• Journal of the East Asian Society of Dietary Life
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• v.19 no.5
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• pp.703-712
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• 2009

The principal objective of this study was to supply basic material determine basic information regarding effective health promotion regimens for elderly women via a comparative survey of health status by aging age between elderly women (=70 y) and college women. The subject groups of elderly women (=70 y) and college women were selected and surveyed from March to October, 2008, in the Seoul area. The average age of the elderly women assessed in this study was $78.64{\pm}7.30$, the average height was $147.07{\pm}5.72$ cm, and the average weight was $50.47{\pm}7.44$ kg. As compared with college women, a higher percentage of elderly women ate breakfast regularly, but the elderly women also experienced difficulties in chewing due to dentures, and therefore ate their meals with large quantities of liquids, and usually ate their meals within 10 minutes. The majority of elderly women suffered from at least one disease, and the most common symptom reported was hypertension (25%). 52.2% of elderly women and 47.8% of college women reported that they exercised 1~2 times per week. They reported that their favorite exercise was light exercise, such as jogging and athletics (73.1%). As compared with college women, the smoking rate was lower among elderly women, but some of the elderly women were long-time smokers or alcoholics. The differences in red blood cells counts, Hb, hematocrit, and MCV of the between elderly women and college women were significant. In addition, but the MCH and MCHC were higher in elderly women compared with college women and the total cholesterol of elderly woman ($175.62{\pm}38.89$ mg/dL) was significantly lower compared with college woman ($186.13{\pm}28.19$ mg/dL). TG ($127.89{\pm}51.25$ mg/dL) and LDL-cholesterol ($120.51{\pm}32.88$ mg/dL) of elderly woman were significantly higher than TG ($79.71{\pm}40.9$ 6mg/dL) and LDL-cholesterol($103.78{\pm}22.94$ mg/dL) of college woman (p<0.05). The levels of HDL-cholesterol ($58.78{\pm}12.90$ mg/dL) in the college women was significantly higher than the HDLcholesterol levels ($48.17{\pm}13.79$ mg/dL) of the elderly women (p<0.05). Serum vitamin C levels in elderly women were significantly higher than those of college women (p<0.05), whereas no significant difference was detected between the two groups. Consequently, it can be concluded that the appropriate education programs for dietary habits and health promotion are necessary for a healthier life. Additionally, it is necessary for individuals to precisely determine precisely their own health status, and develop appropriate dietary programs for themselves.

• Radiation Oncology Journal
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• v.28 no.3
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• pp.155-165
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• 2010

