• Title/Summary/Keyword: 개인적 성과

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Hyperfractionated Radiotherapy Following Induction Chemotherapy for Stage III Non-Small Cell Lung Cancer -Randomized for Adjuvant Chemotherapy vs. Observation- (절제 불가능한 제 3 기 비소세포 폐암의 MVP 복합 항암요법과 다분할 방사선 치료 -추가 항암요법에 대한 임의 선택 -)

  • Choi, Eun-Kyung;Chang, Hye-Sook;Ahn, Seung-Do;Yang, Kwang-Mo;Suh, Cheol-Won;Lee, Kyoo-Hyung;Lee, Jung, Shin;Kim, Sang-Hee;Ko, Youn-Suk;Kim, Woo-Sung;Kim, Won-Dong;Song, Koun-Sik;Sohn, Kwang-Hyun
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.295-301
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    • 1993
  • Since Jan. 1991 a prospective randomized study for Stage III unresectable non small cell lung cancer (NSCLC) has been conducted to evaluate the response rate and tolerance of induction chemotherapy with MVP followed by hyperfractionated radiotherapy and evaluate the efficacy of maintenance chemotherapy in Asan Medical Center. All patients in this study were treated with hyperfractionated radiotherapy (120 cGy/fx BID, 6480 cGy/54 fx) following 3 cycles of induction chemotherapy, MVP (Mitomycin C 6 $mg/m^2,$ Vinblastin 6 $mg/m^2,$ Cisplatin 60 $mg/m^2$) and then the partial and complete responders from induction chemotherapy were randomized to 3 cycles of adjuvant MVP chemotherapy group and observation group. 48 patients were registered to this study until December 1992; among 48 patients 3 refused further treatment after induction chemotherapy and 6 received incomplete radiation therapy because of patient's refusal, 39 completed planned therapy. Twenty-three $(58\%)$ patients including 2 complete responders showed response from induction chemotherapy. Among the 21 patients who achieved a partial response after induction chemotherapy,1 patient rendered complete clearance of disease and 10 patients showed further regression of tumor following hyperfractionated radiotherapy. Remaining 10 patients showed stable disease or progression after radiotherapy. Of the sixteen patients judged to have stable disease or progression after induction chemotherapy, seven showed more than partial remission after radiotherapy but nine showed no response in spite of radiotherapy. Of the 39 patients who completed induction chemotherapy and radiotherapy, 25 patients $(64\%)$ including 3 complete responders showed more than partial remission. Nineteen patients were randomized after radio-therapy. Nine Patients were allocated to adjuvant chemotherapy group and 4/9 showed further regression of tumor after adjuvant chemotherapy. For the time being, there is no suggestion of a difference between the adjuvant chemotherapy group and observation group in distant metastasis rate and survival. Median survival time was 13 months. Actuarial survival rates at 6,12 and 18 months of 39 patients who completed this study were $84.6\%,\;53.7\%\;and\;40.3\%,$ respectively. The partial and complete responders from induction chemotherapy showed significantly better survival than non-responders (p=0.028). Incidence of radiation pneumonitis in this study group was less than that in historical control group inspite of induction chemotherapy. All patients tolerated hypertractionated radiotherapy without definite increase of acute complications compared with conventional radiotherapy group. The longer follow up is needed to evaluate the efficacies of induction and maintenance chemotherapy and survival advantage by hyperfractionated radiotherapy but authors are encouraged with an excellent tolerance, higher response rate and improvement of one year survival rate in patients of this study.

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Study on the Painting of Gyeongwoo-gung Shrine (景祐宮圖) (국립문화재연구소 소장 '경우궁도(景祐宮圖)'에 관한 연구)

