• Radiation Oncology Journal
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• 제21권4호
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• pp.253-260
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• 2003

Purpose: No general consensus has been reached regarding the necessity of postoperative radiation therapy (PORT) and the optimal techniques of its application for patients with chest wall invasion (pT3cw) and node negative (NO) non-small cell lung cancer (NSCLC). We retrospectively analyzed the PT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. Materials and Methods: From Aug. 1994 till June 2000, 21 pT3cwN0 NSCLC patients received PORT at Samsung Medical Center; all of whom underwent curative on-bloc resection of the primary tumor plus the chest wall and regional lymph node dissection. PORT was typically stalled 3 to 4 weeks after operation using 6 or 10 MV X-rays from a linear accelerator. The radiation target volume was confined to the tumor bed plus the immediate adjacent tissue, and no regional lymphatics were included. The planned radiation dose was 54 Gy by conventional fractionation schedule. The survival rates were calculated and the failure patterns analyzed. Results: Overall survival, disease-free survival, loco-regional recurrence-free survival, and distant metastases-free survival rates at 5 years were 38.8$\%$, 45.5$\%$, 90.2$\%$, and 48.1$\%$, respectively. Eleven patients experienced treatment failure: six with distant metastases, three with intra-thoracic failures, and two with combined distant and intra-thoracic failures. Among the five patients with intra-thoracic failures, two had pleural seeding, two had in-field local failures, and only one had regional lymphatic failure in the mediastinum. No patients suffered from acute and late radiation side effects of RTOG grade 3 or higher. Conclusion: The strategy of adding PORT to surgery to improve the probability, not only of local control but also of survival, was justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. The incidence and the severity of the acute and late side effects of PORT were markedly reduced, which contributed to improving the patients' qualify of life both during and after PORT, without increasing the risk of regional failures by eliminating the regional lymphatics from the radiation target volume.

• Journal of agricultural medicine and community health
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• 제27권1호
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• pp.99-113
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• 2002

For this study a sample of 205 people, 66 males and 139 females, over 65 years of age, residing in C-gu of S-si and utilizing senior centers, were selected, The objective of the study was to provide basic data for health promotion program development provided by health centers. A questionnaire was used to collect date on general characteristics, health status, social health status and utilization rate for health services. The instruments used in this study were the Lawton scale, to measure daily routine function, the MMSE-K developed by Folstein and modified to fit the Korea situation, for mental health status, and the CES-Dtool developed by Radloff, for emotional health status. the SPSS Window program was used to calculate percentages. Tests of significance were done using t-test and ANOVA. Multiple regression analysis was used to identify variables influencing the use of health services. The results are as follows : Of those utilizing senior citizen centers, 40.9% of males and 17.3% of the female thought they were healthy. The average score for IADL was 7.4. The daily routine of female respondents consisted of buying household articles and drugs, and other IADLs such as riding the bus or subway alone. These resulted in a higher score compared to males. For emotional health, 7.6% of the males reported depression compared to 21.6% of the females. For mental health, 48.5% of the males and 28.8% of the females were found to be in the group suspicious for dementia. On social health, 57.6% of the males and 62.6% of the females reported no intimate human relations. Of those older people who had close human relations, 52.5% of the males indicated a friend as the closest person and 53.8% of the females, their children. On use of health services, there was a significantly higher need for mobile medical care services treatment for those with lower education levels and status of window/widower. There was a significantly higher need for health exmination services for those with lower levels of exercise, greater satisfaction with sleep, higher levels of oral health care, and higher social contacts. In conclusion, there is a need to provide varied programs for the promotion of health, along with parallel resolution of social, psychological and economic issues. It is recommended that health services for elderly people provided by the health centers be implemented with full recognition of these characteristics and differences.

