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Surgery Alone and Surgery Plus Postoperative Radiation Therapy for Patients with pT3N0 Non-small Cell Lung Cancer Invading the Chest Wall (흉벽을 침범한 pT3N0 비소세포폐암 환자에서 수술 단독과 수술 후 방사선치료)

  • 박영제;임도훈;김관민;김진국;심영목;안용찬
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.845-855
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    • 2004
  • Background: No general consensus has been available regarding the necessity of postoperative radiation therapy (PORT) and its optimal techniques in the patients with chest wall invasion (pT3cw) and node negative (N0) non-small cell lung cancer (NSCLC). We did retrospective analyses on the pT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. And we compared them with the pT3cwN0 NSCLC patients who did not received PORT during the same period. Material and Method: From Aug. of 1994 till June of 2002, 22 pT3cwN0 NSCLC patients received PORT-PORT (+) group- and 16 pT3cwN0 NSCLC patients had no PORT-PORT (-) group. The radiation target volume for PORT (+) group was confined to the tumor bed plus the immediate adjacent tissue only, and no regional lymphatics were included. The prognostic factors for all patients were analyzed and survival rates, failure patterns were compared with two groups. Result: Age, tumor size, depth of chest wall invasion, postoperative mobidities were greater in PORT (-) group than PORT (+) group. In PORT (-) group, four patients who were consulted for PORT did not receive the PORT because of self refusal (3 patients) and delay in the wound repair (1 patient). For all patients, overall survival (OS), disease-free survival (DFS), loco-regional recurrence-free survival (LRFS), and distant metastases-free survival (DMFS) rates at 5 years were 35.3%, 30.3%, 80.9%, 36.3%. In univariate and multivariate analysis, only PORT significantly affect the survival. The 5 year as rates were 43.3% in the PORT (+) group and 25.0% in PORT (-) group (p=0.03). DFS, LRFS, DMFS rates were 36.9%, 84.9%, 43.1 % in PORT (+) group and 18.8%, 79.4%, 21.9% in PORT(-) group respectively. Three patients in PORT (-) group died of intercurrent disease without the evidence of recurrence. Few suffered from acute and late radiation side effects, all of which were RTOG grade 2 or lower. Conclusion: The strategy of adding PORT to surgery to improve the probability not only of local control but also of survival could be 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. Authors were successful in the marked reduction of the incidence as well as the severity of the acute and late side effects of PORT, without taking too high risk of the regional failures by eliminating the regional lymphatics from the radiation target volume.

The Study of Metrics development for Entrepreneurial Program Effectiveness (청소년 창업교육프로그램 효과성 측정지표 개발 연구)

  • Byun, Youngjo;Kim, Myung Seuk;Yang, Young Seok
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.4
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    • pp.77-85
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    • 2014
  • A goal of Bizcool entrepreneurship education targeting on the youth falls on letting understand the process of starts-up, enhance entrepreneurship will and their business creativities rather than training trivial starts-up skills such as writing business plan for successful starts-up. The effects of education enable Bizcoo students to recognize rightly the concept of starts-up training and lead to spread out demand for entrepreneurship education. The feedback check-up for how entrepreneurship education affects students getting through of it is necessary and possible to bring its' improvement alternatives. Despite of such highlight, not many measuring tools and indexes of evaluating an effectiveness of entrepreneurship education are developed and studied up until. This research suggests for the optimal indexes for them. In specific, this research 49 the first question sets of evaluating an effectiveness of entrepreneurship education classified 3 large categories and 11 following sub categories each of them such as entrepreneurship orientation, creativity, entrepreneurship preparing activities etc,. representing embedding education effects though entrepreneurship education. This research carry out the empirical survey research utilizing driven question sets against 5 different Bizcools sampling 287 students. The survey research delivers the final 3 large categories and 8 following sub categories(Innovativeness, risk-taking, problem-solving potent, cooperative decision-making potent, efficient behavior capacity, data collecting potent, career search, starts-up search and preparation), and 38 measuring indexes by search and confirming factor analysis. This research never drop the confidence test over each indexes and obtain the proper figures. Last but not least, this research confirm the gap between starts-up club members and non members as to an effectiveness of entrepreneurship education and 9 different indexes.