  • Kim, Kyung Mee
    • Korean Journal of Heritage: History & Science
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    • v.44 no.1
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    • pp.196-221
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    • 2011
  • The Royal Private Shrines or the Samyo(私廟), were dedicated to members of Choseon's royal family who could not be enshrined at the (official) Royal Ancestral Shrine, the Jongmyo(宗廟). The Samyo were constructed at the national level and were systematically managed as such. Because these private Shrines were dedicated to those who couldn't belong to the Jongmyo but were still very important, such as the ruling king's biological father or mother. The details of all royal constructions were included in the State Event Manuals, and with them, the two-dimensional layouts of the Samyo also. From the remaining "Hyunsa-gung Private Tomb Construction Layout Record(顯思宮別廟營建都監儀軌)" of 1824, which is the construction record of Gyeongwoo-gung Shrine(景祐宮) dedicated to Subin, the mother of King Sunjo(純祖), it became possible to investigate the so far unknown "The Painting of Gyeongwoo-gung Shrine", in terms of the year produced, materials used and other situational contexts. The investigation revealed that the "The Painting of Gyeongwoo-gung Shrine" is actually the "Hyunsa-gung Private Tomb Layout" produced by the Royal Construction Bureau. The bureau painted this to build Hyunsa-gung Private Shrine in a separately prepared site outside the court in 1824, according to the royal verdict to close down and move the temporary shrine inside the courtyard dedicated to Subin who had passed away in 1822. As the Construction Bureau must have also produced the Gyeongwoo-gung Shrine Layout, the painter(s) of this layout should exist among the official artists listed in the State Event Manual, but sadly, as their paintings have not survived to this day, we cannot compare their painting styles. The biggest stylistic character of the Painting of Gyeongwoo-gung Shrine is its perfect diagonal composition method and detailed and neat portrayalof the many palace buildings, just as seen in Donggwoldo(東闕圖, Painting of a panoramic view for Changdeokgung and Changgyeonggung Palaces). A well-perceiving architectural painting employs a specific point of view chosen to fit the purpose of the painting, or it can opt to the multi-viewpoint. Korean traditional architectural paintings in early ages utilized the diagonal composition method, the bird-eye viewpoint, or the multi-viewpoint. By the 18th century, detailed but also artistic architectural paintings utilizing the diagonal method are observed. In the early 19th century, the peak of such techniques is exhibited in Donggwoldo(Painting of a panoramic view for Changdeokgung and Changgyeonggung Palaces). From the perfect diagonal composition method employed and the details of the palace buildings numbering almost two hundreds, we can determine that the Painting of Gyeongwoo-gung Shrine also belongs to the same category of the highly technical architectural paintings as Donggwoldo(Painting of a panoramic view for Changdeokgung and Changgyeonggung Palaces). We can also confirm this hypothesis by comparing the painting techniques employed in these two paintings in detailthe way trees and houses are depicted, and the way ground texture is expressed, etc. The unique characteristic of the Painting of Gyeongwoo-gung Shrine is, however, that the area surrounding the central shrine building(正堂), the most important area of the shrine, is drawn using not the diagonal method but the bird-eye viewpoint with the buildings lying flat on both the left and right sides, just as seen in the "Buildings Below the Central Shrine(正堂以下諸處)" in the State Event Manual's Painting Method section. The same viewpoint method is discovered in some other concurrent paintings of common residential buildings, so it is not certain that this particular viewpoint had been a distinctive feature for shrine paintings in general. On the other hand, when the diagonalmethod pointing to the left direction is chosen, the top-left and bottom-right sections of the painting become inevitably empty. This has been the case for the Painting of Gyeongwoo-gung Shrine, but in contrast, Donggwoldo shows perfect screen composition with these empty margins filled up with different types of trees and other objects. Such difference is consistent with the different situational contexts of these two paintings: the Painting of Gyeongwoo-gung Shrine is a simple single-sheet painting, while Donggwoldo is a perfected work of painting book given an official title. Therefore, if Donggwoldo was produced to fulfill the role of depiction and documentation as well as the aesthetic purpose, contrastingly, the Painting of Gyeongwoo-gung Shrine only served the purpose of copying the circumstances of the architecture and projecting them onto the painting.