Purpose: In order to evaluate the positional uncertainty of internal organs during radiation therapy for treatment of liver cancer, we measured differences in inter- and intra-fractional variation of the tumor position and tidal amplitude using 4-dimentional computed radiograph (DCT) images and gated orthogonal setup kilovolt (KV) images taken on every treatment using the on board imaging (OBI) and real time position management (RPM) system. Materials and Methods: Twenty consecutive patients who underwent 3-dimensional (3D) conformal radiation therapy for treatment of liver cancer participated in this study. All patients received a 4DCT simulation with an RT16 scanner and an RPM system. Lipiodol, which was updated near the target volume after transarterial chemoembolization or diaphragm was chosen as a surrogate for the evaluation of the position difference of internal organs. Two reference orthogonal (anterior and lateral) digital reconstructed radiograph (DRR) images were generated using CT image sets of 0% and 50% into the respiratory phases. The maximum tidal amplitude of the surrogate was measured from 3D conformal treatment planning. After setting the patient up with laser markings on the skin, orthogonal gated setup images at 50% into the respiratory phase were acquired at each treatment session with OBI and registered on reference DRR images by setting each beam center. Online inter-fractional variation was determined with the surrogate. After adjusting the patient setup error, orthogonal setup images at 0% and 50% into the respiratory phases were obtained and tidal amplitude of the surrogate was measured. Measured tidal amplitude was compared with data from 4DCT. For evaluation of intra-fractional variation, an orthogonal gated setup image at 50% into the respiratory phase was promptly acquired after treatment and compared with the same image taken just before treatment. In addition, a statistical analysis for the quantitative evaluation was performed. Results: Medians of inter-fractional variation for twenty patients were 0.00 cm (range, -0.50 to 0.90 cm), 0.00 cm (range, -2.40 to 1.60 cm), and 0.00 cm (range, -1.10 to 0.50 cm) in the X (transaxial), Y (superior-inferior), and Z (anterior-posterior) directions, respectively. Significant inter-fractional variations over 0.5 cm were observed in four patients. Min addition, the median tidal amplitude differences between 4DCTs and the gated orthogonal setup images were -0.05 cm (range, -0.83 to 0.60 cm), -0.15 cm (range, -2.58 to 1.18 cm), and -0.02 cm (range, -1.37 to 0.59 cm) in the X, Y, and Z directions, respectively. Large differences of over 1 cm were detected in 3 patients in the Y direction, while differences of more than 0.5 but less than 1 cm were observed in 5 patients in Y and Z directions. Median intra-fractional variation was 0.00 cm (range, -0.30 to 0.40 cm), -0.03 cm (range, -1.14 to 0.50 cm), 0.05 cm (range, -0.30 to 0.50 cm) in the X, Y, and Z directions, respectively. Significant intra-fractional variation of over 1 cm was observed in 2 patients in Y direction. Conclusion: Gated setup images provided a clear image quality for the detection of organ motion without a motion artifact. Significant intra- and inter-fractional variation and tidal amplitude differences between 4DCT and gated setup images were detected in some patients during the radiation treatment period, and therefore, should be considered when setting up the target margin. Monitoring of positional uncertainty and its adaptive feedback system can enhance the accuracy of treatments.

• Proceedings of the Korean DIstribution Association Conference
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• 2005.05a
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• pp.383-405
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• 2005

The traditional market is foremost a regionally positioned place, wherein the market directly represents regional and cultural centered traits while it plays an important role in the circulation of facilities through reciprocal, informative and cultural exchanges while sewing to form local communities. The traditional market in Korea is one of representative retail businesses and premodern marketing techniques by family owned business of less than five members such as product management, purchase method, and marketing patterns etc. Since the 1990s, the appearance of new circulation-type businesses and large discount convenience stores escalated the loss of traditional competitiveness, increased the living standard of customers, changed purchasing patterns, and expanded the ubiquity of the Internet. All of these changes in external circulation circumstances have led the traditional markets to lose their place in the economy. The traditional market should revive on a regional site basis through the formation of a community of regional neighbors and through knowledge-sharing that leads to the creation of wealth. For the purpose of creating a wealth in a place, the following components are necessary: 1) a facility suitable for the spatial place of the present, 2)trust built through exchanges within the changing market environment, which would simultaneously satisfy customer's desires, 3) international bench marking on cases such as regionally centered TCM (England), BID (USA), and TMO (Japan) so that the market unit of store placement transfers from a spot policy to a line policy, 4)conversion of communicative conception through a surface policy approach centered around a macro-region perspective. The budget of the traditional market funding policy was operational between 2001 and 2004, serving as a counter move to solve the problem of the old traditional market through government intervention in regional economies to promote national economic strength. This national treasury funding project was centered on environmental improvement, research corps, and business modernization through the expenditure of 3,853 hundred million won (Korean currency). However, the effectiveness of this project has yet to be to proven through investigation. Furthermore, in promoting this funding support project, a lack of professionalism among merchants in the market led to constant limitations in comprehensive striving strategies, reduced capabilities in middle-and long-term plan setup, and created reductions in voluntary merchant agreement solutions. The traditional market should go beyond mere physical place and ordinary products creative site strategies employing the communicative approach must accompany these strategies to make the market a new regional and spatial living place. Thus, regarding recent paradigm changes and the introduction of region-based site functions into the traditional market, acquiring a conversion of direction into the newly developed project is essential to reinvestigate the traditional market composed of cultural and economic meanings, for the purpose of the research. Excavating social policy demands through the comparative analysis of domestic and international cases as well as innovative and expert management leadership development for NPO or NGO civil entrepreneurs through advanced case research on present promotion methods is extremely important. Discovering the seeds of the cultural contents industry cored around regional resource usages, commercializing regionally reknowned products, and constructing complex cultural living places for regional networks are especially important. In order to accelerate these solutions, a comprehensive and systemized approach research operated within a mentor academy system is required, as research will reveal distinctive traits of the traditional market in the aging society.

