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The Evaluation of Radiation Therapy and Combined-modality Therapy for Non-small-cell Lung Cancer in Elderly (고령의 비소세포성폐암 환자의 방사선 및 병용치료에 대한 효과 평가)

  • Yoon, Won-Sup;Yang, Dae-Sik;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.101-108
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    • 2007
  • [ $\underline{Purpose}$ ]: To compare radiation therapy alone to combined modality therapy about survival rate and tolerance of elderly patients ($70=or{\geq}$) with non-small-cell lung cancer (NSCLC). $\underline{Materials\;and\;Methods}$: Between 1998 and 2002, 57 patients given radiation therapy due to NSCLC (Stage III) were analysed retrospectively. Radiation therapy alone (RT), concurrent chemoradiation (CRT), and sequential chemoradiation (SCRT) was done to 33, 16 and 8 patients, respectively. Patients' median age was 74 (range $70{\sim}85$). Male and female are 51 patients and 6 patients, respectively. 23 patients were stage IIIa and 34 were stage IIIb. Patients' characteristic distribution of RT and CRT was not significantly different except mass size that RT has a bigger than CRT. The fraction size of radiation therapy was 1.8 Gy in CRT and $1.8{\sim}3\;Gy$ in other groups. Total radiation dose was $51{\sim}63\;Gy$ according to the fraction size. If the prescribed total radiation dose was successfully irradiated, we stated that it was completion of radiation therapy. $\underline{Results}$: 52 patients were dead. Median period of radiation therapy was as follow: RT, 35 days, CRT, 60.5 days and SCRT, 35 days. Overall median survival time (MST) was 10.1 months. The 1 yr- and 2 yr-overall survival rate was 39.8% and 17.6%, respectively. MST of RT, CRT and SCRT was 8.9, 8.2 and 11.7 months, respectively. The 1 yr survival rate of RT, CRT and SCRT was 38.4%, 37.5% and 50% (not significant). Patients given incomplete radiation therapy were 12 (RT, 5 CRT, 6 SCRT, 1). N stage (p=0.081) and the difference of treatment methods (p=0.079) were the factors affecting incompletion of radiation therapy, but it was not significant. In case of combined-agents chemotherapy, 4 of 8 ceased radiation therapy. T stage ($T{\geq}3$), mass size (${\geq}5\;cm$), Karnofsky performance scale (${\leq}70$) and completion of radiation therapy were the prognostic factors in uni- and multi-variate analysis. $\underline{Conclusion}$: In elderly patients with NSCLC, radiation therapy alone was a treatment method with similar survival period compared with other methods. Generally, patients given radiation therapy alone was tolerable to a treatment. Before planning concurrent chemoirradiation in elderly patients with NSCLC, physicians pay attention to a selection of patients and chemotherapy agents considering general condition and toxicity.

Risk Factors and Prognosis for Periventricular Leukomalacia According to Neuroimage in Preterm Infants (미숙아 뇌실주위 백질연화증에서 뇌영상 분류에 따른 예후와 위험인자)

  • Ahn, Jung-Hee;Seo, Yoo-Jin;Yoon, Jung-Rim;Shim, Gyu-Hong;Kim, Seong-Hee;Cho, Woo-Ho;Chey, Myoung-Jae
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.64-74
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    • 2010
  • Purpose : The aim of this study was to determine the risk factors, clinical characteristics and prognosis for the development of periventricular leukomalacia (PVL) in preterm infants according to the extent and site of the PVL. Methods : The medical records of infants (under 36 weeks of gestational age) delivered from January 1999 to December 2008 were reviewed. Twenty-five preterm infants with were PVL were diagnosed by brain magnetic resonance imaging (MRI) and an addition 50preterm infants with no brain lesions were enrolled in this study. The perinatal and neonatal risk factors for the development of PVL was determine in these infants. Mental and Psychomotor Developmental Indices (MDI, PDI) were assessed by a clinical psychologist using the Bayley Scales of Infant Development II. We compared the differences of the clinical characteristics and prognosis according to brain MRI findings. Results : Maternal fever, young maternal age, extended oxygen use, hypotension within the first week of birth, use of inotropics within the first week of birth, and respiratory distress syndrome were the risk factors associated with PVL (P <0.05). In the multivariate analysis, maternal fever and extended oxygen use were statistically significant independent risk factors (P <0.05). The mean MDI and PDI scores of the PVL group (74.4$\pm$ 27.8 and 58.0$\pm$17.7) were significantly lower than those of the control group (103.5$\pm$8.9 and 101.7$\pm$16.1, P <0.05). Conclusion : Maternal fever and extended oxygen use were independent risk factors for PVL. We should pay attention to infants who had the risk factors and follow them up closely by brain imaging study and Bayley Scales of Infant Development II.