Therapeutic compliance and its related factors in pediatrics patients (소아 환자의 치료 순응도 및 이에 영향을 미치는 요인)

  • Park, Ki Soo;Kam, Sin;Kim, Heung Sik;Lee, Jeong Kwon;Hwang, Jin-Bok
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.584-596
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    • 2008
  • Purpose : This study was conducted to investigate treatment compliance and related factors in pediatric patients. Methods : Three hundred and fifty-five patients diagnosed with various acute diseases at a teaching hospital or clinic in October 2003 were enrolled. Data were analyzed using the Health Belief Model, which includes items on self-efficacy and family assistance. Results : The study found that 62.9% of pediatric patients adhered faithfully to agreed-upon hospital revisits, 41.6% complied with dose timings instructions, 65.8% precisely took medication, and 27.2% complied with all of these requirements. According to ${\chi}^2$ test analysis, the factors found to be related to therapeutic compliance (the taking of medicines requested) were; susceptibility, severity, benefit, barriers, mother's self-efficacy, and family assistance (P<.05). Multiple logistic analysis and path analysis showed that susceptibility, severity, barriers, and mother's self-efficacy were related to therapeutic compliance (P<.05). Moreover, mother's self-efficacy was identified as the most important factor. Conclusion : To improve therapeutic compliance among pediatric patients, parental education is necessary, and a health care professional must take a thorough history of how the medication was taken before it is assumed that treatment failure is attributable to the medication prescribed. Furthermore, the type of device recommended for dosing should be determined by clinicians. In addition, it is important that pediatric medications be discussed in relation to their palatability and internal acceptability.

Anti-Inflammatory Effect of Ethanol Extract from Grateloupia crispata on Lipopolysaccharide-Induced Inflammatory Responses in RAW 264.7 Cells and Mice Ears (LPS로 유도된 RAW 264.7 세포와 마우스 귀 조직에 대한 주름까막살 에탄올 추출물의 항염증 효과)

  • Bae, Nan-Young;Kim, Min-Ji;Kim, Koth-Bong Woo-Ri;Park, Sun-Hee;Jang, Mi-Ran;Ahn, Dong-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.8
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    • pp.1090-1098
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    • 2016
  • The anti-inflammatory effects of ethanol extract from Grateloupia crispata (GCEE) were investigated in lipopolysaccharide (LPS)-stimulated murine macrophages. Anti-inflammatory effects were detected by enzyme-linked immunosorbent assay, Western blotting, and immunohistochemistry. There was no cytotoxic effect on proliferation of macrophages treated with GCEE compared to the control. GCEE significantly inhibited production of pro-inflammatory cytokines [interleukin (IL)-6, tumor necrosis $factor-{\alpha}$, and $IL-1{\beta}$] as well as nitric oxide in LPS-stimulated RAW 264.7 cells. In addition, GCEE suppressed expression of inducible nitric oxide synthase, cyclooxygenase-2, and nuclear $factor-{\kappa}B$ in a dose-dependent manner. GCEE significantly reduced activation of mitogen-activated protein kinases. In the in vivo test, evaluation of anti-inflammatory activity of GCEE was performed using croton oil-induced ear edema in ICR mice. Oral administration of 10 mg/kg to 250 mg/kg of GCEE significantly reduced ear edema in a dose-dependent manner compared to croton oil-induced mice. Moreover, GCEE reduced ear thickness and the number of mast cells compared to croton oil-induced mice in the histological analysis. These data suggest that GCEE could be used as a potential source for anti-inflammatory agents.

Follow-Up Method in Patients with Kawasaki Disease who had No Coronary Artery Abnormalities in the Convalescent Period (회복기 심초음파 검사상 관상동맥 내경 크기가 정상 범위인 가와사끼병 환자에서 추적관찰 방법에 대한 고찰)

  • Joo, Hee Jung;Song, Min Seob;Kim, Chul Ho
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.165-173
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    • 2005
  • Purpose : We performed the study to evaluate the value of the follow-up echocardiogram performed 6 months to 1 year after the onset of Kawasaki disease(KD), as recommended by American Heart Association(AHA) guidelines, when echocardiograms in the convalescent period were normal. Methods : Patients were selected from 147 cases diagnosed with KD at Pusan Paik hospital from January 2000 to October 2003. A total of 45 KD patients belonged to AHA risk level I and II were performed follow-up echocardiography. The patient's medical records and echocardiogram were reviewed. Additionally, we sought the opinion of pediatric cardiologists on the subject by means of a multiple-choice survey. Results : 37 children were belonged to AHA risk level I and the remaining 8 patients were belonged to risk level II. Of these 45 children, none were noted to have abnormalities on later follow-up echocardiogram. In the results of questionnaire, 37 percent of the participants advocate no follow-up after convalescent period for risk level I, and 33.3 percent favor periodic follow-up with echocardiography for risk level II up to one year. But there were no consensus about the diagnostic criteria of coronary abnormalities and how to follow-up these patients. Conclusion : All children with KD should have an echocardiogram at present and a follow-up study 6 to 8 weeks after the onset of fever. However, additional echocardiographies are not justified if the 6- to 8-week follow-up echocardiogram is normal. We would recommend that the more reasonable diagnostic criteria for coronary abnormalities and the Korean guidelines for long-term cardiovascular management and follow-up of KD need to be established.

