• Radiation Oncology Journal
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• v.16 no.4
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• pp.389-398
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• 1998

Purpose : To evaluate the role of conventional postoperative adjuvant radiotherapy in the management of supratentorial malignant glioma and to determine favorable prognostic factors affecting survival. Materials and Methods : From Sep. 1985 to Mar. 1997, the number of eligible patients who received postoperative radiotherapy completely was 69. They ranged in age from 7 to 66 years (median, 47). Forty-two (61$\%$) patients were glioblastoma multiforme and the other 27 (39$\%$) were anaplastic astrocytoma. Twenty patients (29$\%$) had Karnofsky score equal or more than 80 preoperatively. Forty-three patients (62$\%$) had symptom duration equal or less than 3 months. Twenty-four patients (35$\%$) had gross total resection and forty patients(58$\%$) had partial resection, the remaining five patients (7$\%$) had biopsy only. Radiotherapy dose ranged from 50.4 Gy to 61.2 Gy (median, 55.8; mode, 59.4) with fraction size of 1 8 Gy-2.0 Gy for 33-83 days(median, 48) except three patients delivered 33, 36, 39 Gr, respectively with fraction size of 3.0 Gy due to poor postoperative performance status. Follow-up rate was 93$\%$ and median follow-up period was 14 months. Results : Overall survival rate at 2 and 3 years and median survival were 38$\%$, 20$\%$, and 16 months for entire patients; 67$\%$, 44$\%$, and 34 months for anaplastic astrocytoma; 18$\%$, 4$\%$, and 14 months for glioblastoma multiforme, respectively (p=0.0001). According to the extent of surgery, 3-year overall survival for gross total resection, partial resection, and biopsy only was 38$\%$, 11$\%$, and 0$\%$, respectively (p=0.02) The 3-year overall survival rates for patients age 40>, 40-59, and 60< were 52$\%$, 8$\%$, and 0$\%$, respectively (p=0.0007). For the variate of performance score 80< vs 80>, the 3-year survival rates were 53$\%$ and 9$\%$, respectively (p=0.008). On multivariate analysis including covariates of three surgical and age subgroups as above, pathology, extent of surgery and age were significant prognostic factors affecting overall survival. On another multivariate analysis with covariates of two surgical (total resection vs others) and two a9e (50> vs 50<) subgroups, then, pathology, extent of surgery and performance status were significant factors instead of age and 3-year cumulative survival rate for the five patients with these three favorable factors was 100$\%$ without serious sequela. Conclusion : We confirmed the role of postoperative conventional radiotherapy in the management of supratentorial malignant glioma by improving survival as compared with historical data of surgery only. Patients with anaplastic astrocytoma, good performance score, gross total resection and/or young age survived longest. Maximum surgical resection with acceptable preservation of neurologic function should be attempted in glioblastoma patients, especially in younger patients. But the survival of most globlastoma patients without favorable factors is still poor, so other active adjuvant treatment modalities should be tried or added rather than conventional radiation treatment alone in this subgroup.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.141-146
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• 2002