• The Journal of Korean Physical Therapy
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• v.5 no.1
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• pp.25-37
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• 1993

This study was conducted to investigate an attitude related to physical therapy students's clinical practice, a questionnaire survey was carried out for 101 third grader(Taegu Junior Health College 66, Andong Junior College 35) from 11th of January to 22th of March. The results are as follow : A. Frequency classified by item 1. Among preconception and anxiety on the clinical practice, a shortage of knowledge$(83.2\%)$ was the highest. 2. Among expectation on the clime practice, the chance to meet patients directly$(94.1\%)$ was the highest. 3. Among anxiety after students experienced clinical practice, a shortage of knowledge$(82.2\%)$ was the highest. 4. Among satisfaction after students experienced clinical practice, after students graduated college, they will maintain physical therapist's life continuously$(71.3\%)$ was the highest. B. The variables that showed statistical difference between general characteristics and variables classified by item are as follow : 1. Between sex and anxiety after students experienced clinical practice, girl-students$(86.7\%)$ showed higher rate than man-students$(61.1\%)$ in, a shortage of knowledge(P<0.01). 2. Between religion and expectation on clinical practice, religionists$(65.1\%)$ showed higher rate than nonreligionists $(44.8\%)$ in the chance to practice love for humanity(P<0.05). 3. Between religion and anxiety after students experienced clinical practice, religionist$(65.1\%)$ showed higher rate than nonreligionist$(56.9\%)$ in not unskillful counsel patients(P<0.01). 4. Between religion and satisfaction after students experienced clinical practice, religionist$(81.4\%)$ showed higher rate than nonreligionists$(63.3\%)$ in pride of major choice(P<0.01). 5. Between hospitalization experience of family and exportation on clinical practice, students who had hospitalization experience of family$(79.7\%)$ were higher rate than unexperienced students's$(62.2\%)$ in the chance to apply knowledge(P<0.05). 6. Between hospitalization experience and satisfaction after students experienced dime practice, students who had hospitalization experience$(68.4\%)$ were higher rate than unexperienced students's$(45.1\%)$ in settlement of anxiety(P<0.05). 1. Between choice motive of physiotherapy(PT) department and expectation on clinical practice, self-will students $(80.5\%)$ showed higher rate than other-will students's $(66.7\%)$ in rejoining participate in treatment(P<0.01). 8. Between choice motive of physiotherapy department and anxiety after students experienced clinical practice, self-will students$(74.0\%)$ showed higher rate than lither-will students's $(58.3\%)$ in the wish PT-job in the future(P<0.05). 9. Between choice motive of physiotherapy department and satisfaction after students experienced clinical practice, self-will students$(75.3\%)$ showed higher rate than other-will students's$(58.3\%)$ in pride on major in physical therapy(P<0.05). It was revealed by this survey that girl-students had higher anxiety than man-students in anxiety after students experiences clinical practice, self-will student had higher satisfaction higher than other-will student in the choice of physiotherapy department.

