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Radiation Therapy and Chemotherapy after Breast Conserving Surgery for Invasive Breast Cancer: An Intermediate Result (침윤성 유방암에서 유방보존수술 후 방사선치료 및 항암화학 병용치료의 성적 및 위험인자 분석)

  • Lee, Seok-Ho;Choi, Jin-Ho;Lee, Young-Don;Park, Heoung-Kyu;Kim, Hyun-Young;Park, Se-Hoon;Lee, Kyu-Chan
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.16-25
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    • 2007
  • [ $\underline{Purpose}$ ]: Breast conserving surgery (BCS) followed by chemotherapy (CTx.) and radiation therapy (RT) is widely performed for the treatment of early breast cancer. This retrospective study was undertaken to evaluate our interim results in terms of failure patterns, survival and relative risk factors. $\underline{Materials\;and\;Methods}$: From January 1999 through December 2003, 129 patients diagnosed with invasive breast cancer and treated with BCS followed by RT were subject to retrospective review. The median age of the patients was 45 years (age distribution, $27{\sim}76$ years). The proportions of patients according to their tumor, nodes, and metastases (TNM) stage were 65 (50.4%) in stage I, 41 (31.7%) in stage IIa, 13 (10.1%) in stage IIb, 9 (7.0%) in stage III, and 1 patient (0.8%) in stage IIIc. For 32 patients (24.8%), axillary node metastasis was found after dissection. BCS consisted of quadrantectomy in 115 patients (89.1%) and lumpectomy in 14 patients (10.6%). Axillary node dissection at axillary level I and II was performed for 120 patients (93%). For 7 patients (5.4%), only sentinel node dissection was performed with BCS. For 2 patients (1.6%) axillary dissection of any type was not performed. Postoperative RT was given with 6 MV X-rays. A tumor dose of 50.4 Gy was delivered to the entire breast area using a tangential field with a wedge compensator. An aditional dose of $9{\sim}16\;Gy$ was given to the primary tumor bed areas with electron beams. In 30 patients (23.3%), RT was delivered to the supraclavicular node. Most patients had adjuvant CTx. with $4{\sim}6$ cycles of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens. The median follow-up period was 50 months (range: $17{\sim}93$ months). $\underline{Results}$: The actuarial 5 year survival rate (5Y-OSR) was 96.9%, and the 5 year disease free survival rate (5Y-DFSR) was 93.7%. Local recurrences were noted in 2 patients (true: 2, regional node: 1) as the first sign of recurrence at a mean time of 29.3 months after surgery. Five patients developed distant metastases as the first sign of recurrence at $6{\sim}33$ months (mean 21 months). Sites of distant metastatic sites were bone in 3 patients, liver in 1 patient and systemic lesions in 1 patient. Among the patients with distant metastatic sites, two patients died at 17 and 25 months during the follow-up period. According to stage, the 5Y-OSR was 95.5%, 100%, 84.6%, and 100% for stage I, IIa, IIb, and III respectively. The 5Y-DFSR was 96.8%, 92.7%, 76.9%, and 100% for stage I, IIa, IIb, and III respectively. Stage was the only risk factor for local recurrence based on univariate analysis. Ten stage III patients included in this analysis had a primary tumor size of less than 3 cm and had more than 4 axillary lymph node metastases. The 10 stage III patients received not only breast RT but also received posterior axillary boost RT to the supraclavicular node. During the median 53.3 months follow-up period, no any local or distant failure was found. Complications were asymptomatic radiation pneumonitis in 10 patients, symptomatic pneumonitis in 1 patient and lymphedema in 8 patients. $\underline{Conclusion}$: Although our follow up period is short, we had excellent local control and survival results and reaffirmed that BCS followed by RT and CTx. appears to be an adequate treatment method. These results also provide evidence that distant failure occurs earlier and more frequent as compared with local failure. Further studies and a longer follow-up period are needed to assess the effectiveness of BCS followed by RT for the patients with less than a 3 cm primary tumor and more than 4 axillary node metastases.

