewed. The extent of surgical tumor removal was gross total or radical subtotal in 38 patients ($68\%$) and partial or biopsy only in the remaining 18 patients ($32\%$). Postooperative radiation therapy was given to 36 patients ($64\%$) of the total 56 patients with minimum dose of 5000 cGy (range=1250 to 7220 cGy). The 5-and 10-year survival rates for the total 56 patients were $44\%$ and $32\%$ respectively with a median survival of 4.1 years. According to the histologic grade the 5- and 10-year survivals were $52\%$ and $35\%$ for the 24 patients respectively with grade I astrocytomas compared to $20\%$ and $10\%$ for the 23 patients with grade II astrocytomas. Survival of oligodendroglioma patients was greater than those with astrocytoma ($65\%$ vs $36\%$ at 5 years), and the difference was also remarkable in the long term period of follow up ($54\%$ vs $23\%$ at 10 years). Those who received high-dose radiation therapy ($\geq$5400 cGy) had significant better survival than those who received low-dose radiation (< 5400cGy) or surgery alone (p<0.05). The 5- and 10-year survival rates were, respectively $59\%$ and $46\%$ for the 23 patients receiving high-dose radiation, $36\%$ and $24\%$ for the 13 patients receiving low-dose radiation, and $35\%$ and $26\%$ for the 20 patients with surgery alone. Survival rates by the extent of surgical resection were similar at 5 years ($46\%$ vs $41\%$), but long term survival was quite different (p<0.01) between total/subtotal resection and partial resection/biopsy ($41\%$ and $12\%$, resepctively). Previously published studies have identified important prognostic factors in these tumor: age, extent of surgery, grade, performance status, and duration of symptoms. But in our cases statistical analysis revealed that grade I histology (p<0.025) and young age (p<0.001) were the most significant good prognostic variables.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.14
no.1
/
pp.81-94
/
2003
Objectives:Developmental reading disorder is a condition which manifests significant developmenttal delay in reading ability or persistent errors. About 3-7% of school-age children have this condition. The purpose of the present study was to validate the diagnostic values of Word/Nonword Reading Test and Letter-Symbol Discrimination Task for the purpose of overcoming the caveats of Basic Learning Skills Test. Methods:Sixty-three reading-disordered patients(mean age 10.48 years old) and sex, age-matched 77 normal children(mean age 10.33 years old) were selected by clinical evaluation and DSM-IV criteria. Reading I and II of Basic Learning Skills Test, Word/Nonword Reading Test, and Letter-Symbol Discrimination Task were carried out to them. Word/Nonword Reading Test:One hundred usual highfrequency words and one hundred meaningless nonwords were presented to the subjects within 1.2 and 2.4 seconds, respectively. Through these results, automatized phonological processing ability and conscious letter-sound matching ability were estimated. Letter-Symbol Discrimination Task:mirror image letters which reading-disordered patients are apt to confuse were used. Reliability, concurrent validity, construct validity, and discriminant validity tests were conducted. Results:Word/Nonword Reading Test:the reliability(alpha) was 0.96, and concurrent validity with Basic Learning Skills test was 0.94. The patients with developmental reading disorders differed significantly from normal children in Word/Nonword Reading Test performances. Through discriminant analysis, 83.0% of original cases were correctly classified by this test. Letter-Symbol Discrimination Task:the reliability(alpha) was 0.86, and concurrent validity with Basic Learning Skills test was 0.86. There were significant differences in scores between the patients and normal children. Factor analysis revealed that this test were composed of saccadic mirror image processing, global accuracy, mirror image processing deficit, static image processing, global vigilance deficit, and inattention-impulsivity factors. By discriminant analysis, 87.3% of the patients and normal children were correctly classified. Conclusion:The patients with developmental reading disorders had deficits in automatized visuallexical route, morpheme-phoneme conversion mechanism, and visual information processing. These deficits were reliably and validly evaluated by Word/Nonword Reading Test and Letter-Symbol Discrimination Task.
This study was aimed at knowing the magnitude of year variation in rice heading dates under the different seasonal cultures, and to estimate the heading date in advance. Using six rice varieties such as Kwansan, Suwon#82, Suwon #144, Norin#17, Yukoo#132 and Paltal, the early, ordinary and late seasonal cultures had been carried out at Paddy Crop Division, Crop Experiment Station at Suwon for the six-year period 1959 to 1964. In addition the data of the standard rice cultures at the Provincial Offices of Rural Development for the 12-year period 1953 to 1954, were analyzed for the purpose of clarifying a relationship between variation of rice heading dates and some of meteorological data related to the locations and years. The results of this study are as follows: 1. Year variation of rice heading dates was as high as 14 to 21 days in the early seasonal culture and 7 to 14 days in the ordinary seasonal culture, while as low as one to seven days in the late seasonal culture which was the lowest among three cultures. The magnitude of variation depended greatly on variety, cultural season and location. 2. It was found out that there was a close negative correlation between the accumulated average air temperature for 40 days from 31 days after seeding and number of days to heading in the early seasonal culture. Accordingly, it was considered possible to predict the rice heading date through calculation of the accumulated average air temperature for the above period and then the linear regression(Y=a+bx). On the other hand, an estimation of the heading date in the late seasonal culture requires for the further studies. In the ordinary seasonal culture, no significant correlation between the accumulated average air temperature and number of days to heading was obtained in the six-year experiments conducted at Suwon. There was a varietal difference in relationship between the accumulated average air temperature for 70 days from seeding and number of days to heading in the standard cultures at the provincial offices of rural development. Some of varieties showed a significant correlation between two factors while the others didn't show any significant correlation. However, there was no regional difference in this relationship.