Objectives : This study was peformed in order to assess the incidence of hypertension based on two-years follow-up of a rural hypertension-free cohort in Korea. Methods : The study cohen comprised 2,580 subjects aged above 20 (1,107 men and 1,473 women) of Chung-Song County in Kyungpook Province judged to be hypertensive-free at the baseline examination in 1996. For each of two examinations in the two-year follow-up, those subjects free of hypertension were followed for the development of hypertension to the next examination one year (1997) and two years later (1998). The drop-out rate was 24.7% in men and 19.6% in women. Hypertension was defined as follows 1) above mild hypertension as a SBP above 140 mmHg or a DBP above 90 mmMg,2) above moderate hypertension as a SBP above 160 mmHg or a DBP above 100 mmHg or when the participant reported having used antihypertensive medication after beginning this survey. Results : The age-standardized incidence of above mild hypertension was 6 per 100 person years (PYS) in men and that of above moderate hypertension was 1.2. In women, the age-standardized rate for above mild hypertension was 5.7 and 1.5 for above mild and moderate hypertension, respectively. However, the rates of incidence as calculated by the risk method were 4.8% and 1.0% in men and 4.6%, 1.2% in women, respectively. In both genders, incidence was significantly associated with advancing age(p<0.01), In men, the incidences of above moderate hypertension by age group were 0.5 per 100 PYS aged 20-39, 0.7 aged 40-49, 1.7 aged 50-59, 3.6 aged 60-69, and 5.8 aged above 70(p<0.01). In women, those the incidence measured 0.6 per 100 PYS aged 20-39, 1.8 aged 40-49, 1.3 aged 50-59, 3.3 aged 60-69, and 5.6 aged above 70(p<0.01). After age 60, the incidence of hypertension increased rapidly. Conclusions : The incidence data of hypertension reported in this study may serve as a reference data for evaluating the impact of future public efforts in the primary prevention of hypertension in Korea.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.142-149
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• 2003

Purpose : The urinary mass screening program for the detection of urinary abnormalities in school aged population has been performed in Seoul since 1981. Nation-wide urinary mass screening program was also performed since 1998. The aim of this study was to analyze the cause and nature of isolated proteinuria detected by chance on the urinary mass screening test in Busan and Kyungsangnam-do Province Methods : The medical records of 44 cases of isolated proteinuria detected by chance on the urinary mass screening test in Busan and Kyungsangnam-do Province, and evaluated for urinary abnormalities at the pediatrics outpatients renal clinics of Busan Paik Hospital from April 2002 to August 2003 were reviewed prospectively. Results : The cause and incidence of isolated proteinuria were as follows; transient proteinuria 4 cases(9.1%), orthostatic proteinuria 36 cases(81.8%) and persistent proteinuria 4 cases (9.1%). The total protein amount of the 24 hour urine were $121.0{\pm}136.4\;mg$ in transient proteinuria, $179.1{\pm}130.0\;mg$ in orthostatic proteinuria and $1532.8{\pm}982.5\;mg$ in persistent proteinuria. In the orthostatic proteinuria group, the total protein amount of the 24 hour urine was in the range of 40-616 mg. Spot urine protein/creatinine ratio(PCR) were $0.10{\pm}0.01$ in transient proteinuria, $0.61{\pm}0.61$ in orthostatic proteinuria and $4.35{\pm}4.04$ in persistent proteinuria. In the orthostatic proteinuria group, spot me PCR was in the range of 0.09-2.32. Renal biopsy was peformed in 4 children of the persisitent proteinuria group. They showed minimal change in 1 case, membranoproliferatiye glomerulonephritis in 2 cases and secondary renal amyloidosis in 1 case. Conclusion : The majority of isolated proteinuria which was detected by chance on school urinary mass screening were transient or orthostatic proteinuria. Even though the incidence of persistent proteinuria was much lower, it is necessary to take care of these children regularly and continuously, because persistent proteinuria itself is a useful marker of the progressive renal problems.

• The Korean Journal of Nuclear Medicine
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• v.39 no.1
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• pp.34-43
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• 2005