The Clinical Significance of Serum CD23 and CD25 in Chronic Cough Patients (만성 기침환자에서 혈청 CD23와 CD25 측정의 임상적 의의)

  • Choi, Jae-Chol;Park, Young-Bum;Jee, Hyun-Suk;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.471-477
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    • 2000
  • Background : Coughing is the most common complaint for which patients seek medical service. When caughing continues over 3 weeks in non-smokers who do not take cough-provoking drugs, they are classified as patients with chronic cough. Three well known main causes of chronic caugh are postnasal drip syndrome, bronchial asthma and gastroesophaseal reflux disease. Among them, postnasal drip syndrome is reported to be the most common cause of all in chronic cough diseases, and allergic inflammation plays an important role in the pathogenesis of postnasal drip syndrome. CD23 and CD25 which are low affinity receptor for IgE and IL-2 receptor alpha, respectively, are closely related to allergic inflammation and their roles were evaluated in chronic cough patients. Methods : We evaluated 105 patients with chronic cough and selected 56 patients for measurement of serum CD23 & CD25 levels. We selected 10 normal, medical students for comparison of serum CD23 & CD25 levels. Result : The postnasal drip syndrome was found to be the most common cause of chronic cough. Serum CD23 and CD25 did not increase in chronic cough patient compared to normal controls. However in bronchial asthma patient, serum CD23 level was increased relative to normal control (p<0.05). Conclusion : In bronchial asthma presented as chronic cough, lymphocyte mediated allergic inflammation may related with the pathogenesis of the disease.

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Survival and Compliance with the Use of Radiation Therapy for Anaplastic Thyroid Carcinoma (미분화 갑상선암에서 방사선치료 순응도와 생존기간)

  • Oh, Yoon-Kyeong;Jang, Ji-Young;Chung, Woong-Ki
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.229-236
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    • 2008
  • Purpose: The purpose of this study was to evaluate the impact of the use of external radiation therapy (ERT) in terms of survival and compliance in patients with anaplastic thyroid carcinoma. Materials and Methods: The medical records of 17 patients with anaplastic thyroid carcinoma treated with ERT between 1993 and 2002 were retrospectively reviewed. ERT was administered after surgery in 14 patients and after a biopsy in three patients. Among the 14 patients who had undergone surgery, nine underwent a curative resection and five underwent a palliative resection. Six patients had associated well-differentiated thyroid carcinomas and 14 patients were diagnosed with a tumor size exceeding 5 cm. The radiation dose ranged from $6{\sim}70\;Gy$ (median dose, 37.5 Gy). Eleven patients completed the planned course of ERT, whereas six patients did not. The follow-up period ranged from $1{\sim}104$ months (median, 5 months; mean, 20 months). Results: Five patients started the ERT without the presence of a gross mass and all of the patients competed ERT without a re-growth of tumor. Twelve patients (four patients after a curative resection, five patients after a palliative resection and three patients after a biopsy) started ERT with a gross mass present and only six patients were able to complete the planned course of ERT. Among the six patients who completed ERT, two patients showed a marked regression of the tumor mass, whereas two patients showed slight regression and two patients showed no response. The median survival was five months (range, $1{\sim}104$ months) and the mean survival was 21 months. The overall survival was 41% at 1-year, 24% at 2-years and 12% at 5-years. Significant prognostic factors included the number of primary tumors present, tumor size, whether surgery was performed and completion of ERT as planned. Long-term survivors showed a tendency of having smaller sized initial tumors and smaller sized pre-ERT tumors than the short-term survivors. Conclusion: This study suggests that patients with a small initial tumor (${\leq}5\;cm$), which was treated by surgery (curative resection or palliative resection) before ERT, and without rapid re-growth of the mass seen at the surgical site at the beginning of the ERT course, would be the best candidates for postoperative ERT. In contrast, patients with a large initial tumor (>5 cm) and did not undergo surgery before ERT or that rapid re-growth of the mass was observed at the surgical site are likely to have a short survival time, along with the interruption of ERT. In these cases, the role of ERT is very limited and the omission of ERT could be considered.