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Electrical Stimulation Parameters in Normal and Degenerate Rabbit Retina (정상 망막과 변성 망막을 위한 전기자극 파라미터)

  • Jin, Gye-Hwan;Goo, Yong-Sook
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.73-79
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    • 2008
  • Retinal prosthesis is regarded as the most feasible method for the blind caused by retinal diseases such as retinitis pigmentosa (RP) or age related macular degeneration (AMD). Recently Korean consortium launched for developing retinal prosthesis. One of the prerequisites for the success of retinal prosthesis is the optimization of the electrical stimuli applied through the prosthesis. Since electrical characteristics of degenerate retina are expected to differ from those of normal retina, we performed voltage stimulation experiment both in normal and degenerate retina to provide a guideline for the optimization of electrical stimulation for the upcoming prosthesis. After isolation of retina, retinal patch was attached with the ganglion cell side facing the surface of microelectrode arrays (MEA). $8{\times}8$ grid layout MEA (electrode diameter: $30{\mu}m$, electrode spacing: $200{\mu}m$, and impedance: $50k{\Omega}$ at 1 kHz) was used to record in-vitro retinal ganglion cell activity. Mono-polar electrical stimulation was applied through one of the 60 MEA channel, and the remaining channels were used for recording. The electrical stimulus was a constant voltage, charge-balanced biphasic, anodic-first square wave pulse without interphase delay, and 50 trains of pulse was applied with a period of 2 sec. Different electrical stimuli were applied. First, pulse amplitude was varied (voltage: $0.5{\sim}3.0V$). Second, pulse duration was varied $(100{\sim}1,200{\mu}s)$. Evoked responses were analyzed by PSTH from averaged data with 50 trials. Charge density was calculated with Ohm's and Coulomb's law. In normal retina, by varying the pulse amplitude from 0.5 to 3V with fixed duration of $500{\mu}s$, the threshold level for reliable ganglion cell response was found at 1.5V. The calculated threshold of charge density was $2.123mC/cm^2$. By varying the pulse duration from 100 to $1,200{\mu}s$ with fixed amplitude of 2V, the threshold level was found at $300{\mu}s$. The calculated threhold of charge density was $1.698mC/cm^2$. Even after the block of ON-pathway with L-(1)-2-amino-4-phosphonobutyric acid (APB), electrical stimulus evoked ganglion cell activities. In this APB-induced degenerate retina, by varying the pulse duration from 100 to $1200{\mu}s$ with fixed voltage of 2 V, the threshold level was found at $300{\mu}s$, which is the same with normal retina. More experiment with APB-induced degenerate retina is needed to make a clear comparison of threshold of charge density between normal and degenerate retina.

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Postoperative Radiation Therapy for Chest Wall Invading pT3N0 Non-small Cell Lung Cancer: Elective Lymphatic Irradiation May Not Be Necessary (흉벽을 침범한 pT3N0 비소세포폐암 환자에서 수술 후 방사선치료)

  • Park, Young-Je;Ahn, Yong-Chan;Lim, Do-Hoon;Park, Won;Kim, Kwan-Min;Kim, Jhingook;Shim, Young-Mog;Kim, Kyoung-Ju;Lee, Jeung-Eun;Kang, Min-Kyu;Nam, Hee-Rim;Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.21 no.4
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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.