Development of a Small Gamma Camera Using NaI(T1)-Position Sensitive Photomultiplier Tube for Breast Imaging (NaI (T1) 섬광결정과 위치민감형 광전자증배관을 이용한 유방암 진단용 소형 감마카메라 개발)

  • Kim, Jong-Ho;Choi, Yong;Kwon, Hong-Seong;Kim, Hee-Joung;Kim, Sang-Eun;Choe, Yearn-Seong;Lee, Kyung-Han;Kim, Moon-Hae;Joo, Koan-Sik;Kim, Byuug-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.365-373
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    • 1998
  • Purpose: The conventional gamma camera is not ideal for scintimammography because of its large detector size (${\sim}500mm$ in width) causing high cost and low image quality. We are developing a small gamma camera dedicated for breast imaging. Materials and Methods: The small gamma camera system consists of a NaI (T1) crystal ($60 mm{\times}60 mm{\times}6 mm$) coupled with a Hamamatsu R3941 Position Sensitive Photomultiplier Tube (PSPMT), a resister chain circuit, preamplifiers, nuclear instrument modules, an analog to digital converter and a personal computer for control and display. The PSPMT was read out using a standard resistive charge division which multiplexes the 34 cross wire anode channels into 4 signals ($X^+,\;X^-,\;Y^+,\;Y^-$). Those signals were individually amplified by four preamplifiers and then, shaped and amplified by amplifiers. The signals were discriminated ana digitized via triggering signal and used to localize the position of an event by applying the Anger logic. Results: The intrinsic sensitivity of the system was approximately 8,000 counts/sec/${\mu}Ci$. High quality flood and hole mask images were obtained. Breast phantom containing $2{\sim}7 mm$ diameter spheres was successfully imaged with a parallel hole collimator The image displayed accurate size and activity distribution over the imaging field of view Conclusion: We have succesfully developed a small gamma camera using NaI(T1)-PSPMT and nuclear Instrument modules. The small gamma camera developed in this study might improve the diagnostic accuracy of scintimammography by optimally imaging the breast.

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Factors which Influence Customers' Intention to Switch from Call-Based Driver-for-hire Services to App-Based Driver-for-hire Services Based on Online to Offline (O2O) Business Model: Focusing on Kakao Driver service (콜 대리업체 서비스에서 O2O 방식이 적용된 대리운전 사업 모델로의 소비자 전환 의도에 관한 연구: 카카오 드라이버를 중심으로)

  • Kim, Daewon;Jeong, Hye Seung
    • The Journal of Society for e-Business Studies
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    • v.21 no.3
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    • pp.51-78
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    • 2016
  • Online-to-offline (O2O) commerce is the new trend that merges online commerce with traditional industries in various fields. The primary purpose of this paper is to find out which factors influence customers' intention to switch from call-based driver-for-hire services to O2O app-based services. This study used variables and factors based on Theory of Switching Intention, and Extended Unified Theory of Acceptance and Use of Technology in order to design research questions. We surveyed 500 users of call-based driver-for-hire services. According to the result of this study, dissatisfaction with the current call-based driver-for-hire services is estimated to be a significant factor that strengthens customers' intention to switch from the call-based driver-for-hire services to the app-based services. Loyalty to the previous call-based driver-for-hire services was not seen as a crucial motivator that causes customers to switch to the new O2O driver service. Switching cost also did not play a key role in explaining the relationship between dissatisfaction with the current call-based service and the intention to use the new app-based service. Performance expectancy, easiness in use, the level of user's knowledge or available assistance in relation to the use of app-based services, and expectancy for reasonable price was found to have meaningful impacts on customers' intention to switch from the call-based driver-for-hire services to the app-based services. Age, gender and user experience on the new service were found incapable of moderating the relationship between aforementioned factors which influence customers' choice of the app-based driver-for-hire service, and customers' intent to switch to the app-based service.