Studies of the Properties of Commercial Woods Grown in the Southern Part of Korea (한국산(韓國産) 유용목재(有用木材)의 기초재질(基礎材質)에 관(關)한 연구(硏究))

  • Chung, Byung-Jae;Lee, Jyung-Seuk;Kim, Yoon-Soo
    • Journal of the Korean Wood Science and Technology
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    • v.6 no.2
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    • pp.3-19
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    • 1978
  • Five species, Abies koreana Wilson (A. koreana), Castanopsis cuspidata var. Sieboldii Nakai (C. Cuspidata). Machilus thunbergii Sieb. et Zucc. (M. thunbergii), Styrax japonica (S. japonica), and Quercus acuta Thunberg(Q. acuta) growing in the southern part of Korea were selected for the investigation of wood properties. In order to evaluate the wood properties of these five species, anatomical, physical, mechanical, chemical and pulping characteristics were investigated. And this study also covered wood technological problems related to the drying, gluing, debarking, flooring, and wood workability so that these species might serve to the best advantage. The results obtained were summarized as follows: 1. The trunk of A. koreana with many knots was straight. However, the trunks of S. japonica and C. cuspidata were crooked. 2. A. koreana showed the longest and the widest ill the fiber morphology; 2.97mm in length, 39.3${\mu}$ in width. In general, fiber width of all the species investigated were greater than those of other Korean hardwoods. 3. The specific gravity of Q. acuta was 0.74${\pm}$0.03, and that of A.koreana was 0.34${\pm}$0.02. The range of specific gravity of the other species was 0.47-0.52. 4. The adsorption of water was propotioned inversely with the specific gravity, but the adsorption of humidity was proportioned with the specific gravity. In spite of their medium density, S. japonica showed the greatest adsorption, and M. thunbergii the least. The water adsorption of cross section was twice greater than that of lateral direction, and there was a slight difference in between the radial and the tangential direction. 5. Shrinkage for tested five species was ranged from 5.36 to 10.24% in tangential direction, and 2.83~6.13% in radial direction. Q. acuta recorded the greatest shrinkage rate, and A. koreana the least. The greater was the specific gravity, the larger was the shrinkage rate. 6. The mechanical properties of Q. acuta were similar to those of Quercus mongolica which grow in Kangwon-Do. Strength properties of C. cuspidata, M. thunbergii, A. koreana were equivalent to those of other Korean commercial woods with similar specific gravity, except S. japonica which showed slightly higher strength than that of other species with similar density. 7. Higher glue joint strength for urea and phenol adhesieves was recorded in the species of M. thunbergii and C. cuspidata, however, high-density species(Q. acuta) and even low-density species(A. koreana) did not show good joint strength. 8. The attractive figure of M. thunbergii in texture seemed to he appreciated for decoration. And the grain and texture of other species were proper for furniture and building materials. 9. All of the species except Q. acuta were considered good for wood workability. 10. The denser the specific gravity was, the longer the drying time took. However, severe drying defects were formed in M. thunbergii whose density was medium. 11. All the species were considered suitable for the flooring wood expect A. koreana whose density was light. 12. Pentosan component in all the species was great, and the amount of extractives in Q. acuta was worth noticing. 13. Yield in kraft pulp was above the level of economic pulp yield, i.e. 45% in all species. 14. Debarking was easy in the species of A. koreana and M. thunbergii, and debarking after being boiled in water was the most efficient in all species.

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Survey Studies on Serviceable Sericultural Communities in Korea (養蠶適地選定에 관한 調査硏究)