Comparison of Retinal Waveform between Normal and rd/rd Mouse (정상 마우스와 rd/rd 마우스의 망막파형 비교)

  • Ye, Jang-Hee;Seo, Je-Hoon;Goo, Yong-Sook
    • Progress in Medical Physics
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    • v.19 no.3
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    • pp.157-163
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    • 2008
  • Retinal prosthesis is regarded as the most feasible method for the blind caused by retinal diseases such as retinitis pigmentosa or age-related macular degeneration. One of the prerequisites for the success of retinal prosthesis is the optimization of the electrical stimuli applied through the prosthesis. Since electrical characteristics of degenerate retina are expected to differ from those of normal retina, we investigated differences of the retinal waveforms in normal and degenerate retina to provide a guideline for the optimization of electrical stimulation for the upcoming prosthesis. After isolation of retina, retinal patch was attached with the ganglion cell side facing the surface of microelectrode arrays (MEA). $8{\times}8$ grid layout MEA (electrode diameter: $30{\mu}m$, electrode spacing: $200{\mu}m$, and impedance: 50 $k{\Omega}$ at 1 kHz) was used to record in-vitro retinal ganglion cell activity. In normal mice (C57BL/6J strain) of postnatal day 28, only short duration (<2 ms) retinal spikes were recorded. In rd/rd mice (C3H/HeJ strain), besides normal spikes, waveform with longer duration (~100 ms), the slow wave component was recorded. We attempted to understand the mechanism of this slow wave component in degenerate retina using various synaptic blockers. We suggest that stronger glutamatergic input from bipolar cell to the ganglion cell in rd/rd mouse than normal mouse contributes the most to this slow wave component. Out of many degenerative changes, we favor elimination of the inhibitory horizontal input to bipolar cells as a main contributor for a relatively stronger input from bipolar cell to ganglion cell in rd/rd mouse.

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An Analysis of the Managerial Level's Gender Gap and "Glass Ceiling" of the Corporation (기업 관리직의 젠더 격차와 "유리천장" 분석)

  • Cho, Heawon;Hahm, Inhee
    • 한국사회정책
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    • v.23 no.2
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    • pp.49-81
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    • 2016
  • This study agrees with the idea that a situation centered perspective provides a useful contribution in understanding women's attitude on organizations. Women's occupational experiences are less related to their "femaleness" than to the structural constraints inherent in the occupational positions women fill. So characteristics of the organizational situation including gender composition and hierarchical status may "shape and define" women's experience on the job. The present study examined the managerial level's gender gap and "glass ceiling" of the corporation. According to Kanter, if the ratio of women to men in organizations begins to shift, as affirmative action and new hiring and promotion policies promised, forms of relationships and corporate culture should also change. However, the mere presence of women on workplace may not, in itself, result in women-friendly work condition. This study analyzes "Korean Women Manger Panel survey(2010 3rd. wave)" to examine how much gender gap of the managerial level persists and when the glass ceiling effect emerges. Using t-test and ANOVA, various aspects of the gender gap within managerial level were verified. The most significant finding is the glass ceiling effect starts from very low level of management. Policy implications from the statistical analysis of the Panel survey are: 1) We need to increase the absolute number of the women managers for securing middle level women leadership pipe line. 2) We need to confront the fact that the glass ceiling starts from the very low managerial level, and to explore more realistic way to break up the vicious circle for the tokenism. and 3) We need to looking beyond numbers in approaching women's matter at work. At the cultural and institutional level, work-family programs and policies, women's ratings of their competence, and family-friendly organization's climate should be considered.

Factors Influencing Satisfaction on Home Visiting Health Care Service of the Elderly based on the degree of chronic diseases (만성질환 유병상태에 따른 노인 방문건강관리 서비스 만족도 영향요인 연구)