• Radiation Oncology Journal
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• 제28권3호
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• pp.125-132
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• 2010

Purpose: To retrospectively assess the advantages and side effects of prophylactic Paraaortic irradiation in cervical cancer patients with common iliac nodal involvement, the results for survival, patterns of failure, and treatment-related toxicity. Materials and Methods: From May 1985 to October 2004, 909 patients with cervical carcinoma received postoperative radiotherapy at the Seoul National University Hospital. Among them, 54 patients with positive common iliac nodes on pathology and negative Paraaortic node were included in the study. In addition, 44 patients received standard pelvic irradiation delivered 50.4 Gy per 28 fractions (standard irradiation group), and chemotherapy was combined in 16 of them. The other 10 patients received pelvic irradiation at a dose of 50.4 Gy per 28 fractions in addition to Paraaortic irradiation at 45 Gy per 25 fractions (extended irradiation group). In addition, all of them received chemotherapy in combination with radiation. Follow-up times for pelvic and Paraaortic irradiation ranged from 6 to 201 months (median follow-up time, 58 months) and 21 to 58 months (median follow-up time, 47 months), respectively. Results: The 4-year overall survival, disease free survival, and distant metastasis free survival in the standard irradiation group and extended irradiation group were 67.2% vs. 90.0% (p=0.291), 59.0% vs. 70.0% (p=0.568) and 67.5% vs. 90.0% (p=0.196), respectively. The most common site of first failure for the standard irradiation group was the paraaortic lymph node, while no paraaortic failure was observed in the extended irradiation group. Relatively, hematologic toxicity grade 3 or greater was common in the extended irradiation group (2/10 extended vs. 2/44 standard), while gastrointestinal toxicity of grade 3 or greater was lower (2/10 extended vs. 6/44 standard), and urologic toxicity of grade 3 or greater was observed in the standard irradition group only (0/10 vs. 3/44). Conclusion: Concurrent chemotherapy and prophylactic Paraaortic irradiation in patients with common iliac nodal involvement showed slightly improved clinical outcomes aside from increased hematologic toxicity, which was statistically insignificant. Considering the relatively small number of patients and short follow-up times, additional studies are needed to obtain more conclusive outcomes.

• Journal of Nutrition and Health
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• 제42권7호
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• pp.650-663
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• 2009

The purposes of this study were to investigate one portion size of menus served and to evaluate nutrient intake of lunch at three elderly care facility food services located in Seoul. A weighed plate method was employed to measure plate wastes and consumption of the menus served. Yield factors were calculated from cooking experiments based on standardized recipes, and were used to evaluate nutrient intake. One hundred elderly participated in this study for measuring plate waste and were asked to complete questionnaire. Nutrient analyses for the served and consumed meal were performed using CAN program. The yield factors of rice dishes after cooking are 2.4 regardless of rice dish types, 1.58 for thick soups, 0.60 to 0.70 for meat dishes, and 1.0 to 1.25 branched vegetable. Average consumption quantity of dishes were 235.97 g for rice, 248.53 g for soup, 72.83 g for meat dishes, 39.80 g for vegetables and 28.36 g for Kimchi. On average the food waste rate is 14.0%, indicating the second highest plate waste percentage of Kimchi (26.2%), and meat/fish dish (17.3%). The evaluation results of NAR (Nutrition Adequacy Ratio) showed that iron (0.12), calcium (0.64), riboflavin (0.80), and folic acid (0.97) were less than 1.0 in both male and female elderly groups, indicating significant differences of NAR among three facilities. Compared to the 1/3 Dietary Reference Intake (DRIs) for the elderly groups, nutrient intake analysis demonstrated that calcium (100%) and iron (100%), followed by riboflavin, vitamin A, and Vitamin B6 did not met of the 1/3 EAR (Estimated Average Requirement). For the nutritious meal management, a professional dietitian should be placed at the elderly care center to develop standardized recipes in consideration of yield factors and the elderly's health and nutrition status.

• Radiation Oncology Journal
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• 제14권1호
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• pp.1-8
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• 1996