Predictors of Drug-resistance in Patients with Pulmonary Tuberculosis (폐결핵환자에서 약제내성의 예측인자)

  • Koh, Hyung-Ki;Kang, Yoon-Jung;Lim, Sung-Yong;Shin, Jong-Wook;Choi, Jae-Sun;Yoo, Ji-Hoon;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.311-316
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    • 1999
  • Background: The drug-resistant tuberculosis has recently decreased in Korea, but it is still one of the major obstacles in the treatment of pulmonary tuberculosis. Unfortunately there are no reliable ways to figure out the drug sensitivity pattern of the M. tuberculosis in the starting point of treatment. At least several months which is critical for the success of treatment have to be passed away before getting the report of drug-sensitivity test. The aim of this study was to find out the clinical and radiological parameters that make it possible to predict the drug-resistant pulmonary tuberculosis and to make a correct decision on the antituberculosis drug regimens. Method: We studied 253 pulmonary TB patients with sputum and/or bronchial washing fluid culture-positive diagnosed at the Chung-Ang University Young-San Hospital in the period of 1989-1994. The differences in the clinical and raiological variables between the drug-sensitive and the drug-resistant tuberculosis patients were evaluated. Results: In 66 out of 253 patients(26.1%), drug resistant tuberculosis to at least one antituberculosis drug were found. Patients with retreatment showed higher resistance rate than those with initial treatment(30/69, 43.5% vs 36/184, 19.5%, p<0.01). Patients with cavitary TB showed higher resistance rate than those with non-cavitary TB(24/54, 44.4% vs 42/199, 21.1%, p<0.05). Among patients with initial treatment, those with far-advanced TB showed a higher drug resistance rate than those with minimal lesion(9/23, 36.9% vs 10/82, 12.5%, p<0.05). Patients with culture positive only in the bronchial washing fluid showed lower resistance rate than those with sputum culture positive(7/63, 11.1 % vs 59/190, 31.1%, p<0.05). Conclusion: Prior treatment history for pulmonary tuberculosis, the presence of cavity & far advanced tuberculosis in the radiologic exam, sputum rather than solely bronchial washing culture positivity would be the related factors to the drug resistance. So in the patients with such characteristics, it is needed to try to find out the drug sensitivity pattern of the infecting tuberculosis organism as soon as possible.

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Development of an Adaptive Capacity Indicator to Climate Change in the Agricultural Water Sector (농업용수의 기후변화 적응능력 지표 개발 - 가뭄에 대한 적응을 중심으로 -)

  • Yoo, Ga-Young;Kim, Jin-Teak;Kim, Jung-Eun
    • Journal of Environmental Policy
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    • v.7 no.4
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    • pp.35-55
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    • 2008
  • Assessing vulnerability to climate change is the first step to take when setting up appropriate adaptation strategies. Adaptive capacity to climate change is the important factor comprising vulnerability. An adaptive capacity index in agricultural water management system was developed considering agricultural water supply and demand for rice production in Jeolla-do, Korea. The agricultural water supply was assumed to be equal to the amount of water stored in the major agricultural reservoirs, while data on the agricultural water demand was obtained from the dynamic simulation results by Korea Agriculture Corporation(KAC). The spatial unit for analysis was conducted at the county(Si, Gun, Gu) level and temporal scale was based on every month from 1991-2003. Adaptive capacity for drought stress index(ACDS index) was calculated as the percentage of data points where the irrigated water supply was greater than the crop water demand. The ACDS index was compared with SWSCI(Standard Water Storage Capacity Index) and the relationship showed high degree of fit($R^2$=0.84) using the exponential function, indicating that the developed ACDS index is useful for evaluating the status of the balance between agricultural water supply and demand, especially for the small sized agricultural reservoirs. This study provided the methodological basis for developing climate change vulnerability index in agricultural water system which is projected to be more frequently exposed to drought condition in the future due to climate change. Further research should be extended to the study on the water demand of the crops other than rice and to the projection of the change in ACDS index in the future.

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Selective Word Embedding for Sentence Classification by Considering Information Gain and Word Similarity (문장 분류를 위한 정보 이득 및 유사도에 따른 단어 제거와 선택적 단어 임베딩 방안)