  • Seo, Daram;Shon, Changwoo
    • 한국노년학
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    • v.41 no.2
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    • pp.271-284
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    • 2021
  • This study was conducted to derive factors that affect the satisfaction of home visiting health care services and to develop effective community care models by using the results of Seoul's outreach service which is the basis for Korean community care. The population of the study was the elderly aged 65 and 70 who participated in the Seoul's outreach community services 3rd stage (July 2017 - June 2018) and 4th stage (July 2018 to June 2019). 2,200 people were extracted by the proportional allocation method and home visit interviews were conducted on them. Subjects were divided into sub-groups based on chronic disease prevalence, and logistic regression was conducted to derive factors that affect the satisfaction of home visiting health care services. The results demonstrated that the elderly without chronic diseases were more satisfied when they received health education and counseling services, the elderly with one chronic disease were more satisfied when they received Community resource-linked services. In the case of elderly people with two or more chronic diseases, the service satisfaction level is increased when health condition assessment and Community resource-linked services are provided. Regardless of whether or not they have chronic diseases, service delivery time was a factor that increased satisfaction in home visiting health care. And the degree of explanation understanding was a factor that increased satisfaction for both single and complex chronic patients. Home Visiting health care services based on the community is a key component of the ongoing community care. In order to increase the sustainability and effectiveness of community care in the future, Community-oriented health care services based on the degree of chronic diseases of the elderly should be provided. In order to provide more effective services, however, it is necessary (1) to establish a linkage system to share health information of the subject held by the National Health Insurance Service to local governments and (2) to provide capacity-building education for visiting nurses to improve the quality of home visiting health care services. It is hoped that this study will be us ed as bas ic data for the successful settlement of community care.

Popularization of Marathon through Social Network Big Data Analysis : Focusing on JTBC Marathon (소셜 네트워크 빅데이터 분석을 통한 마라톤 대중화 : JTBC 마라톤대회를 중심으로)

  • Lee, Ji-Su;Kim, Chi-Young
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.3
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    • pp.27-40
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    • 2020
  • The marathon has long been established as a representative lifestyle for all ages. With the recent expansion of the Work and Life Balance trend across the society, marathon with a relatively low barrier to entry is gaining popularity among young people in their 20s and 30s. By analyzing the issues and related words of the marathon event, we will analyze the spottainment elements of the marathon event that is popular among young people through keywords, and suggest a development plan for the differentiated event. In order to analyze keywords and related words, blogs, cafes and news provided by Naver and Daum were selected as analysis channels, and 'JTBC Marathon' and 'Culture' were extracted as key words for data search. The data analysis period was limited to a three-month period from August 13, 2019 to November 13, 2019, when the application for participation in the 2019 JTBC Marathon was started. For data collection and analysis, frequency and matrix data were extracted through social matrix program Textom. In addition, the degree of the relationship was quantified by analyzing the connection structure and the centrality of the degree of connection between the words. Although the marathon is a personal movement, young people share a common denominator of "running" and form a new cultural group called "running crew" with other young people. Through this, it was found that a marathon competition culture was formed as a festival venue where people could train together, participate together, and escape from the image of a marathon run alone and fight with themselves.

A Study Seeking the Practical Implementation of the Yellow Sea Large Marine Ecosystem Project (황해광역해양생태계 프로젝트의 실효성 확보에 관한 연구)

  • Kim, Jin-kyung;Kown, Suk-jae;Lee, Sang-il
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.27 no.7
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    • pp.987-994
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    • 2021
  • The Yellow sea, as described in article 123 of UNCLOS, is semi-enclosed sea surrounded by the Republic of Korea, the People's Republic of China and North Korea. In addition, the Yellow Sea is one of the 66 large marine ecosystems as it contains large amounts of marine resources. According to article 194 of UNCLOS, states should be aware of rights and duties with respect to the protection and preservation of the marine environment to be engaged with countries directly as regional entity or indirectly. Therefore, the legal blank is urgent in terms of trans-boundary environmental pollutant issues. The UNDP has conducted a project called Yellow Sea Large Marine Ecosystem (YSLME) which has reached the 2nd phase. The project has some notable achievements, namely performing joint activities on analysis of diagnostic trans-boundary issues in collaboration with China and South Korea, developing a strategic action plan based on TDA, and establishing regional strategic action plan. However, on the other hand, the project could not reflect the full participation of North Korea as a state party. As a result, the project has a limitation on effective implementation of RSAP. Therefore, this study focuses on the suggestion of a legally-binding trilateral treaty as a blue print for the next, 3rd phase of the project. By analyzing the best practice of the Wadden Sea Trilateral Treaty case, the study verifies the validity of legislative measures on establishing and managing a legally-binding trilateral YSLME Commission. By suggesting a three phase treaty, incorporating a joint declaration by establishing the commission, the signing of the treaty, and formulating an umbrella convention and implementation arrangement, the study expects to guarantee the consistency and sustainability of the trilateral treaty regardless of political issues pertaining to North Korea.