Purpose: We tried to evaluate the role of conventional radiotherapy alone or with neoadjuvant chemotherapy in oropharyngeal cancer in terms of survival rates and to identify prognostic factors affecting survival by retrospective analysis. Materials and Methods: Forty seven patients of oropharyngeal cancer were treated by conventional radiotherapy in our hospital from Nov. 1985 to APr. 1993. Of these, twenty six patients were treated by conventional radio-therapy alone, and 21 patients with neoadjuvant chemotherapy of mostly two or more cycles of cisplatin and pepleomycin. The Patient characteristics of radiotherapy alone group and neoadjuvant chemotherapy group were not different generally. Radiotherapy was performed by 6MV-LINAC and the total radiation doses of Primary tumors were 54.0-79.2 Gy and cervical lymph nodes were 55.8-90.0 Gy with a fraction size of 1.8 or 2.0 Gy per day. The range of follow-up periods was 3-102 months and median was 20 months. The range of a9e was 33-79 years old and median was 58 years old. Results : Overall 3-year actuarial survival rate (3YSR) of all patients was $39\%$. The 3YSRS of stage I (n=5), II (n=11), III (n=12) and IV (n=19) were 60, 55, 33 and $32\%$, respectively The 3YSRS of Tl+2, T3+4 and No, N+ were 55, $18\%$ (p=0.005) and 43, $36\%$ (p>0.1), respectively. There was no difference in 3YSRS between radiotherapy alone group and neoadjuvant chemotherapy group (38 vs $43\%$, p>0.1). According to the original site of primary tumor, the 3YSRS of tonsil (n=32), base of tongue (n=8), soft palate or uvula (n=6) and pharyngeal wall (n=1) were 36 38, 67 and $0\%$, respectively The Patients of soft palate or uvular cancer had longer survival than other primaries but the difference was not significant statistically (p>0.1). Of 32 patients of tonsillar cancer, 22 Patients who had primary extension to adjacent tissue showed inferior survival rate to the ones who had not Primary extension, but the difference was marginally significant statistically (24 vs $60\%$, p=0.08). On Cox multivariate analysis in entire patients with variables of age, T stage, N stage, total duration of radiotherapy, the site of primary tumor and the use of neoadjuvant chemotherapy, only T stage was a significant Prognostic factor affecting 3YSR. Conclusion : The difference of 3YASRS of conventional radiotherapy alone group and neoadjuvant chemotherapy group was not significant statistically. These treatments could be effective in oropharyngeal cancer of early stage, especially such as soft palate, uvular or tonsillar cancer which did not extend to adjacent tissue. But in order to improve the survival of patients of most advanced oropharyngeal cancer, other altered fractionated radiotherapy such as hyperfractionation rather than conventional fractionation or multi-modal approach combining radiotherapy and accessible surgery or concurrent chemotherapy might be beneficial.

• Radiation Oncology Journal
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• 제27권3호
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• pp.126-132
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• 2009

Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

• Journal of Chest Surgery
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• 제39권10호
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• pp.739-748
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• 2006

Background: The purpose of this study is to ascertain the neuroprotective effect of cyclosporin A on the 25-min surgical ischemia model in the spinal cords of rabbits with neuropathological correlation and histoimmunochemical analyses, Material and Method: Thirty-two New Zealand white rabbits were randomly divided into four groups: Rabbits were randomly divided into four groups: the control 12 group (n=8), the control 17 group (n=8), the cyclosporin Cs2 group (n=8), and the cyclosporin Cs7 group (n=8). The 12 group underwent a 25-min aortic cross- clamp without intervention and were sacrificed on the 2nd day postoperatively, while the 17 group underwent a 25- min of aortic cross-clamp without intervention and were sacrificed on the 7th day postoperatively. The Cs2 group received cyclosporin A (25 mg/kg) intravenously 15 min after the 25-min cross-clamp and were sacrificed on the End day postoperatively, while the Cs7 group received cyclosporin A (25 mg/kg) intravenously 15 min after the 25-min cross-clamp and were sacrificed on the 7th day postoperatively. The rabbits underwent 25-min surgical aortic cross-clamp. Neurologic functions were evaluated on the 2nd day and 7th postoperative day using Tarlov scoring system. After scoring neurologic function, all rabbits were sacrificed for histopathologic observation. Result: All rabbits survived the experimental procedure. The values of Tarlov score did not show any differences between the control and cyclosporin groups on the 2nd day. The scores of group Cs7 ($2.75{\pm}0.89$) were significantly higher than those of group 17 ($1.25{\pm}1.39$) on the 7th day (p<0,05). On the histologic exanminations, specimens of the spinal cord showed necrosis and apoptosis. The pathologic scores of group Cs7 ($1,0{\pm}0.53$) was less than those of group 17 ($2.13{\pm}1.36$, p<0.05). TUNEL staing showed apoptosis of the specimen in group 12 and Cs2 but there was no stastically significant difference between groups on the score. There were more overexpression of HSP70 and nNOS in cyclosporine group than in control group. Conclusion: We think that cyclosporin A may decrease neuronal cell death with induced upregulation of HSP70 against 25-min ischemia of the spiral cord in the rabbit.