• Radiation Oncology Journal
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• v.26 no.2
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• pp.118-125
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• 2008

Purpose: On-line image guided radiation therapy(on-line IGRT) and(kV X-ray images or cone beam CT images) were obtained by an on-board imager(OBI) and cone beam CT(CBCT), respectively. The images were then compared with simulated images to evaluate the patient's setup and correct for deviations. The setup deviations between the simulated images(kV or CBCT images), were computed from 2D/2D match or 3D/3D match programs, respectively. We then investigated the correctness of the calculated deviations. Materials and Methods: After the simulation and treatment planning for the RANDO phantom, the phantom was positioned on the treatment table. The phantom setup process was performed with side wall lasers which standardized treatment setup of the phantom with the simulated images, after the establishment of tolerance limits for laser line thickness. After a known translation or rotation angle was applied to the phantom, the kV X-ray images and CBCT images were obtained. Next, 2D/2D match and 3D/3D match with simulation CT images were taken. Lastly, the results were analyzed for accuracy of positional correction. Results: In the case of the 2D/2D match using kV X-ray and simulation images, a setup correction within $0.06^{\circ}$ for rotation only, 1.8 mm for translation only, and 2.1 mm and $0.3^{\circ}$ for both rotation and translation, respectively, was possible. As for the 3D/3D match using CBCT images, a correction within $0.03^{\circ}$ for rotation only, 0.16 mm for translation only, and 1.5 mm for translation and $0.0^{\circ}$ for rotation, respectively, was possible. Conclusion: The use of OBI or CBCT for the on-line IGRT provides the ability to exactly reproduce the simulated images in the setup of a patient in the treatment room. The fast detection and correction of a patient's positional error is possible in two dimensions via kV X-ray images from OBI and in three dimensions via CBCT with a higher accuracy. Consequently, the on-line IGRT represents a promising and reliable treatment procedure.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.31-45
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• 2000

Objectives : The present study was performed to reveal differences between female and male cases of alopecia in their alopecia related variables such as patterns of hair loss, psychiatric characteristics, associate illnesses, and methods of treatment, and to use them as basic materials for proper management and early prevention of the alopecia prone cases. Methods : In order to analysis the gender difference in hair losses, the subjects were divided into two subgroups as the 51 cases of female alopecia and the 42 cases of male alopecia, who had visited to the department of psychiatry consulted from the department of dermatology, Yongsan hopital, ChungAng University, Seoul, Korea, from January 1998 to December 1998. In data analysis, the subjects were statistically assesed by chi-squre test and analysis of varaiance, through SPSS-$PC^+$ 9.0V. Results : 1) Female subjects were more likely showed lower socio-economical level including lower eonomical level, lower educational level, or lower occupational level in their parent's job, were more likely to have larger number of siblings and to have many sisters comparison to the male cases. 2) Female subjects were more likely visited to the department of dermatology, more history of alopecia in their female family members, lesser history of alopecia in their male family members, more loss of hairs in vertex or frontal region of scalp, lesser loss of hairs in occipital region, and lesser nail changes in comparison to the male cases. 3) Female subjects were more suffered from intra-familial conflicts and economical changes, or their introverted personality makeup, lesser likely suffered from changes of business and health changes, and showed lesser conflicts related with poorer adaptaion in their job life. 4) Female subjects were more likely diagnosed as depression or conversion disorders, more frequently complaint anxiety symptoms or depressive symptoms, higher level of anxiety index, lesser complaint somatization or obsessive compulsive symptoms, and lesser diagnosed as anxiety disorder in comparison to the male cases. 5) Female subjects were more likely tended to show personality makeup such as the introverted, the lie, the repressed, or the feminine trends than the male cases. 6) Female subjects were more significantly treated by antianxiety drug such as etizolam and dermatological therapies include tretinoin, and lesser treated by clotiazepam and prednicarbonate in comparison to the male cases. Conclusion : From the facts that The most important factors in developing hair loss in the female subjects in comparison to the male cases seems to be closely correlated with the serious psychopathology such as the presence of mental disorders including depression, the presence of complaining anxiety or depressive symptomatology, the presence of stressful life events such as intrafamilial life changes, and the presence of personality makeup such as the introverted, the lie, the repressed, or the feminine trends, the authors confirmed that dermatologists act as the primary care physician are in a unique position to recognize psychiatric comorbidity and execute meaningful intervention for female patients with the alopecia with psychiatrists.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.237-246
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• 2008