  • Choe, Byong-Hee;Gwon, Yeong-Ha;Mun, Jae-Yu;Baek, Hyeon-Jun;Lee, Geon-Yeong;Lee, Sang-Pung;Lee, Won-Ju;Im, Su-Ho;Jo, Dong-Ok;Kim, Seong-Ho;Hwang, Hong-Do;Kim, Gi-Seok;Kim, Su-Gyeong;Go, Nak-Yong;So, Byeong-Ju;Lee, Geon-U;Lee, Jae-Ok;Im, Dong-Rak;Jo, Jin-Gu
    • Journal of Sericultural and Entomological Science
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    • v.25 no.1
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    • pp.34-43
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    • 1983
  • These studies have been carried out to find better locations for sericultural service regardless of the international silk market fluctuation in Korea. In order to acieve the purpose, various investigations and analyses have been carried out for more than four hundred sericultural communities to find out the main factors which caused to decrease in cocoon production in spite of a gloomy past silk market. Now, we believe that we have set up some fundamental guide lines in developing sound serviceable sericultural communities in Korea in case the government accepts the written advices, and the results obtained are as follows: 1. The Korean sericulture has been very prosperous from the 60's to the 70's. In 1976 the cocoon production was at its peak, reaching 41,704M/T from which its decline took place with annual averages of 18.5% for total cocoon production and 16.4% for mulberry field. These figures represent a quantitative decrease to one-third of the total amount in 1976. Since then, the Korean sericulture had continuously suffered from a shortage of raw silk resulting in a slow development of sericulture. At present, a steady development through all possible measures is great importance. 2. The downfall of the korean sericulture resulted from two factors of such as the external, which led to the decline in the price of raw silk at the international market and restrain of import and, the internal, resulting in the little increase of cocoon price and a comparatively lower benefits from the sericulture than from other cash crops. 3. The already established sericultural zone collapsed and then reorganized with the outstanding regional specialization so the decline in total cocoon production in the country. Based on the agricultural regions, 1980 cocoon production was very stable in the mountaineaus area of the east-south which used with intercropping. In this area there was small decline of 33% compare with that of the 1979, and with 70% decline in the dry field farming area of Kangwon Do. In an administrative districtwise, six counties beginning with Sanchnung county of Kyungsang Nam Do, showed less than 20% decline of cocoon production, sixteen counties beginning with Samchuck county of Kangwon Do marked above 80% decrease of cocoon production. In the smaller unit area-wise, there was a big difference among them. twenty-five myons rather increased and a hundrd fourty-three myons decreased above 80% of it. 4. The cocoon production was positively correlated with the decreasing percentage of cocoon production per household. It was also affected by the ratio of the mulberry field area to the total cultivated area per household and cocoon productivity per 10a. 5. Four hundred sixty-four villages in the seventeen counties were surveyed on the basis of farm management and techniques concerned ('80/'79), and then the results were evaluated by using of computer. These results are summarized as foolows: (1) Cocoon production per household There was no difference among the agricultural regions in cocoon production. The cocoon production per household in the comparatively stable villages increased from 100.8kg in 1979 to 122kg in 1981. Cocoon yield in the stable villages decreased by 20% of '81/'79. The cocoon production per house hold in while that of the unstable villages decreased by more than 40% from 102.9kg in 1979 to 82kg in 1981. (2) Cocoon yield per 10a mulberry field The cocoon yield per 10a was higher in the plain area than in the mountaineous area. The stable villages had an average of 73.4kg cocoon yield/10a while the unstabe ones had only an average of 55kg. (3) Adoption the mulberry branch rearing method The branch rearing method was more popular in the plain area than in the mountainous area. In the stable vilages adopted 24.2% in spring and 16.7% in autumn of 1979. In 1981 it shwed increases of 34.3% and 10.1% in the two seasons respectivly. However, the unstable villages showed 13.3% and 126% in both seasons, respectively. (4) The patterns of the combined management system in the sericultural farming The popular management system in the sericultural from was combined with rice and other cash crops, showing 55% of the total households surveyed. Fourteen percent of the households combined the management system with rice and other cash crops and 14% of the households combined with rice only. The villages wich earned less than 20% of the total income from the sericulture reached 81% of the total houscholds indicating that they were still far beyond a complete combination system. (5) Damage by agricultural chemicals The damage caused by agricultural chemicals was mainly due to the protection of rice against insectpests and diseases in the plain areas and took place mostly in the autumn season. The chemicals applied was 65% of Iiquid and 35% of powder forms and 35% of damage was from granulat form of the chemicals. The use of the granular chemicals was low because of high cost.

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Potassium Physiology of Upland Crops (밭 작물(作物)의 가리(加里) 생리(生理))