Objective : Hydrocephalus and vasospasm are the common complications following subarachnoid hemorrhage (SAH). In spite of development of perioperative management and operative technique, hydrocephalus cause neurological deficit and poor prognosis. Usually CSF drainage procedure(external ventricular drainage(EVD) or shunt) is needed in hydrocephalus following SAH. The aim of this study was to investigate whether the need for shunting and the outcome after shunting in hydrocephaus following SAH can be related to the duration, daily and total amount of cerebrospinal fluid(CSF) drainage at EVD. Material and Method : IVH is one of several factors which cause hydrocephalus. In this retrospective study, firstly we investigated the incidence of IVH in total cases and frequency of IVH according to aneurysmal site and then prognosis of IVH following SAH. Among 629 patients with SAH, hydrocephalus was diagnosed by CT scan and symptoms. And then those 102 hydrocephalus following SAH were divided into two groups which were hydrocephalus with IVH group and without IVH group. In these two groups, we investigated and compared the incidence of hydrocephalus in all case, frequency of hydrocephalus according to aneurysmal site, the outcome according to H-H grade on admission and the need rate of shunt, etc. Of those hydrocephalus, 100 EVD procedures were done. The duration, daily and total amount of CSF drainage at EVD were investigated. Fifty cases expired during EVD was excluded. We analyzed whether the need rate of shunt and the final outcome after shunting can be related to IVH, the duration and daily and total amount of CSF drainage. Result : The incidence of hydrocephalus following SAH was 20%(with IVH group ; 64%, without IVH group ; 11%). As H-H grade on admission was better, the outcome of hydrocephalus was also better. The mortality rate of hydrocephalus with IVH was 64% which was higher than 40% that of hydrocephalus without IVH. The need rate of shunt in all cases of hydrocephalus following SAH was 20%, but those with IVH group excluding expired patients before shunt was 40%. This was very similar to 41% of the need rate of shunt in hydrocephalus without IVH. The total amount of CSF drainage was statistically related to the need rate of shunt(total amount : need rate of shunt/<1000cc : 15%, 1000-2000cc : 40%, >2000cc : 50%). The duration and daily amount of CSF drainage were not statistically related to the need rate of shunt, but as daily amount of CSF drainage was more and duration was longer, the need rate of shunt was increased(daily amount : need rate of shunt /<100cc : 16%, 100-200cc : 25%, >200cc : 40%//duration : need rate of shunt/<1week : 8%, 1-2weeks : 30%, >2weeks : 47%), and also the final outcome after shunting was poor. Especially the total amount of CSF drainage was significant related to the final outcome after shunting(total amount : GOS/<1000cc : I&II(3/4), 1000-2000cc : II(2/4), III(2/4), >2000cc : III&IV(6/7)). Conclusion : This study revealed that the incidence and mortality rate of hydrocephalus following SAH were influenced by IVH. So SAH associated IVH has the higher incidence of hydrocephalus and poor outcome. As the CSF drainage amount was more and duration of drainage was longer, the need rate of shunt was increased and the final outcome after shunting was poor. Especially the total amount of CSF drainage were strongly related to the need rate of shunt and the outcome after shunting.
Kim, Hyung-Tae;Sung, Si-Chan;Kim, Si-Ho;Bae, Mi-Ju;Lee, Hyoung-Doo;Park, Ji-Ae;Chang, Yun-Hee
Journal of Chest Surgery
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v.43
no.4
/
pp.364-374
/
2010
Background: We assessed the early and mid-term results of the modified Norwood procedure for first-stage palliation of hypoplastic left heart syndrome (HLHS) and its variants to identify the risk factors for hospital mortality. Material and Method: Between March, 2003, and December, 2009, 23 patients (18 males and 5 females) with HLHS or variants underwent the modified Norwood procedure. The age at operation ranged from 3 to 60 days (mean, $11.7{\pm}13.2days$) and weight at operation ranged from 2.2 to 4.8 kg (mean, $3.17{\pm}0.52kg$). We used a modified technique that spared the anterior wall of the main pulmonary artery in 20 patients. The sources of pulmonary blood flow were RV-PA conduit in 15 patients (group I) and RMBTS in 8 (group II). Follow-up was completed in 19 patients (19/20, 95%) in our hospital (mean $26.0{\pm}22.8months$). Result: Early death occurred in 3 patients (3/23, 13%), of whom 2 had TAPVC. Fourteen patients underwent subsequent bidirectional cavopulmonary connection (BCPC, stage 2) and seven underwent the Fontan operation (stage 3). Three patients died between stages, 2 before stage 2 and one before stage 3. The estimated 1-year and 5-year survival rates were 78% and 69%, respectively. On multivariate regression analysis, aberrant right subclavian artery (RSCA) and associated total anomalous pulmonary venous connection (TAPVC) were risk factors for hospital mortality after stage 1 Norwood procedure. Conclusion: HLHS and its variants can be palliated by the modified Norwood procedure with low operative mortality. Total anomalous pulmonary venous connection adversely affects the survival after a stage 1 Norwood procedure, and interstage mortality rates need to be improved.
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