Purpose: Three-dimensional conformal radiation therapy (3DCRT) and intensity-modulated radiation therapy (IMRT) were found to reduce the incidence of acute and late rectal toxicity compared with conventional radiation therapy (RT), although acute and late urinary toxicities were not reduced significantly. Acute urinary toxicity, even at a low-grade, not only has an impact on a patient's quality of life, but also can be used as a predictor for chronic urinary toxicity. With bladder filling, part of the bladder moves away from the radiation field, resulting in a small irradiated bladder volume; hence, urinary toxicity can be decreased. The purpose of this study is to evaluate the impact of bladder volume on acute urinary toxicity during RT in patients with prostate cancer. Materials and Methods: Forty two patients diagnosed with prostate cancer were treated by 3DCRT and of these, 21 patients made up a control group treated without any instruction to control the bladder volume. The remaining 21 patients in the experimental group were treated with a full bladder after drinking 450 mL of water an hour before treatment. We measured the bladder volume by CT and ultrasound at simulation to validate the accuracy of ultrasound. During the treatment period, we measured bladder volume weekly by ultrasound, for the experimental group, to evaluate the variation of the bladder volume. Results: A significant correlation between the bladder volume measured by CT and ultrasound was observed. The bladder volume in the experimental group varied with each patient despite drinking the same amount of water. Although weekly variations of the bladder volume were very high, larger initial CT volumes were associated with larger mean weekly bladder volumes. The mean bladder volume was $299{\pm}155\;mL$ in the experimental group, as opposed to $187{\pm}155\;mL$ in the control group. Patients in experimental group experienced less acute urinary toxicities than in control group, but the difference was not statistically significant. A trend of reduced toxicity was observed with the increase of CT bladder volume. In patients with bladder volumes greater than 150 mL at simulation, toxicity rates of all grades were significantly lower than in patients with bladder volume less than 150 mL. Also, patients with a mean bladder volume larger than 100 mL during treatment showed a slightly reduced Grade 1 urinary toxicity rate compared to patients with a mean bladder volume smaller than 100 mL. Conclusion: Despite the large variability in bladder volume during the treatment period, treating patients with a full bladder reduced acute urinary toxicities in patients with prostate cancer. We recommend that patients with prostate cancer undergo treatment with a full bladder.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.233-243
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• 2000