  • Park, Hoon
    • Korean Journal of Soil Science and Fertilizer
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    • v.10 no.3
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    • pp.103-134
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    • 1977
  • The physiological and biochemical role of potassium for upland crops according to recent research reports and the nutritional status of potassium in Korea were reviewed. Since physical and chemical characteristics of potassium ion are different from those of sodium, potassium can not completely be replaced by sodium and replacement must be limited to minimum possible functional area. Specific roles of potassium seem to keep fine structure of biological membranes such as thylacoid membrane of chloroplast in the most efficient form and to be allosteric effector and conformation controller of various enzymes principally in carbohydrate and protein metabolism. Potassium is essential to improve the efficiency of phoro- and oxidative- phosphorylation and involve deeply in all energy required metabolisms especially synthesis of organic matter and their translocation. Potassium has many important, physiological functions such as maintenance of osmotic pressure and optimum hydration of cell colloids, consequently uptake and translocation of water resulting in higher water use efficiency and of better subcellular environment for various physiological and biochemical activities. Potassium affects uptake and translocation of mineral nutrients and quality of products. potassium itself in products may become a quality criteria due to potassium essentiality for human beings. Potassium uptake is greatly decreased by low temperature and controlled by unknown feed back mechanism of potassium in plants. Thus the luxury absorption should be reconsidered. Total potassium content of upland soil in Korea is about 3% but the exchangeable one is about 0.3 me/100g soil. All upland crops require much potassium probably due to freezing and cold weather and also due to wet damage and drought caused by uneven rainfall pattern. In barley, potassium should be high at just before freezing and just after thawing and move into grain from heading for higher yield. Use efficiency of potassium was 27% for barley and 58% in old uplands, 46% in newly opened hilly lands for soybean. Soybean plant showed potassium deficiency symptom in various fields especially in newly opened hilly lands. Potassium criteria for normal growth appear 2% $K_2O$ and 1.0 K/(Ca+Mg) (content ratio) at flower bud initiation stage for soybean. Potassium requirement in plant was high in carrot, egg plant, chinese cabbage, red pepper, raddish and tomato. Potassium content in leaves was significantly correlated with yield in chinese cabbage. Sweet potato. greatly absorbed potassium subsequently affected potassium nutrition of the following crop. In the case of potassium deficiency, root showed the greatest difference in potassium content from that of normal indicating that deficiency damages root first. Potatoes and corn showed much higher potassium content in comparison with calcium and magnesium. Forage crops from ranges showed relatively high potassium content which was significantly and positively correlated with nitrogen, phosphorus and calcium content. Percentage of orchards (apple, pear, peach, grape, and orange) insufficient in potassium ranged from 16 to 25. The leaves and soils from the good apple and pear orchards showed higher potassium content than those from the poor ones. Critical ratio of $K_2O/(CaO+MgO)$ in mulberry leaves to escape from winter death of branch tip was 0.95. In the multiple croping system, exchangeable potassium in soils after one crop was affected by the previous crops and potassium uptake seemed to be related with soil organic matter providing soil moisture and aeration. Thus, the long term and quantitative investigation of various forms of potassium including total one are needed in relation to soil, weather and croping system. Potassium uptake and efficiency may be increased by topdressing, deep placement, slow-releasing or granular fertilizer application with the consideration of rainfall pattern. In all researches for nutritional explanation including potassium of crop yield reasonable and practicable nutritional indices will most easily be obtained through multifactor analysis.

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Studies on Nutrio-physiological Response of Rice Plant to Root Environment (근부환경(根部環境)에 따른 수도(水稻)의 영양생리적(營養生理的) 반응(反應)에 관(關)한 연구(硏究))

  • Park, J.K.;Kim, Y.S.;Oh, W.K.;Park, H.;Yazawa, F.
    • Korean Journal of Soil Science and Fertilizer
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    • v.2 no.1
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    • pp.53-68
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    • 1969
  • The nutriophysiological response of rice plant to root environment was investigated with eye observation of root development and rhizosphere in situation. The results may be summarized as follows: 1) The quick decomposition of organic matter, added in low yield soil, caused that the origainal organic matter content was reached very quickly, in spite of it low value. In high yield soil the reverse was seen. 2) In low yield soil root development, root activity and T/R value were very low, whereas addition of organic matter lowered them still wore. This might be contributed to gas bubbles around the root by the decomposition of organic matter. 3) Varietal difference in the response to root environment was clear. Suwon 82 was more susceptible to growth-inhibitine conditions on low-yield soil than Norin 25. 4) Potassium uptake was mostly hindered by organic matter, while some factors in soil hindered mostly posphorus uptake. When the organic matter was added to such soil, the effect of them resulted in multiple interaction. 5) The root activity showed a correlation coeffieient of 0.839, 0.834 and 0.948 at 1% level with the number of root, yield of aerial part and root yield, respectively. At 5% level the root-activity showed correlation-coefficient of 0.751, 0.670 and 0.769 with the uptake of the aerial part of respectively. N, P and K and a correlation-coefficient of 0.729, 0.742 and 0.815 with the uptake of the root of respectively N.P. and K. So especially for K-uptake a high correlation with the root-activity was found. 6) The nitrogen content of the roots in low-yield soil was higher than in high-yield soil, while the content in the upper part showed the reverse. It may suggest ammonium toxicity in the root. In low-yield soil Potassium and Phosphorus content was low in both the root and aerial part, and in the latter particularly in the culm and leaf sheath. 7) The content of reducing sugar, non-recuding sugar, starh and eugar, total carbohydrates in the aerial part of plants in low yield soil was higher than in high yield soil. The content of them, especially of reducing sugar in the roots was lower. It may be caused by abnormal metabolic consumption of sugar in the root. 8) Sulfur content was very high in the aerial part, especially in leaf blade of plants on low yield soil and $P_2O_5/S$ value of the leaf blade was one fifth of that in high yield soil. It suggests a possible toxic effect of sulfate ion on photophosphorization. 9) The high value of $Fe/P_2O_5$ of the aerial part of plants in low yield soil suggests the possible formation of solid $Fe/PO_4$ as a mechanical hindrance for the translocation of nutrients. 10) Translocation of nutrients in the plant was very poor and most nutrients were accumulated in the root in low yield soil. That might contributed to the lack of energy sources and mechanical hindrance. 11) The amount of roots in high yield soil, was greater than that in low yield soil. The in high-yield soil was deep, distribution of the roots whereas in the low-yield soil the root-distribution was mainly in the top-layer. Without application of Nitrogen fertilizer the roots were mainly distributed in the upper 7cm. of topsoil. With 120 kg N/ha. root were more concentrated in the layer between 7cm. and 14cm. depth. The amount of roots increased with the amount of fertilizer applied.