  • Lee, Min Seok;Yang, Seok Woo;Lee, Hong Joo
    • Journal of Intelligence and Information Systems
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    • v.25 no.4
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    • pp.105-122
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    • 2019
  • Dimensionality reduction is one of the methods to handle big data in text mining. For dimensionality reduction, we should consider the density of data, which has a significant influence on the performance of sentence classification. It requires lots of computations for data of higher dimensions. Eventually, it can cause lots of computational cost and overfitting in the model. Thus, the dimension reduction process is necessary to improve the performance of the model. Diverse methods have been proposed from only lessening the noise of data like misspelling or informal text to including semantic and syntactic information. On top of it, the expression and selection of the text features have impacts on the performance of the classifier for sentence classification, which is one of the fields of Natural Language Processing. The common goal of dimension reduction is to find latent space that is representative of raw data from observation space. Existing methods utilize various algorithms for dimensionality reduction, such as feature extraction and feature selection. In addition to these algorithms, word embeddings, learning low-dimensional vector space representations of words, that can capture semantic and syntactic information from data are also utilized. For improving performance, recent studies have suggested methods that the word dictionary is modified according to the positive and negative score of pre-defined words. The basic idea of this study is that similar words have similar vector representations. Once the feature selection algorithm selects the words that are not important, we thought the words that are similar to the selected words also have no impacts on sentence classification. This study proposes two ways to achieve more accurate classification that conduct selective word elimination under specific regulations and construct word embedding based on Word2Vec embedding. To select words having low importance from the text, we use information gain algorithm to measure the importance and cosine similarity to search for similar words. First, we eliminate words that have comparatively low information gain values from the raw text and form word embedding. Second, we select words additionally that are similar to the words that have a low level of information gain values and make word embedding. In the end, these filtered text and word embedding apply to the deep learning models; Convolutional Neural Network and Attention-Based Bidirectional LSTM. This study uses customer reviews on Kindle in Amazon.com, IMDB, and Yelp as datasets, and classify each data using the deep learning models. The reviews got more than five helpful votes, and the ratio of helpful votes was over 70% classified as helpful reviews. Also, Yelp only shows the number of helpful votes. We extracted 100,000 reviews which got more than five helpful votes using a random sampling method among 750,000 reviews. The minimal preprocessing was executed to each dataset, such as removing numbers and special characters from text data. To evaluate the proposed methods, we compared the performances of Word2Vec and GloVe word embeddings, which used all the words. We showed that one of the proposed methods is better than the embeddings with all the words. By removing unimportant words, we can get better performance. However, if we removed too many words, it showed that the performance was lowered. For future research, it is required to consider diverse ways of preprocessing and the in-depth analysis for the co-occurrence of words to measure similarity values among words. Also, we only applied the proposed method with Word2Vec. Other embedding methods such as GloVe, fastText, ELMo can be applied with the proposed methods, and it is possible to identify the possible combinations between word embedding methods and elimination methods.

On a "duality" of the Corps-actant structure in Misaeng: with Jang Geurae as the central figure (『미생』에 나타난 신체 행위소 구조의 이중성에 관한 고찰 - 장그래를 중심으로)

  • Song, Taemi
    • 기호학연구
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    • no.57
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    • pp.211-255
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    • 2018
  • This paper attempts to "re-read" the webtoon Misaeng, which was once an important issue in the field of public discourse on "labor". Our hypothesis was that the dual actactial structure of Misaeng's hero Jang Geurae gave a dual structure to the entire text, which leads to the discovery of text meaning that was not mentioned in the existing discourse. This is based on the concept of 'meta-story character', which Hiroki Azuma talked in his postmodern literary theory. To verify this hypothesis we analyzed the text by applying the Parisian semiotics, more specifically J. Fontanille's theory. Jang Geurae is observed to be a actant of dual structure divided into 'character' of the enunciated level and 'player' of the enunciation level. Considering this characteristic of the hero, Misaeng can be interpreted as a metafiction that shows the 'shifting' between the subject of the enunciated level and the subject of the enunciation level. On the level of 'character' Jang's existence mode turns out to be "Deficiency (actualized)", but on the level of 'player' Jang 's existence mode turns out to be "Inanity(potentiallized)." His somatic responses also show a duality, which is represented by Fontanille's corps-actant model, where on the level of 'character' the somatic actant of Jang consists of 'Moi-chair(ego-flesh)' and 'Soi-idem(self-idem)', and on the level of 'player' it consists of 'Moi-chair(ego-flesh)' and 'Soi-ipse(self-ipse)'. The former mainly acts as a 'role' and takes charge of exteroceptive perception, while the latter mainly acts as 'attitude' and takes charge of interoceptive perception. Because of this dissociative nature of actant, Jang's two 'self' draw the re-adjustment of values without serious conflict between the collective norms and the individual identity. This is in sharp contrast with other characters who struggle with the conflict between the environment and "self". It becomes customary to adopt norms that are suspected to ineffective, but if you raise questions, the normative system can be updated. On one axis of Misaeng there are characters who have lost themselves in customs. On the other axis, there is Jang who can not help dismantling the existing ineffective norms and updating the normative system. Jang's existence mode seems to be one of many possible modes generated by this era where people share no longer solid community values, His actantial structure also communicates with readers of these days who put themselves more in subject of enunciation level than of enunciated level.