Effects of University Students' Entrepreneurial Passion on Performance through Exploration Capability and Connection Capability (대학생의 기업가 열정이 정보 탐색 및 연계 역량을 통해 창업의지에 미치는 영향에 관한 연구)

  • Yoon, Byeong seon;Kim, Chun Kyu
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.3
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    • pp.97-110
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    • 2019
  • This study analyzed various factors of influence affecting the will to start a business and established and empirically analyzed a research model to see which factors significantly affect the will to start a business. To this end, we investigated the general characteristics and experiences of individuals, conducted a study on the will to start a business, and analyzed the entrepreneurship passion for startups, the ability to find business opportunities, and the ability to connect with partner companies. The intent to start a business survey was investigated in a recertive style with a 7 point scale, and the reliability and feasibility review were analyzed through the PLS analysis method, which enables the implementation of a measurement model and a structural model. To collect valid data, the survey was conducted using an entrepreneurial curriculum class hours to collect and analyze 421 data. In summary, the results are as follows: First, college students have many opportunities to develop their capabilities through competitions held by universities and support institutions, and by utilizing them, they have no fear of starting a business. Second, the ability of students to discover product clients themselves has been improved by fostering entrepreneurship in the special lectures on startup in universities. Third, it can be seen that it has received various information on startups from support agencies to enhance its commitment to startups. The implications are as follows. First, they should foster entrepreneurship among college students by offering practical oriented courses that can broaden their understanding of startups. Second, it needs to be improved from entrepreneurial enthusiasm to a program that can grow into a company that can collaborate with partner companies and confirm its commitment to corporate establishment and product development and determine market opportunities. Third, it is necessary to establish an ecosystem of start-ups that can carry out systematic planning and performance management as it is weak to carry out projects with will to startups.

Trend of Medical Care Utilization and Medical Expenditure of the Elderly Cohort (노인 코호트의 의료이용 및 입원진료비 변화 추이 -공.교 의료보험 대상자를 대상으로-)

  • Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.437-461
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    • 1997
  • Because of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 30 years, the life expectancy of the Korean people has lengthened considerably and as a result, the number of the elderly has markedly increased. Such an increase of the number of aged population brought about many social, economic, and medical problems which were never seriously considered before. This study was conducted to assess the trend of medical care utilization and medical expenditure of the elderly. The data of each patient in the study were taken from computer database maintained for administrative purpose by the Korea Medical Insurance Corporation. The study population was 132,670 who were 60 years old or more and registered in Korean Medical Insurance Corporation from 1989 to 1993. The study subjects were predominantly female(56.3%) and 10,000-20,000 Won premium group(50.6%). The following are summaries of findings : The total increase of the number of inpatient cases was 40.5% from 1989 through 1993. The average annual increase was 3.7% in inpatient medical expenditures per case, 4.4% in inpatient medical expenditures per day and 0.08% in length of stay per case from 1989 through 1993. Cataract was the most prevalent disease of 10 leading frequent diseases in all ages from 1989 through 1993. The case mix in 1993 compared to 1989 revealed that cataract and ischemic cerebral disease were increased whereas essential hypertension and pulmonary tuberculosis were decreased . The average annual increase of medical expenditures was 3.8% in general hospitals, 6.3% in hospitals and 2.4% in clinics. From 1989 through 1993, medical expenditures used by high-cost patients accounted for about 14% to 20% of all expenditures for inpatient care, while they represented less than 2.5% of the elderly population. Time series analysis revealed that total medical expenditures and doctor's fee for inpatient will be progressively increased whereas drug expenditures for inpatient will be decreased. And there will be no change in length of stay. Based on the above results, the factors increasing medical cost and utilization should be identified and the method of cost containment for the elderly health care should be developed systematically.