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Multiplication of Infectious Flacherie and Densonucleosis Viruses in the Silkworm, Bombyx mori (가잠의 전염성 연화병 및 농핵병 바이러스 증식에 관한 연구)

  • 김근영;강석권
    • Journal of Sericultural and Entomological Science
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    • v.25 no.2
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    • pp.1-31
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    • 1984
  • Flacherie, as one of the most prevalent silkworm diseases, causes severe economic damage to sericultural industry and its pathogens have been proved to be flacherie virus (FV) and densonucleosis virus (DNV). Multiplications of the viruses in the larvae of the silkworm, Bombyx mori, were studied by the sucrose density gradient centrifugation and electron microscopy. The quantitative and qualitative changes of nucleic acids and proteins were investigated from the midgut and hemolymph in the silkworm larvae infected separately with FV and DNV. The histopathological changes of epithelial cells of infected midgut also were examined by an electron microscope. 1. Purified fractions of FV or DNV in a sucrose density gradient centrifugation yielded one homogenous and sharp peak without a shoulder, suggesting no heterogenous materials in the preparation. Electron microscopy also revealed that FV and DNV were spherical particles, 27nm and 21nm in diameter, respectively. 2. Silkworm larvae showed a decrease in body weight on the 6th day and in midgut weight on the 3rd day after inoculation with FV or DNV. 3. DNA content was higher in the midgut when infected with FV or DNV, but the hemolymph of the infected larvae showed no difference during first 6 days after inoculation, after which DNA concentration declined rapidly. 4. RNA synthesis of silkworm larvae infected separately with FV and DNV was stimulated in the midgut, but RNA content was reduced in the hemolymph at the early stage of virus multiplication. At the late stage of virus multiplication, however, it was extremely reduced in both midgut and hemolymph. 5. The concentration of protein in the midgut and hemolymph of silkworm larvae infected separately with FV and DNV showed no difference from that of the healthy larvae at the early stage of virus multiplication, but it was significantly reduced at the late stage of virus multiplication. 6. There was no difference in the electrophoretic patterns of RNAs extracted from the midgut of healthy or virus-infected larvae. 7. The electrophoresis of proteins extracted from the midgut infected with FV or DNV, when carried out on the 1st and 5th day after virus inoculation, showed no difference from that of the healthy larvae. But, there was an additional band with medium motility in the proteins on the 8th day after virus inoculation, while a band with low mobility shown in the proteins of healthy larvae disappeared in the infected larvae. However, a band with high mobility in the healthy larvae was separated into two fractions in the infected larvae. 8. The electrophoretic pattern of hemolymph proteins of the silkworm larvae infected separately with FV and DNV was similar to that of the healthy larvae, but the concentration of hemolymph proteins in the infected larvae was lower than that of the healthy larvae at the late stage. 9. Two types of inclusion bodies were shown by the double staining of pyronin-methyl green in the columnar cell of the midgut on the 8th day after FV inoculation. 10. Electron microscopy of the infected midgut revealed that the 'cytoplasmic wall' of the goblet cell thickened on the 5th day after FV inoculation and several types of the cytopathogenic structures, such as virus$.$specific vesicles, virus particles, linear structures, tubular structures, and high electron-dense matrices were observed in the cytoplasm of the goblet cell. The virus particles were also observed in the microvilli and the structures similar to spherical virus particles were observed around the virus-specific vesicles, suggesting the virus assembly in the cytoplasm. 11. Fluorescence micrograph of the infected midgut stained with acridine orange showed that the nucleus, the site of DNV multiplication in the columnar cell, enlarged on the 5th day after virus inoculation. 12. Electron microscopic examination of DNV infected midgut revealed that the nucleolus of the columnar cell was broken into granules and those granules dispersed into apical region of the nucleus on the 5th day after virus inoculation. On the 8th day after inoculation, it was also observed that the nucleus of the columnar cell was full with the high electron-dense virogenic stroma which were similar to virus particles. These facts suggest that the virogenic stroma were the sites of virus assembly in the process of DNV multiplication.