Decreased Nocturnal Blood Pressure Dipping in Patients with Periodic Limb Movements in Sleep (수면중 주기성 사지 운동에서 나타나는 야간 혈압 강하의 감소)

  • Lee, Mi Hyun;Choi, Jae-Won;Oh, Seong Min;Lee, Yu Jin
    • Sleep Medicine and Psychophysiology
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    • v.25 no.2
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    • pp.51-57
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    • 2018
  • Objectives: Previous studies have shown that periodic limb movements in sleep (PLMS) could be one of risk factors for cardiovascular morbidity. The purpose of this study was to investigate the association between PLMS and blood pressure changes during sleep. Methods: We analyzed data from 358 adults (176 men and 182 women) aged 18 years and older who were free from sleep apnea syndrome (Respiratory Disturbance Index < 5) and sleep disorders such as REM sleep behavior disorder or narcolepsy. Demographic characteristics, polysomnography records, and clinical variable data including blood pressure, body mass index, alcohol, smoking, and current medications were collected. In addition, self-report questionnaires including the Beck Depression Index, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were completed. Blood pressure change from bedtime to awakening was compared between the two periodic limb movement index (PLMI) groups [low PLMI ($PLMI{\leq}15$) and high PLMI (PLMI > 15)]. Blood pressure change patterns were compared using repeated measures analysis of variance. Results: Systolic blood pressure in the high PLMI group was lower than that in the low PLMI group (p = 0.036). These results were also significant when adjusted for gender and age, but were not statistically significant when adjusted for BMI, alcohol, smoking, anti-hypertension medication use and sleep efficiency (p = 0.098). Systolic blood pressure dropped by 9.7 mm Hg in the low PLMI group, and systolic blood pressure in the high PLMI group dropped by 2.9 mm Hg. There was a significant difference in delta systolic blood pressure after sleep between the two groups in women when adjusted for age, BMI, alcohol, smoking, antihypertensive medication use and sleep efficiency (p = 0.023). Conclusion: PLMS was significantly associated with a decreasing pattern in nocturnal BP during sleep, and this association remained significant in women when adjusted for age, BMI, alcohol, smoking, antihypertension medication use and sleep efficiency related to blood pressure. We suggest that PLMS may be associated with cardiovascular morbidity.

Research on Cultural Heritage and Its Conservation in the Process of Unification in Germany - Focusing on Archaeological Investigations and Site Conservation - (독일 통일과정에서 문화유산 조사와 보존관리 - 고고학 조사와 유적 보존을 중심으로 -)

  • Kim, Jongil
    • Korean Journal of Heritage: History & Science
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    • v.52 no.2
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    • pp.38-61
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    • 2019
  • Up until the early twentieth century in Germany, there were two research trends: 1) emphasizing objectives and making detailed observations of archaeological artifacts and sites, 2) tracing the remains of specific nations or ethnic groups and defining their temporal-spatial boundaries by conducting research on material culture in terms of nationalism or ethnocentrism. After the Second World War ended and Germany was divided, West German archaeology focused on observations of artifacts and sites, cataloging them, and doing research on chronology and distribution following their own traditional methodologies. East German archaeology attempted to prove the developing process of history and its Marxist principles based upon material culture and to examine the historic value of inherent specific cultural heritage based on criteria regarding how it corresponded to socialism and contributed to the development of socialism. Nevertheless, East and West German archaeology shared traditional archaeological methods inherited from German archaeology since the nineteenth century, and contact between archaeologists in West and East Germany continued to a degree. Furthermore, East German archaeology produced significant archaeological achievements acknowledged by West German and European archaeologists. These facts provided the momentum to complete rapid incorporation of the archaeologies of West and East Germany in spite of a one-sided process imposed by West German archaeology. In the case of Korea, it seems necessary to make an effort to share common research history and traditions and to encourage mutual academic exchange (e.g. joint excavation and archaeological research). Furthermore, it is also imperative to have open-minded attitudes toward accepting substantial results and interpretations achieved by North Korean archaeologists under scrutiny when and where necessary, despite seeming to have been fossilized by Marxism and Juche ideology. Any efforts to narrow the gap in archaeological research and conservation of cultural heritage between the archaeologies of South and North Korea should be made immediately. The case of Germany demonstrates how such a project could proceed efficaciously.