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A Study on the Excavated Sab(a funeral fan) from Lime-filled Tomb and Lime-layered Tomb during the Joseon Dynasty (조선시대 회격·회곽묘 출토 삽(翣)에 대한 고찰)

  • Yi, Seung Hae;An, Bo Yeon
    • Korean Journal of Heritage: History & Science
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    • v.41 no.2
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    • pp.43-59
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    • 2008
  • Sap(?, a funeral fan) is a funeral ceremonial object used in association with a Confucian ceremonial custom, which was crafted by making a wooden frame, attaching a white cloth or a thick paper onto it, drawing pictures on it, and making a holder for a handle. According to Liji(Records of Rites), Sap was used since the Zhou Dynasty, and these Chinese Sap examples are no big different than the Korean Sap examples, which were described in Joseon Wangjo Sillok(Annals of the Joseon Dynasty), Gukjo Oryeui(the Five Rites of the State), and Sarye Pyeollam(Handbook on Four Rituals). This study explored Sap excavated in lime-filled tombs and lime-layered tombs of aristocrats dating back to Joseon, as well as their historical records to examine Sap's characteristics according to their examples, manufacturing methods, and use time. The number and designs of Sap varied according to the deceased' social status aristocrats used mainly one pair of 亞-shaped Bulsap, and a pair of Hwasap with a cloud design depicted on it. A Sap was wrapped twice with Chojuji paper or Jeojuji paper, and for the third time with Yeonchangji paper. Then, it was covered with a white ramie, a hemp, a cotton, a silk satin, etc. Bobul(an axe shape and 亞-shape design) was drawn on both sides of Sap, and a rising current of cloud was drawn at the peripheral area mainly with red or scarlet pigments. Sap, which were excavated from aristocrats'lime-filled and lime-layered tombs, are the type of Sap which were separated from its handle. These excavated Sap are those whose long handles were burnt during the death carriage procession, leaving Sap, which later were erected on both sides of the coffin. The manufacturing process of excavated relics can be inferred by examining them. The excavated relics are classified into those with three points and those with two points according to the number of point. Of the three-point type(Type I), there is the kind of relic that was woven into something like a basket by using a whole wood plate or cutting bamboo into flat shapes. The three-point Sap was concentrated comparatively in the early half of Joseon, and was manufactured with various methods compared with its rather unified overall shape. In the meantime, the two-point Sap was manufactured with a relatively formatted method; its body was manufactured in the form of a rectangle or a reverse trapezoid, and then its upper parts with two points hanging from them were connected, and the top surface was made into a curve(Type II) or a straight line(Type III) differentiating it from the three-point type. This manufacturing method, compared with that of the three-point type, is simple, but is not greatly different from the three-point type manufacturing method. In particular, the method of crafting the top surface into a straight line has been used until today. Of the examined 30 Sap examples, those whose production years were made known from the buried persons'death years inscribed on the tomb stones, were reexamined, indicating that type I was concentrated in the first half of the $16^{th}$ century. Type II spanned from the second half of the $16^{th}$ century to the second half of the $17^{th}$ century, and type III spanned from the first half of the $17^{th}$ century to the first half of the $18^{th}$ century. The shape of Sap is deemed to have changed from type I to type II and again from type II to type III In the $17^{th}$ century, which was a time of change, types II and III coexisted. Of the three types of Sap, types II and III re similar because they have two points; thus a noteworthy transit time is thought to have been the middle of the $16^{th}$ century. Type I compared with types II and III is thought to have required more efforts and skills in the production process, and as time passed, the shape and manufacturing methods of Sap are presumed to have been further simplified according to the principle of economy. The simplification of funeral ceremonies is presumed to have been furthered after Imjinwaeran(Japanese invasion of Joseon, 1592~1598), given that as shown in the Annals of King Seonjo, state funerals were suspended several times. In the case of Sap, simplification began from the second half of the $16^{th}$ century, and even in the $18^{th}$ century, rather than separately crafting Sap, Sap was directly drawn on the coffin cover and the coffin. However, in this simplification of form, regulations on the use of Sap specified in Liji were observed, and thus the ceremony was rationally simplified.