Purpose : First of all, this study was performed to assess the result of curative radiotherapy and to evaluate different possible prognostic factors for squamous cell carcinoma of the supraglottic larynx treated at the Pusan National University Hospital. The second goal of this study was by comparing our data with those of other study groups, to determine the better treatment policy of supraglottic cancer in future. Methods and Material : Thirty-two patients with squamous cell carcinoma of the supraglottic larynx were treated with radiotherapy at Pusan National University Hospital, from August 1985 to December 1996. Minimum follow-up period was 29 months, Twenty-seven patients (84.4$\%$) were followed up over 5 years. Radiotherapy was delivered with 6 MV photons to the primary laryngeal tumor and regional iymphatics with shrinking field technique. Ail patients received radiotherapy under conventional fractionated schedule (once a day). Median total tumor dose was 70.2 Gy (range, 55.8 to 75.6 Gy) on primary or gross tumor lesion. Thirteen patients had Induction chemotherapy with cisplatln and 5-fluorouracil (1-3 cycles). Patient distribution, according to the different stages, were as follows: stage I, 5/32 (15.6$\%$): stage II, 10/32 (31.3$\%$); stage III, 8/32 (25$\%$): stage IV, 9/32 (28.1$\%$). Results :The 5-year overall survival rate of the whole series (32 patients) was 51.7$\%$. The overall survival rate at 5-years was 80$\%$ in stage I, 66.7$\%$ in stage II, 42.9$\%$ in stage III, 25$\%$ in stage IV (p=0.0958). The S-year local control rates after radiotherapy were as fellows: stage I, 100$\%$; stage II, 60$\%$ stage III, 62.5$\%$; stage IV, 44.4$\%$ (p=0.233). Overall vocal preservation rates was 65.6$\%$, 100% In stage I, 70% in stage II, 62.5$\%$ In stage III, 44.4$\%$ in stage IV (p=0.210). There was no statistical significance in survival and local control rate between neoadjuvant chemotherapy followed by radiotherapy group and radiotherapy alone group. Severe laryngeal edema was found in 2 cases after radiotllerapy, emergent tracheostomy was done. Four patients were died from distant metastsis, . three in lung, one in brain. Double primary tumor was found in 2 cases, one in lung (metachronous), another in thyroid (synchronous). Ulcerative lesions were revealed as unfavorable prognostic factor ( p=0.0215), and radiation dose (more or less than 70.2 Gy) was an important factor on survival (p=0.002). Conclusion : The role of radiotherapy treatment of supraglottic carcinoma is to important factor on survival and to preserve the laryngeal function. Based on our data and other studies, early and moderately advanced supragiottic carcinomas could be successfully treated with either consewative surgery or radiotherapy alone. Both modalities showed similar results in survival and vocal preservation. For the advanced cases, radiotherapy alone is Inadequate for curative aim and surgery combined with radiotherapy should be done in operable patients. When patients refuse operation or want to preserve vocal function, or for the patients with inoperable medical conditions, combined chemoradiotherapy (concurrent) or altered fractionated radiotherapy with or without radiosensitizer should be taken into consideration in future.

• Journal of the East Asian Society of Dietary Life
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• v.13 no.4
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• pp.267-283
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• 2003

This study reviewed the prisoners' dietary lift status under the world panics and Japanese food shortage based on the data of the 1920~1930's prisons' main dish supplies in Chosun, Shinchu boys' prison in Taiwan, Franue correction center in France and Moabit detention house in Germany. 1. The status of main dish food supply of Chosun prisons in 1920~1930's was as follows: 1) Meals were provided with 12 rates depending on the working activities. There were big differences in energy supply between 1$^{st}$ rate of 6045.0 ㎉ in the Mockpo prison and 12$^{th}$ rate of 1855.8 ㎉ in the Masan prison in accordance with the grain supply ratio and the diet rates. 2) The average ratio of energy provided with protein, fat and carbohydrate(PFC ratio) was 20.0: 20.2: 59.8. The supplies of protein and fat were relatively high because main dish was mostly composed of soybean. The soybean was used in 20 ~60％ of main dish in prisons except Gaesung. 3) It was estimated that PFC ratio(8.3: 8.1 : 83.6) in Gaesung boys' prison was not appropriate for growing boys because the soybean supply was low. 2. The overall comparison of nutrition supply of prisons in Chosun, Taiwan, France and Germany was as follows: 1) The daily supplies of energy in Keongsung prison was 3966.5 ㎉, of which the PFC ratio was 18.9: 16.6: 64.5. This showed that the PFC ratio seemed to be balanced, even though the total amount of energy is too high and the ratios of protein and fat were somewhat high and somewhat low, respectively. 2) The main dish of the Taiwan boys' prison was provided with 6 rates and the side dish in the from of weekly cycle menu. The energy intakes from 1$^{st}$ rate of 2862.9 ㎉ to 6$^{th}$ rate of 1388.9 ㎉ were not quite enough for growing boys. It was estimated that the amounts of protein and fat taken were small but the quality was not that bad because animal protein such as protein small fish and fried tofu were supplied. 3) In the French Frenue correction center and the German Moabit detention house, the daily total amounts of energy were 2771.3 ㎉ and 2678.7 ㎉, respectively, which was estimated as appropriate compared with standard energy amount of 3000 ㎉ at that time and the current energy RDA of 2500 ㎉ for adult. The ratio of PFC was 16.2: 12.0: 71.8 in Frenue correction center and 12.4: 14.3: 73.3 in Moabit detention house, which showed that the amount of fat was slightly lacked. From this study, it was suggested that the prisons in Chosun and Taiwan under the Japanese rule and European prisons after the world panic were making an efforts to supply prisoners the appropriate amount of energy. The only question remains is that this data may be from only the food supply plan not from the data the prisoners took in real.eal.