The Effects of Entrepreneurship Mentoring on Entrepreneurial Will and Mentoring Satisfaction: Focusing on Opus Entrepreneurship Education (창업 멘토링 기능이 창업의지와 멘토링 만족도에 미치는 영향: 오퍼스 창업교육을 중심으로)

  • Kim, Ki-Hong;Lee, Chang-Young;Joe, Jee-Hyung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.3
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    • pp.211-226
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    • 2023
  • As we transition into the post-COVID era, economic activities that were stagnant are regaining momentum. In particular, there is a growing trend of technology entrepreneurship driven by the opportunities of digital transformation in the Fourth Industrial Revolution. However, entrepreneurship education content is struggling to keep up with the rapid pace of technological change. This study aims to emphasize the importance of entrepreneurship mentoring as a crucial component of entrepreneurship education content that requires adaptation and advancement due to the increasing demand for technology entrepreneurship. This study redefines startup mentoring, which is differentiated from general mentoring, at the present time when the demand for startups, which increases with the declining employment rate, increases, and the development of quality startup education contents and securing professional startup mentors are required. According to the start-up stage, it is divided into preliminary entrepreneurs and early entrepreneurs, and the effect of entrepreneurship knowledge and self-efficacy among start-up mentoring functions on entrepreneurial will and mentoring satisfaction is improved by empirically researching the effects of start-up mentoring functions in the case of initial entrepreneurs as a moderating effect. To confirm the importance of entrepreneurship mentoring effect for. To this end, among the mentoring functions, entrepreneurship knowledge and self-efficacy were set as independent variables, and entrepreneurial will and mentoring satisfaction were set as dependent variables. The research model was designed and hypotheses were established. In addition, empirical analysis was conducted by conducting a questionnaire survey on trainees who received entrepreneurship mentoring education at ICCE Startup School and Opus Startup School. To summarize the results of the empirical analysis, first, among the entrepreneurship mentoring functions, entrepreneurship knowledge and self-efficacy were analyzed to have a significant positive (+) effect on entrepreneurial will. Second, among the entrepreneurship mentoring functions, entrepreneurship knowledge and self-efficacy were analyzed to have a significant positive (+) effect on mentoring satisfaction. Third, it was analyzed that entrepreneurship had no significant moderating effect on entrepreneurial knowledge and entrepreneurial will. Fourth, it was analyzed that entrepreneurship had no significant moderating effect on mentoring satisfaction. Fifth, it was found that entrepreneurship had a significant moderating effect between self-efficacy and will to start a business. As a result of the research analysis, the first implication is that the mentoring function in start-up education is analyzed to produce meaningful results for both the initial entrepreneurs and the prospective entrepreneurs in the will to start a business and satisfaction. . Second, it was analyzed that there was no significant relationship between whether a business was started and the mentoring function and effect. However, it was analyzed that the will to start a business through improvement of self-efficacy through mentoring was significantly related to whether or not to start a business. turned out to be helpful. Many start-up education programs currently conducted in Korea educate both early-stage entrepreneurs and prospective entrepreneurs at the same time for reasons such as convenience. However, through the results of this study, even in small-scale entrepreneurship mentoring, it is suggested that customized mentoring through detailed classification such as whether the mentee has started a business can be a method for successful entrepreneurship and high satisfaction of the mentee.

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