• The Korean Journal of Nuclear Medicine
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• 제38권4호
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• pp.318-324
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• 2004

Purpose: Philips GEMINI is a newly introduced whole-body GSO PET/CT scanner. In this study, performance of the scanner including spatial resolution, sensitivity, scatter fraction, noise equivalent count ratio (NECR) was measured utilizing NEMA NU2-2001 standard protocol and compared with performance of LSO, BGO crystal scanner. Methods: GEMINI is composed of the Philips ALLEGRO PET and MX8000 D multi-slice CT scanners. The PET scanner has 28 detector segments which have an array of 29 by 22 GSO crystals ($4{\times}6{\times}20$ mm), covering axial FOV of 18 cm. PET data to measure spatial resolution, sensitivity, scatter fraction, and NECR were acquired in 3D mode according to the NEMA NU2 protocols (coincidence window: 8 ns, energy window: $409[\sim}664$ keV). For the measurement of spatial resolution, images were reconstructed with FBP using ramp filter and an iterative reconstruction algorithm, 3D RAMLA. Data for sensitivity measurement were acquired using NEMA sensitivity phantom filled with F-18 solution and surrounded by $1{\sim}5$ aluminum sleeves after we confirmed that dead time loss did not exceed 1%. To measure NECR and scatter fraction, 1110 MBq of F-18 solution was injected into a NEMA scatter phantom with a length of 70 cm and dynamic scan with 20-min frame duration was acquired for 7 half-lives. Oblique sinograms were collapsed into transaxial slices using single slice rebinning method, and true to background (scatter+random) ratio for each slice and frame was estimated. Scatter fraction was determined by averaging the true to background ratio of last 3 frames in which the dead time loss was below 1%. Results: Transverse and axial resolutions at 1cm radius were (1) 5.3 and 6.5 mm (FBP), (2) 5.1 and 5.9 mm (3D RAMLA). Transverse radial, transverse tangential, and axial resolution at 10 cm were (1) 5.7, 5.7, and 7.0 mm (FBP), (2) 5.4, 5.4, and 6.4 mm (3D RAMLA). Attenuation free values of sensitivity were 3,620 counts/sec/MBq at the center of transaxial FOV and 4,324 counts/sec/MBq at 10 cm offset from the center. Scatter fraction was 40.6%, and peak true count rate and NECR were 88.9 kcps @ 12.9 kBq/mL and 34.3 kcps @ 8.84 kBq/mL. These characteristics are better than that of ECAT EXACT PET scanner with BGO crystal. Conclusion: The results of this field test demonstrate high resolution, sensitivity and count rate performance of the 3D PET/CT scanner with GSO crystal. The data provided here will be useful for the comparative study with other 3D PET/CT scanners using BGO or LSO crystals.

• KDI Journal of Economic Policy
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• 제32권2호
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• pp.93-143
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• 2010

This paper estimates the impact of Japan's economic sanction on DPRK trade in the 2000s. It conceptualizes the effects of sanction on DPRK trade, econometrically tests whether such effects exist in case of Japan's sanction using currently available DPRK trade statistics, and measures the size of the effects by correcting and reconfiguring the deficiencies of the currently available DPRK trade statistics. The main findings of the paper are as follows. First, Japan's sanction can have two different effects on DPRK trade: 'Sanction Country Effect' and "Third Country Effect.' The former means that the sanction diminishes DPRK trade with Japan while the latter refers to the effects on DPRK trade with other countries as well. The third country effect can arise not simply because the DPRK changes its trade routes to circumvent the sanction, but because the sanction forces the DPRK to readjust its major trade items and patterns. Second, currently no official DPRK trade statistics are available. Thus, the so-called mirror data referring to DPRK trading partners' statistics should be employed for the analysis of the sanction effects. However, all currently available mirror data suffer from three fundamental problems: 1) they may omit the real trade partners of the DPRK; 2) they may confuse ROK trade with DPRK trade; 3) they cannot distinguish non-commercial trade from commercial trade, whereas only the latter concerns Japan's sanction. Considering those problems, we have to adopt the following method in order to reach a reasonable conclusion about the sanction effect. That is, we should repeat the same analysis using all different mirror data currently available, which include KOTRA, IMF and UN Commodity Trade Statistics, and then discuss only the common results from them. Third, currently available mirror data make the following points. 1) DPRK trade is well explained by the gravity model. 2) Japan's sanction has not only the sanction country effect but also the third country effect on DPRK trade. 3) The third country effect occurs differently on DPRK export and import. In case of export, the mirror statistics reveal positive (+) third country effects on all of the major trade partners of the DPRK, including South Korea, China and Thailand. However, on DPRK import, such third country effects are not statistically significant even for South Korea and China. 4) This suggests that Japan's sanction has greater effects on DPRK import rather than its export. Fourth, as far as DPRK export is concerned, it is possible to resolve the abovementioned fundamental problems of mirror data and thus reconstruct more accurate statistics on DPRK trade. Those reconstructed statistics lead us to following conclusions. 1) Japan's economic sanction diminished DPRK's export to Japan from 2004 to 2006 by 103 million dollars on annual average (Sanction Country Effect). It comprises around 60 percent of DPRK's export to Japan in 2003. 2) However, for the same period, the DPRK diverted its exports to other countries to cope up with Japan's sanction, and as a result its export to other countries increased by 85 million dollars on annual average (Third Country Effect). 3) This means that more than 80 per cent of the sanction country effect was made up for by the third country effect. And the actual size of impact that Japan's sanction made on DPRK export in total was merely 30 million dollars on annual average. 4) The third country effect occurred mostly in inter-Korean trade. In fact, Japan's sanction increased DPRK export to the ROK by 72 million dollars on annual average. In contrast, there was no statistically significant increase in DPRK export to China caused by Japan's sanction. 5) It means that the DPRK confronted Japan's sanction and mitigated its impact primarily by using inter-Korean trade and thus the ROK. Fifth, two things should be noted concerning the fourth results above. 1) The results capture the third country effect caused only by trade transfer. Facing Japan's sanction, the DPRK could transfer its existing trade with Japan to other countries. Also it could change its main export items and increase the export of those new items to other countries as mentioned in the first result. However, the fourth results above reflect only the former, not the latter. 2) Although Japan's sanction did not make a huge impact on DPRK export, it might not be necessarily true for DPRK import. Indeed the currently available mirror statistics suggest that Japan's sanction has greater effects on DPRK import. Hence it would not be wise to argue that Japan's sanction did not have much impact on DPRK trade in general, simply using the fourth result above.

• Journal of Fisheries and Marine Sciences Education
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• 제10권2호
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• pp.139-161
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• 1998

This thesis includes a study on the legal regulation, the system and formalities on the control of illegal fishing. And the author analyzed the details of the lists of illegal fishing controlled by fishing patrol vessels of Ministry of Maritime Affairs and Fisheries from 1994 to 1996 in adjacent sea area of Korea. The results are summarized as follows ; 1. The fishing patrol vessels controlled total 826 cases in 2,726 days of 292 voyages by 17 vessels in 1994, total 1,086 cases in 3,060 days of 333 voyages by 18 vessels in 1995 and total 933 cases in 3,126 days of 330 voyages by 19 vessels in 1996. 2. The fishing period of illegal fishing was generally concentrated from April to September. But year after year, illegal fishing was scattered throughout the year. 3. The most controlled sea area of illegal fishing was the south central sea area in the sea near Port of Tongyeong. The sea area occupied about 36~51% of totality and the controlled cases were gradually increased every year. The second was the south western sea area in the sea near Port of Yosu. The sea area occupied about 18-27% and the controlled cases were a little bit increased every year. The third was the south eastern sea area in the sea near Pusan. The sea area occupied about 13~23% and the controlled cases were gradually decreased year by year. 4. The most controlled kind of illegal fishing was the small size bottom trawl. This occupied about 81-95% of totality and the controlled cases were gradually increased year by year. The second was the medium size bottom trawl. This occupied about 4-7% and the controlled cases were gradually decreased year by year. The third was the trawl of the coastal sea, this occupied about 2~4% and the controlled cases were a little bit decreased every year. 5. The most controlled address of illegal fishing manager was Pusan city which occupied about 33-51% of totality. The second was Cheonnam which occupied about 24-29%. The third was Kyungnam which occupied about 16~35%. 6. The most controlled violation of regulations was Article 57 of the Fisheries Act which occupied about 56-64% of totality. The second was Article 23 of Protectorate for Fisheries Resources which occupied about 21-36%. And the controlled cases by it were gradually increased every year.