• Journal of Intelligence and Information Systems
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• v.19 no.4
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• pp.55-79
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• 2013

In this paper, we propose a hybrid genetic algorithm (HGA) approach to effectively solve the reverse logistics network with centralized centers (RLNCC). For the proposed HGA approach, genetic algorithm (GA) is used as a main algorithm. For implementing GA, a new bit-string representation scheme using 0 and 1 values is suggested, which can easily make initial population of GA. As genetic operators, the elitist strategy in enlarged sampling space developed by Gen and Chang (1997), a new two-point crossover operator, and a new random mutation operator are used for selection, crossover and mutation, respectively. For hybrid concept of GA, an iterative hill climbing method (IHCM) developed by Michalewicz (1994) is inserted into HGA search loop. The IHCM is one of local search techniques and precisely explores the space converged by GA search. The RLNCC is composed of collection centers, remanufacturing centers, redistribution centers, and secondary markets in reverse logistics networks. Of the centers and secondary markets, only one collection center, remanufacturing center, redistribution center, and secondary market should be opened in reverse logistics networks. Some assumptions are considered for effectively implementing the RLNCC The RLNCC is represented by a mixed integer programming (MIP) model using indexes, parameters and decision variables. The objective function of the MIP model is to minimize the total cost which is consisted of transportation cost, fixed cost, and handling cost. The transportation cost is obtained by transporting the returned products between each centers and secondary markets. The fixed cost is calculated by opening or closing decision at each center and secondary markets. That is, if there are three collection centers (the opening costs of collection center 1 2, and 3 are 10.5, 12.1, 8.9, respectively), and the collection center 1 is opened and the remainders are all closed, then the fixed cost is 10.5. The handling cost means the cost of treating the products returned from customers at each center and secondary markets which are opened at each RLNCC stage. The RLNCC is solved by the proposed HGA approach. In numerical experiment, the proposed HGA and a conventional competing approach is compared with each other using various measures of performance. For the conventional competing approach, the GA approach by Yun (2013) is used. The GA approach has not any local search technique such as the IHCM proposed the HGA approach. As measures of performance, CPU time, optimal solution, and optimal setting are used. Two types of the RLNCC with different numbers of customers, collection centers, remanufacturing centers, redistribution centers and secondary markets are presented for comparing the performances of the HGA and GA approaches. The MIP models using the two types of the RLNCC are programmed by Visual Basic Version 6.0, and the computer implementing environment is the IBM compatible PC with 3.06Ghz CPU speed and 1GB RAM on Windows XP. The parameters used in the HGA and GA approaches are that the total number of generations is 10,000, population size 20, crossover rate 0.5, mutation rate 0.1, and the search range for the IHCM is 2.0. Total 20 iterations are made for eliminating the randomness of the searches of the HGA and GA approaches. With performance comparisons, network representations by opening/closing decision, and convergence processes using two types of the RLNCCs, the experimental result shows that the HGA has significantly better performance in terms of the optimal solution than the GA, though the GA is slightly quicker than the HGA in terms of the CPU time. Finally, it has been proved that the proposed HGA approach is more efficient than conventional GA approach in two types of the RLNCC since the former has a GA search process as well as a local search process for additional search scheme, while the latter has a GA search process alone. For a future study, much more large-sized RLNCCs will be tested for robustness of our approach.