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Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer (III 기 비소세포성 폐암에서 Cisplatin-방사선동시병합요법의 효과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Jie Young;Song Jung Sub;Lee Sun Hee;Kuak Mun Sub;Shinn Kyung Sub
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.27-36
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    • 1997
  • Purpose : This study was tried to evaluate the Potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate. overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250 cGy given 10 times up to 2500 cGy) was combined with $6mg/m^2$ of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up Period ranged from 36 months to 105 months with median of 62 months. Result : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%, CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%. The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for Patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a Prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs 6% and bone marrow toxicities (25% vs. 15.6% were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%. The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%. In analyses for relationship of field size and Pulmonary toxicity, the Patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

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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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A Study on the Dietary Behaviors, Physical Development and Nutrient Intakes in Preschool Children (학령 전 아동의 식습관, 신체 발달 및 영양 섭취상태에 관한 연구)

  • Yu, Kyeong-Hee
    • Journal of Nutrition and Health
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    • v.42 no.1
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    • pp.23-37
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    • 2009
  • The purpose of this study was to investigate the health status of preschool children using the questionnaires about dietary behaviors and anthropometric indices. And also nutritional status was investigated using questionnaires for 24-hr recall method. The study was conducted in 145 children aged 3 to 6 years and questionnaires for dietary behaviors and dietary intakes were performed by mothers of children in Ulsan. Just nine percent of children were graded as good in terms of having healthy eating habits, this means that the nutrition education for the dietary behaviors should be more focused on preschool children. With regard to the frequency of food intake, children consumed green & yellow vegetables less frequently, meanwhile consumed high protein source food (meat, egg and bean) and milk and its product more frequently. Children almost never consumed fried foods as often as 1-2 times a weak. In assessment of the health status, children have the highest prevalence of colds and allergy, but lower prevalence of clinical symptoms due to the nutritional deficiency. The mean height was $103.6\;{\pm}\;6.4\;cm$ and significantly different among age (p < 0.05), but was not significantly different between sex. The mean weight was $17.8\;{\pm}\;3.0\;kg$ and significantly different in 5, 6years old among age. By the WLI criteria, 11.1% of children were underweight and 17.4% of children were overweight or obese. By the Rohrer index criteria, any children were not underweight and 86.8% of children were overweight or obese. By the Kaup index criteria, 2.8% of children were underweight and 29.2% of children were overweight or obese. And Obesity Index criteria, 2.1% of children were underweight and 20.8% of children were overweight or obese. The results of obesity rate by all criteria except Rohrer index indicated similar level, were significantly high in age 3 with all criteria, and decreased with age increased. The energy intake of children was lower than EER (Estimated Energy Requirements) of Dietary Reference Intakes for Koreans (KDRIs) by as much as 85.7%. Acceptable Macronutrient Distribution Ranges (AMDR) was 62.6:21.5:15.7 as carbohydrate:protein:lipid, so children consumed protein more, but consumed lipid less compared with those of KDRIs. Vitamin A intake was 133% of recommended intakes (RI) and calcium intake which was identified as the nutrient most likely to be lacking in diets was 98.9% of RI. The intakes of all minerals and vitamins except folate were higher than KDRIs. 33.3% of children were distributed in insufficiency of energy intake, 42.7% of children were distributed in insufficiency of lipid intake. These results indicate that the need of developing of nutrition education program and further concern of a public health center, university and children care center about dietary life for preschool children.