Purpose: $^{99m}Tc$-sestamibi(MIBI) and $^{99m}Tc$-tetrofosmin have been used as substrates for P-glycoprotein (Pgp) and multidrug resistance associated protein (MRP), which are closely associated with multidrug resistance of the tumors. To understand different handling of radiotracers in cancer cell lines expressing Pgp and MRP, we compared cellular uptakes of $^{99m}Tc$-MIBI and $^{99m}Tc$-tetrofosmin. The effects of cyclosporin A (CsA), well-known multidrug resistant reversing agent, on the uptake of both tracers were also compared. Materials and Methods: HCT15/CL02 human colorectal cancer cells for Pgp expressing cells, and human non-small cell lung cancer A549 cells for MRP expressing cells, were used for in vitro and in vivo studies. RT-PCR, western blot analysis and immunohistochemistry were used for detection of Pgp and MRP. MDR-reversal effect with CsA was evaluated at different drug concentrations after incubation with MIBI or tetrofosmin. Radioactivities of supernatant and pellet were measured with gamma well counter. Tumoral uptake of the tracers were measured from tumor bearing nude mice treated with or without CsA. Results: RT-PCR, western blot analysis of the cells and irnrnunochemical staining revealed selective expression of Pgp and MRP for HCY15/CL02 and A549 cells, respectively. There were no significant difference in cellular uptakes of both tracers in HCT15/CL02 cells, but MIBI uptake was slightly higher than that of tetrofosmin in A549 cells. Co-incubation with CsA resulted in a increase in cellular uptakes of MIBI and tetrofosmin. Uptake of MIBI or tetrofosmin in HCT15/CL02 cells was increased by 10- and 2.4-fold, and by 7.5 and 6.3-fold in A549 cells, respectively. Percentage increase of MIBI was higher than that of tetrofosmin with CsA for both cells (p<0.05). In vivo biodistribution study showed that MIBI (114% at 10 min, 257% at 60 min, 396% at 240 min) and tetrofosmin uptake (110% at 10 min, 205% at 60 min, 410% at 240 min) were progressively increased by the time, up to 240 min with CsA. But increases in tumoral uptake were not significantly different between MIBI and tetrofosmin for both tumors. Conclusion: MIBI seems to be a better tracer than tetrofosmin for evaluating MDR reversal effect of the modulators in vitro, but these differences were not evident in vivo tumoral uptake. Both MIBI and tetrofosmin seem to be suitable tracers for imaging Pgp- and MRP-mediated drug resistance in tumors.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.161-167
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• 2018

Purpose : This study evaluates the usefulness of the Modified Hybrid-VMAT scheme with consideration of background radiation when establishing a treatment plan for multiple bone metastatic cancer including multiple tumors on the same axis. Materials and Methods : The subjects of this study consisted of five patients with multiple bone metastatic cancer on the same axis. The planning target volume(PTV) prescription dose was 30 Gy, and the treatment plan was established using Ray Station(Ray station, 5.0.2.35, Sweden). In the treatment plan for each patient, two or more tumors were set as one isocenter. A volumetric modulated arc therapy(VMAT) plan, a hybrid VMAT(h) plan with no consideration of background radiation, and a modified hybrid VMAT(mh) with consideration of background radiation were established. Then, using each dose volume histogram(DVH), the PTV maximum dose($D_{max}$), mean dose($D_{mean}$), conformity index(CI), and homogeneity index(HI) were compared among the plans. In addition, the organ at risk(OAR) of each treatment site was evaluated, and the total MU(Monitor Unit) and treatment time were also analyzed. Results : The PTV $D_{max}$ values of VMAT, VMAT(h) and VMAT(mh) were 3188.33 cGy, 3526 cGy, and 3285.67 cGy, the $D_{mean}$ values were 3081 cGy, 3252 cGy, and 3094 cGy; the CI values were $1.35{\pm}0.19$, $1.43{\pm}0.12$, and $1.30{\pm}0.06$; the HI values were $1.06{\pm}0.01$, $1.14{\pm}0.06$, and $1.09{\pm}0.02$; and the VMAT(h) OAR value was increased 3 %, and VMAT(mh) OAR value was decreased 18 %, respectively. Furthermore, the mean MU values were 904.90, 911.73, and 1202.13, and the mean beam on times were $128.67{\pm}10.97$, $167.33{\pm}7.57$, and $190.33{\pm}4.51$ respectively. Conclusions : Applying Modified Hybrid-VMAT when treating multiple targets can prevent overdose by correcting the overlapping of doses. