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Prognostic Relevance of WHO Classification and Masaoka Stage in Thymoma (흉선종양에서의 WHO 분류와 Masaoka 병기, 임상양상간의 상관관계연구)

  • Kang Seong Sik;Chun Mi Sun;Kim Yong Hee;Park Seung Il;Eeom Dae W.;Ro Jaee Y.;Kim Dong Kwan
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.44-49
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    • 2005
  • Although thymomas are relatively common mediastinal tumors, to date not only has a universal system of pathologic classification not been established but neither has a clearly defined predictable relationship between treatment and prognosis been made. Recently, a new guideline for classification was reported by WHO, and efforts, based on this work, have been made to better define the relationship between treatment and pro­gnostic outcome. In the present study a comparative analysis between the WHO classification and Masaoka stage system with the clinical disease pattern was conducted. Material and Method: A total of 98 patients undergoing complete resection for mediastinal thymoma between Juanuary 1993 and June 2003 were included in the present study. The male female ratio was 48 : 50 and the mean age at operation was $49.6{\pm}13.9\;years.$ A retrospective analytic comparison studying the relationship between the WHO classification and the Masaoka stage system with the clinical disease pattern of thymoma was conducted. Pathologic slide specimens were carefully examined, details of postoperative treatment were documented, and a relationship with the prognostic outcome and recurrence was studied. Result: There were 7 patients in type A according to the WHO system of classification, 14 in AB, 28 in B 1, 23 in B2, 18 in B3, and 9 in type C. The study of the relationship between the Masaoka stage and WHO classification system showed 4 patients to be in WHO system type A, 7 in type AB, 22 in B 1, 17 in B2, and 3 in type B3 among 53 $(54{\%})$ patients shown to be in Masaoka stage I. Among 28 $(28.5{\%})$ patients in Masaoka stage II system, there were 2 patients in type A, 7 in AB, 4 in B 1, 2 in B2, 8 in B3, and 5 in type C. Among 15 $(15.3{\%})$ in Masaoka stage III, there were 1 patient in type B1, 3 in B2, 7 in B3, and 4 in type C. Finally, among 2 $(2{\%})$ patients found to be in Masaoka stage IV there was 1 patient in type B1, and 1 in type B2. The mean follow up duration was $28{\pm}6.8$ months. There were 3 deaths in the entire series of which 2 were in type B2 (Masaoka stages III and IV), and 1 was in type C (Masaoka stage II). Of the patients that experienced relapse, 6 patients remain alive of which 2 were in type B2 (Masaoka III), 2 in type B3 (Masaoka I and III) and 2 in type C (Masaoka stage II). The 5 year survival rate by the Kaplan-Meier method was $90{\%}$ for those in type B2 WHO classification system, $87.5{\%}$ for type C. The 5 year freedom from recurrence rate was $80.7{\%}$ for those in WHO type B2, $81.6{\%}$ for those in type B3, and $50{\%}$ for those in type C. By the Log-Rank method, a statistically significant correlation between survival and recurrence was found with the WHO system of classification (p<0.05). An analysis of the relationship between the WHO classification and Masaoka stage system using the Spearman correction method, showed a slope=0.401 (p=0.023), showing a close correlation. Conclusion: As type C of the WHO classification system is associated with a high postoperative mortality and recurrence rate, aggressive treatment postoperatively and meticulous follow up are warranted. The WHO classification and Masaoka stage system were found to have a close relationship with each other and either the WHO classification method or the Masaoka stage system may be used as a predict prognostic outcome of Thymoma.

Overview of Utilization of Four-wheel Tractor in Korea(I) -Ownership and Annual Use by Different Farm Groups- (농용(農用)트랙터 이용(利用)에 관(關)한 조사연구(調査硏究)(I) -경영형태별(經營形態別) 농작업이용실태분석(農作業利用實態分析)-)

  • Park, Ho Seok;Kim, Kyong Su;Lee, Yong Kook;Han, Sung Kum
    • Journal of Biosystems Engineering
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    • v.6 no.2
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    • pp.20-32
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    • 1982
  • This survey was conducted to investigate the present status of farm tractor utilization for obtaining a basic reference to the establishment of the government's agricultural mechanization strategies. Thirty two counties from the eight provinces except Jeju were covered in this study. From these selected areas, 433 sample farms having farm tractor were taken to obtain the general informations by the enquete, and 93 sample farms among them to investigate the status of daily tractor use in the year of 1980. The analyzed results are summarized as follows: 1. Farm tractors owned by the rice-oriented farms holds 71.5 percent of the total number of tractors the livestock-oriented farms 17.0 percent, and the orchard-oriented farms 7.0 percent. Among the farm tractors 64.3 percent was a large size (46ps) and 35.7 percent a small size(19~23ps). 2. Most of the tractors surveyed were equipped with the essential attachments such as plow and rotavator. About 18 percent of the tractor owners had no trailer, which seemed too high considering the large percentage of tractor use for transportation. The availability of other attachments was very low except a grader on the rice-oriented farms and a hay harvester and a front loader on the livestock-oriented farms. 3. The average size of farm was 3.9 hectare for the rice-oriented farms, 13.9 hectare for the livestock-oriented farms and 7.4 hectare for the orchard-oriented farms. It was obious that the average farm size of was too small compared to the theoretical machine capacity of the tractors. 4. About 70 percent of the tractor operators were in the age of twenties and thirties. About 90 percent of them had an educational level of middle school graduate or above even though their technical level was very low. 5. Any particular problem in tractor use was not found in this survey. From the farmer's preference for purchasing a new tractor, however, it is estimated the demand on a 20-30ps tractor will be more increased. 6. The average annual use of tractor was of about 100 days or 400 hours. It appeared that the rice-oriented farms used most with 412.4 hours per year, and followed by the livestock-oriented farms with 403.6 hours, the orchard oriented farms with 377.7 hours. 7. Among the total hours of tractor use, 47.3 percent was for transportation, and 41.6 percent was for plowing and rotary tillage. The largest portion of the annual tractor use was taken by transportation on the livestock-oriented farms, by land preperation on the rice-oriented farms, and by loading and chemical spraying on the orchard-oriented farms. 8. The hours of tractor use had a peak in May. The hours of use for own farm was remarkably different among the different farm oriented, but there was no considerable difference between the too different sizes of tractor. 9. The hours of tractor use decreased as the age of the operator or the educational level increased. The reason might be that the operators who had a high educational level or were older had a tendency of disliking custom works. 10. The average custom use of tractor was 171.3 hours per year, and the ratio of custom work was 63.7 percent on the rice-oriented farms, 31.7 percent on the livestock-oriented farms and 22.4 percent on the orchard-oriented farms. Among the custom works, the most popular one was the grader leveling. 11. The charge on custom work was about 40,000 Won per hectare for plowing and rotary tillage, and it was the most expensive in the southeastern region, and next followed by the southwestern region. 12. The average plowing capacity of the small tractor was 7.8 hours per hectare in the paddy field, and that of the large tractors was 4.3 hours per hectare. The average rotary-tilling capacities of the small and the large tractors were 6.5 and 4.3 hours per hectare, in the paddy field respectively.

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Seasonal Variations of Water Quality in the Lower Part of the Nagdong River (낙동강 하류수질의 계절적 변화)

  • KIM Yong-Gwan;SHIM Hye-Kung;CHO Hak-Rae;YOU Sun-Jae
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.17 no.6
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    • pp.511-522
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    • 1984
  • The Nagdong is one of the biggest rivers in Korea, which is very important water source not only for tap water of Pusan city but also for the industrial water. Therefore, authors tried to check the water quality year by year. In this experiment one hundred and twenty water samples collected from August 1983 to July 1984 were analyzed bacteriologically and physiologically. Fifteen sampling stations were established between near Samrangjin and estuary of the river. To evaluate the water quality, temperature, pH, chloride ion, salinity, chemical oxygen demand (COD), electrical conductivity, nutrients, total coliform, fecal coliform, fecal streptococcus, viable cell count and bacterial flora were observed. The variation of water temperature was ranged $-1.5{\sim}29.0^{\circ}C$ (Mean value $13.9{\sim}16.5^{\circ}C$), it in spring was higher as $10{\sim}15^{\circ}C$ about $10^{\circ}C$ than in winter and it in autumm was very stabilized as about $20^{\circ}C$ at each station. The pH variation of the samples was ranged $6.68{\sim}9.15$. The range of concentration of chloride ion and salinity varied $7.4{\sim}l,020.5$ mg/l and $1.05{\sim}33.0\%0$, respectively. Especially, salinity of the 3rd water war was the higher than others as $25.76{\sim}31.58\%0$. COD was ranged $1.45{\sim}14.94$ mg/l and the lower part of the Nagdong River was heavily contaminated by domesitc sewage and waste water from the adjacent factor area. The range of electrical conductivity was $1.360{\times}10^2{\sim}5.650{\times}10^4{\mu}{\mho}/cm$ and that was by far higher the estuary than the upper. Concentration of nutrients were $0.008{\sim}0.040$ mg/l (Mean value $0.019{\sim}0.068$ mg/l) for $NO_2-N,\;0.038{\sim}5.253$ mg/l ($0.351{\sim}2.347$ mg/l) for $NO_3-N,\;0.100{\sim}2.685$ mg/l($0.117{\sim}1.380$ mg/l) for $NH_4-N,\;0.003{\sim}0.084$ mg/l($0.014{\sim}0.065$ mg/l) for $PO_4-P$ and $0.154{\sim}6.123$ mg/l ($1.165{\sim}3.972$ mg/l) for $SiO_2-Si$, respectively. Usually nutrients contents of the water in the upper part(included station 1 to 5) were higher than those of the estuarine area. The bacterial density of the samples ranged 7.3 to 460,000/100 ml for total coliforms, 3.6 to 460,000/100 ml for fecal coliform, $0{\sim}46,000/100ml$ for fecal streptococcus and $<30{\sim}1.2{\times}10^5/ml$ for viable cell count. Composition of coliform was $28\%$ Escherichia coli group, $18\%$ Citrobacter freundii group, $31\%$ Enterobacter aerogenes group and $22\%$ others. Predominant species among the 659 strains isolated from the samples were Pseudomonas spp. ($42\%$), Flavobacterium spp. ($20\%$) and Moraxella spp. ($12\%$).

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The Landscape Configuration and Semantic Landscape of Hamheo-pavilion in Gokseong (곡성 함허정(涵虛亭)의 경관짜임과 의미경관)

  • Lee, Hyun-Woo;Sim, Woo-Kyung;Rho, Jae-Hyun;Shin, Sang-Sup
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.33 no.1
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    • pp.52-64
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    • 2015
  • This research traced the characteristics of the semantic landscape, construction intent, landscape composition, and geomantic conditions of the area subject to the research based on the research methods of 'field investigation, document studies, and interviews,' centering around the entire area of Gokseong Hamheo-pavilion (Jeonnam Tangible Cultural Assets No. 160). The result of the research, specifically revealing the forms and methods by which the reciprocal view of nature and landscape composition appearing in the landscape of the entire area of Hamheo-pavilion, as part of the analysis and interpretation over the view-based construction characteristics and position of the entire area of Gokseong Hamheo-pavilion, can be summarized as follows. First, Hamheo-pavilion is a pavilion built as a resting area and as a venue for educational activities in 1543 in the nearby areas after Gwang-hyeon Sim founded Gunjichon-jeongsa for educational activities and dwelling purposes at Gunchon at the 30th year of King Jungjong. Gunchon, where Hamheo-pavilion and Gunjichon-jeongsa is located, exhibits the typical form having water in the front, facing Sunja-river(present Seomjin-river), and a mountain in the back side. Dongak-mountain, which is a guardian mountain, is in a snail-type form where cows leisurely ruminate and lie on the riverside, and the Hamheo-pavilion area is said to be an area bordering on one's way of enjoying peace and richness as it is a place with plentiful grass bushes available for cows to ruminate and lie down while sheppards may leisurely play their flutes at the riverside. The back hill of Hamheo-pavilion is a blood vessel that enters the water into the underwater palace of the turtle, and the building sitting on the turtle's back is Hamheo-pavilion, and the Guam-jodae(龜巖釣臺) and lava on the southern side below the cliff can be interpreted to be the underwater fairly land wanted by the turtle.6) Second, Hamheo-pavilion is the scenery viewpoint of Sungang-Cheongpung (3rd Scenery) and Seolsan-Nakjo(雪山落照, 9th Scenery) among the eight sceneries of Gokseong, while also the scenery viewpoint of Hamheo-Sunja(2nd Scenery) and Cheonma-Gwiam(天馬歸岩, 3rd Scenery) among the eight sceneries of Ipmyeon. On the other hand, the pavilion is reproduced through the aesthetics of bends through sensible penetration and transcendental landscape viewed based on the Confucian-topos and ethics as the four bends among the five bends of Sunja-river arranged in the 'Santaegeuk(山太極) and Sutaeguek(水太極, formation of the yin-yang symbol by the mountain and water)' form, which is alike the connection of yin and yang. In particular, when based on the description over Mujinjeong (3rd Bend), Hoyeonjeong(4th Bend), andHapgangjeong(2nd Bend) among the five bends of Sunja-river in the records of Bibyeonsainbangan-jido(duringthe 18th century) and Okgwahyeonji(1788), the scenery of the five bends of Sunja-river allow to glimpse into its reputation as an attraction-type connected scenery in the latter period of the Joseon era, instead of only being perceived of its place identity embracing the fairyland world by crossing in and out of the world of this world and nirvana. Third, Hamheo-pavilion, which exhibits exquisite aesthetics of vacancy, is where the 'forest landscape composed of old big trees such as oak trees, oriental oak trees, and pine trees,' 'rock landscape such as Guam-jodae, lava, and layered rocks' and 'cultural landscape of Gunchon village' is spread close by. In the middle, it has a mountain scenery composed of Sunja-river, Masan-peak, and Gori-peak, and it is a place where the scenery by Gori-peak, Masan-peak, Mudeung-mountain, and Seol-mountain is spread and open in $180^{\circ}$ from the east to west. Mangseo-jae, the sarangchae (men's room)of Gunjichon-jeongsa, means a 'house observing Seoseok-mountain,' which has realized the diverse view-oriented intent, such as by allowing to look up Seol-mountain or Mudeung-mountain, which are back mountains behind the front mountain, through landscape configuration. Fourth, the private home, place for educational activities, pavilion, memorial room, and graveyard of Gunji-village, where the existence and ideal is connected, is a semantic connected scenery relating to the life cycle of the gentry linking 'formation - abundance - transcendence - regression.' In particular, based on the fact that the descriptions over reciprocal views of nature regarding an easy and comfortable life and appreciations for a picturesque scene of the areas nearby Sunja-river composes most of the poetic phrases relating to Hamheo-pavilion, it can be known that Hamheo-pavilion is expressed as the key to the idea of 'understanding how to be satisfied while maintaining one's positon with a comfortable mind' and 'returning to nature,' while also being expressed of its pedantic character as a place for reclusion for training one's mind and training others through metaphysical semantic scenery.

A Study on Intelligent Value Chain Network System based on Firms' Information (기업정보 기반 지능형 밸류체인 네트워크 시스템에 관한 연구)

  • Sung, Tae-Eung;Kim, Kang-Hoe;Moon, Young-Su;Lee, Ho-Shin
    • Journal of Intelligence and Information Systems
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    • v.24 no.3
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    • pp.67-88
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    • 2018
  • Until recently, as we recognize the significance of sustainable growth and competitiveness of small-and-medium sized enterprises (SMEs), governmental support for tangible resources such as R&D, manpower, funds, etc. has been mainly provided. However, it is also true that the inefficiency of support systems such as underestimated or redundant support has been raised because there exist conflicting policies in terms of appropriateness, effectiveness and efficiency of business support. From the perspective of the government or a company, we believe that due to limited resources of SMEs technology development and capacity enhancement through collaboration with external sources is the basis for creating competitive advantage for companies, and also emphasize value creation activities for it. This is why value chain network analysis is necessary in order to analyze inter-company deal relationships from a series of value chains and visualize results through establishing knowledge ecosystems at the corporate level. There exist Technology Opportunity Discovery (TOD) system that provides information on relevant products or technology status of companies with patents through retrievals over patent, product, or company name, CRETOP and KISLINE which both allow to view company (financial) information and credit information, but there exists no online system that provides a list of similar (competitive) companies based on the analysis of value chain network or information on potential clients or demanders that can have business deals in future. Therefore, we focus on the "Value Chain Network System (VCNS)", a support partner for planning the corporate business strategy developed and managed by KISTI, and investigate the types of embedded network-based analysis modules, databases (D/Bs) to support them, and how to utilize the system efficiently. Further we explore the function of network visualization in intelligent value chain analysis system which becomes the core information to understand industrial structure ystem and to develop a company's new product development. In order for a company to have the competitive superiority over other companies, it is necessary to identify who are the competitors with patents or products currently being produced, and searching for similar companies or competitors by each type of industry is the key to securing competitiveness in the commercialization of the target company. In addition, transaction information, which becomes business activity between companies, plays an important role in providing information regarding potential customers when both parties enter similar fields together. Identifying a competitor at the enterprise or industry level by using a network map based on such inter-company sales information can be implemented as a core module of value chain analysis. The Value Chain Network System (VCNS) combines the concepts of value chain and industrial structure analysis with corporate information simply collected to date, so that it can grasp not only the market competition situation of individual companies but also the value chain relationship of a specific industry. Especially, it can be useful as an information analysis tool at the corporate level such as identification of industry structure, identification of competitor trends, analysis of competitors, locating suppliers (sellers) and demanders (buyers), industry trends by item, finding promising items, finding new entrants, finding core companies and items by value chain, and recognizing the patents with corresponding companies, etc. In addition, based on the objectivity and reliability of the analysis results from transaction deals information and financial data, it is expected that value chain network system will be utilized for various purposes such as information support for business evaluation, R&D decision support and mid-term or short-term demand forecasting, in particular to more than 15,000 member companies in Korea, employees in R&D service sectors government-funded research institutes and public organizations. In order to strengthen business competitiveness of companies, technology, patent and market information have been provided so far mainly by government agencies and private research-and-development service companies. This service has been presented in frames of patent analysis (mainly for rating, quantitative analysis) or market analysis (for market prediction and demand forecasting based on market reports). However, there was a limitation to solving the lack of information, which is one of the difficulties that firms in Korea often face in the stage of commercialization. In particular, it is much more difficult to obtain information about competitors and potential candidates. In this study, the real-time value chain analysis and visualization service module based on the proposed network map and the data in hands is compared with the expected market share, estimated sales volume, contact information (which implies potential suppliers for raw material / parts, and potential demanders for complete products / modules). In future research, we intend to carry out the in-depth research for further investigating the indices of competitive factors through participation of research subjects and newly developing competitive indices for competitors or substitute items, and to additively promoting with data mining techniques and algorithms for improving the performance of VCNS.

CELL CULTURE STUDIES OF MAREK'S DISEASE ETIOLOGICAL AGENT (조직배양(組織培養)에 의한 Marek 병(病) 병원체(病原體)의 연구(硏究))

  • Kim, Uh-Ho
    • Korean Journal of Veterinary Research
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    • v.9 no.1
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    • pp.23-62
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    • 1969
  • Throughout the studies the following experimental results were obtained and are summarized: 1. Multiplication of agents in primary cell cultures of both GF classical and CR-64 acute strain of Marek's disease infected chicken kidneys was accompanied by the formation of distinct transformed cell foci. This characteristic nature of cell transformation was passaged regularly by addition of dispersed cell from infected cultures to normal chicken kidney cell cultures, and also transferred was the nature of cell transformation to normal chick-embryo liver and neuroglial cell cultures. No cytopathic changes were noticed in inoculated chick-embryo fibroblast cultures. 2. The same cytopathic effects were noticed in normal kidney cell monolayers after the inoculation of whole blood and huffy coat cells derived from both forms of Marek's disease infected chickens. In these cases, however, the number of transformed cell foci appearing was far less than that of uninoculated monolayers prepared directly from the kidneys of Marek's disease infected chickens. 3. The change in cell culture IS regarded as a specific cell transformation focus induced by an oncogenic virus rather than it plaque in slowly progressing cytopathic effect by non-oncogenic viruses, and it is quite similar to RSV focus in chick-embryo fibroblasts in many respects. 4. The infective agent (cell transformable) were extremely cell-associated and could not be separated in an infective state from cells under the experimental conditions. 5. The focus assay of these agents was valid as shown by the high degree of linear correlation (r=0.97 and 0.99) between the relative infected cell concentration (in inoculum) and the transformed cell foci counted. 6. No differences were observed between the GF classical strain and the CR-64 acute strain of Marek's disease as far as cell culture behavior. 7. Characterization of the isolates by physical and chemical treatments, development of internuclear inclusions in Infected cells, and nucleic acid typing by differential stainings and cytochemical treatments indicated that the natures of these cell transformation agents closely resemble to those described fer the group B herpes viruses. 8. Susceptible chicks inoculated with infected kidney tissue culture cells developed specific lesions of Marek's disease, and in a case of prolonged observation after inoculation (5 weeks) the birds developed clinical symptoms and gross lesions of Marek's disease. Kidney cell cultures prepared from those inoculated birds and sacrificed showed a superior recovery of cell transformation property by formation of distinct foci. 9. Electron microscopic study of infected kidney culture cells (GF agent) by negative staining technique revealed virus particles furnishing the properties of herpes viruses. The particle was measured about $100m{\mu}$ and, so far, no herpes virus envelop has been seen from these preparations. 10. No relationship of both isolates to avian leukosis/sarcoma group viruses and PPLO was observed.

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Effect of Different PE Mulching Duration on the Competition Ability of Sesame Growing in Association with Various Weed Communities (비닐피복기간(被覆期間)이 잡초군락형성(雜草群落形成)에 참깨의 경합력(競合力)에 미치는 영향(影響))

  • Lee, J.I.;Kang, C.W.;Kwon, Y.W.
    • Korean Journal of Weed Science
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    • v.6 no.1
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    • pp.33-41
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    • 1986
  • This experiment was conducted to determine the influence of weed competition in sesame and the periods for weed control. Competition periods (days), for which sesame was seeded under transparent polyethylene film at May 15, were 10, 15, 30, 45, 60, 75, 90, and full growth season of sesame. Weed control periods (days), for which sesame was seeded under black polyethylene film at June 15, were 10, 15, 30, 45, 60, and full growth season of sesame. Dominant weeds were Ponulaca oleracea, Digitaria sanguinalis, Acalypha australis, L. Cyperus arnuricus, Arenaria aesrphllifolia, Cardamine flexucosa, Mollugo Stricta and Digitaria eschaemum. The number of weeds was maximum at the 30 days after planting. Broad leaf weeds were dominant than grass weeds, and then decreased the total number of weeds by the reason of major decrease of broad leaf weeds. However, the weight of weeds increased continuously. No weeds appeared until the 15 days after planting and the weight of broad leaf weeds was heavier than that of grass weeds until 45 days after planting. However, grass weeds were heavier than broad leaf weeds after 60 days after planting. The hazards of weeds on the growth and development appeared seriously from the 60 to 75 days after planting, but main yield reduction appeared from 30 days after planting. Therefore once more hand weeding should be practiced within 30 days after planting to minimize yield decrease. Serious hazards by weed growing appeared by removing black PE film after 15 to 30 days after planting in growth characteristics and 30 days later in grain yield. Leaf growth showed maximum from 45 to 60 days after planting and then decreased as compared with the continuous increase of stem and root in optimum planting, transparent PE film mulch and hand weeding. Leaf growth didn't show reducing in PE film mulch and weedy check but total weight of weeds increased and growth of sesame decreased as compared to PE film mulch and hand weeding. Leaf, stem and root growth of sesame, and weed weight under black PE film mulch showed same tendancy and lower growth of sesame as compared with optimum planting, transparent PE film mulch. Correlation between sesame yield and weeds weight were r =$ -0.874^{**}$ in the optimum planting and r = $-0.712^{**}$ in the late planting, so that the more weeds increase, the lesser sesame yield.

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Optimum Radiotherapy Schedule for Uterine Cervical Cancer based-on the Detailed Information of Dose Fractionation and Radiotherapy Technique (처방선량 및 치료기법별 치료성적 분석 결과에 기반한 자궁경부암 환자의 최적 방사선치료 스케줄)

  • Cho, Jae-Ho;Kim, Hyun-Chang;Suh, Chang-Ok;Lee, Chang-Geol;Keum, Ki-Chang;Cho, Nam-Hoon;Lee, Ik-Jae;Shim, Su-Jung;Suh, Yang-Kwon;Seong, Jinsil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.143-156
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    • 2005
  • Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

Ecological Studies on the Transition of Sheath Blight of Rice in Korea (한국(韓國)에서의 벼 잎집무늬마름병 발생변동(發生變動)에 관(關)한 생태학적(生態學的) 연구(硏究))

  • Yu, Seung-hun
    • Korean Journal of Agricultural Science
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    • v.4 no.2
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    • pp.283-316
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    • 1977
  • In an attempt to obtain a basic information to develop an effective integrated system of controlling sheath blight of rice in Korea, the transition of this disease, the variation of cultural characters and pathogenicity of the pathogen, environmental conditions affecting the disease outbreak and varietal resistance have been investigated. 1. Rice sheath blight which has been minor disease in the past was widely spread, especially since 1971. This disease has promptly spread all over the country and infected 65.2% of total rice growing area in 1976. Various factors are considered to be related to such transition of this disease. Above all, increace of application of nitrogenous fertilizer, early season and earlier cultivation of rice, introduction of more susceptible "Tongil" varieties etc. must be important factors influencing the outbreak of this disease. 2. Great variations in cultural characteristics-such as mycelial growth rate, color of the medium, amount of the aerial mycelium, shape and color of the sclerotia- and in the pathogenicity of isolates of the pathogen, Thanatephorus cucumeris Dank were observed. The optimum temperature for mycelial growth also varied with isolates, from $25^{\circ}C$ to $30^{\circ}C$. There were not necessarily any correlation between curtural characteristics and pathogenicity of isolates of Thanatephorus cucumens. 3. Mycelial grow th of isolates of Thanatephorus cucumens on the PDA medium were correlated with the air temperatures of the region where the isolates were collected. The isolates from the regions with high temperature grew well on PDA medium at $35^{\circ}C$ than those from the region with low temperature, on the other hand, the isolates from the regions with the low temperature grew well on the same medium at $12^{\circ}C$ than those from the regions with high temperature. 4. Pectin polygalacturonase (PG) and cellulase (Cx) were most active on the 3rd day after inoculation on the leaves of rice plant with Thanatephorus cucumeris, whereas pectin methylestrase (PE) was most active on the 4th day after inoculation. Relationship between the activities of PE of isolates and the strength of pathogenicity of isolates was obtained, but PG and cellulase activities were not correlated with pathogenicity of isolates. 5. The tolerence of sclerotia from in-vitro culture to low temperature varied with their water content, the dried cultural sclerotia were more tolerent than wet ones, Dried cultural sclerotia maintained almost 100% germinability for 45 days at $-20^{\circ}C$, whereas wet sclerotia lost viability at $-5^{\circ}C$. The germination ratio of the sclerotia after overwintering changed from 18% to 70% according to the water content of the test paddy fields and the ratio was low in wet paddy condition. 6. To investigate the host range of this fungi in and near paddy field, 17 weeds were inoculated with fungi. The lesions of sheath blight disease was obserbed on Sagittaria trifolia L., Echinochloa crusgalli P. Beauv., Monochoria vaginal is Presl, Polygonum Hydropiper L., Eclipta prostrata L., Digitaria sanguinalis Scapoli. 7. When the level of nitrogen applied was doubled over standard level, total nitrogen content in rice sheath increased, ami when silicate was applied, starch content in rice sheath decreased, inducing the rice plants more susceptible to sheath blight disease. Increased dressing of potash ferilizer reduced the incidence of sheat blight disease. 8. The percentage of infected stems in the early period increased more in the narrow hill plot than in the wide hill plot, but in the late period this tendency was inversed; the percentage of infected stems as well as severity in the wide hill plot increased more compared to the narrow hill plot, and the disease severity in the one plant per hill plot was also low. The number of stems in the wide hill plot was more than the number of stems in the narrow hill plot. This indicates that the microclimate, such as the relative humidity, in the narrow hill plot was more favorable for the development of this disease. 9. There was a high negative correlation between the disease severity of varieties to the sheath blight and the maturity of the varieties, that is, the early varieties were more susceptible than the late ones, and much-tillering varieties usually showed more infection than less tillering varieties. 10. No relationship was obtained between the percentage of infected stems in the early period and the severity after heading, whereas a distinct relationship was obtained between former and latter after Aug. 10.

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Efficacy of Pigtail Catheter Drainage in Patients with Thoracic Empyema or Complicated Parapneumonic Effusion (농흉 및 합병된 부폐렴성 흉막 삼출 환자에서 Pigtail 도관 배액의 유용성)

  • Park, Jeong Woo;You, Seung Min;Seol, Won Jong;Paik, Eun Ki;Lee, Kyu Hoon;Seo, Joon Beom;Jeong, Seong Hwan;An, Chang Hyeok;Lim, Youg Hee;Park, Jeong Woong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.219-229
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    • 2003
  • Background : The management of thoracic empyema and complicated parapneumonic effusion requires adequate antibiotics use and prompt drainage of infected pleural space. Tube thoracostomy for loculated empyema has low success rate and is also an invasive procedure with potential morbidity. Complications include hemothorax, perforation of intra-abdominal or intra-thoracic organs, diaphragmatic laceration, empyema, pulmonary edema, and Horner's syndrome. Given the potential morbidity of traditional chest tube insertion, use of the image-guided pigtail catheter drainage(PCD) of empyema has been employed. We retrospectively analyzed the medical records of patients with empyema or complicated parapneumonic effusion to determine the efficacy of percutaneous pigtail catheter drainage. Materials and Methods : 45 patients with complicated parapneumonic effusions or empyema were treated at Gil medical center from January 1998 to June, 1999. All were initially given PCD procedure and the following data were collected: clinical symptoms at the time of diagnosis, alcohol and smoking history, the characteristics of pleural effusion, radiologic findings (at the time of catheter insertion, removal and 1 month after catheter removal), the amount of effusion drained for initial 24 hours, the time from catheter insertion to removal and the use of surgical approach. Results : Male gender was more frequent (42 men vs. 3 women), the mean age of the study population was 52(range: 21~74) years. Empyema was found in 23 patients, complicated parapneumonic effusion in 22 patients. Four patients(three, parapneumonic effusion and one, with empyema) with PCD only treated, were cast off. Among the available patients, 36(80%) patients were treated with PCD only or PCD with urokinase. Among the 23 patients with empyema, surgical approach was required in five patients(27.1%, one required decortication, four open thoracostomy), one patient, treated with surgical procedure, died of sepsis. There was no significant difference of the duration of catheter insertion, the duration of hospital admission after catheter insertion and the mean amount of effusion drained for initial 24 hours between the patients with only PCD treated and the patients treated with PCD and urokinase. The duration of catheter insertion($9.4{\pm}5.25days$ vs. $19.2{\pm}9.42days$, p<0.05) and the duration of hospital admission after catheter insertion($15.9{\pm}10.45days$ vs. $38.6{\pm}11.46days$, p<0.01) of the patients with only PCD treated were more longer than those of the patients treated with surgical procedure after PCD. They were same between the patients treated with urokinase after PCD and the patients treated with surgical procedure after PCD($11.1{\pm}7.35days$ vs. $19.2{\pm}9.42days$, p<0.05, $17.5{\pm}9.17days$ vs. $38.6{\pm}11.46days$, p<0.01). In 16 patients(44.4%) with only PCD treated or PCD and urokinase treated, the amount of effusion at the time of catheter removal was decreased more than 75% and in 17 patients(47.2%) effusion decreased 50~75%. .In one patient effusion decreased 25~50%, in two patients effusion decreased less than 25%. One month after catheter removal, in 35 patients(97.2%, four patients were cast off), the amount of pleural effusion was successfully decreased more than 50%. There were no complications related to pigtail catheter insertion. Conclusion : In this study, PCD seemed to be an early efficacious procedure in treating the patients with complicated parapneumonic effusion or empyema without any serious procedure related complication.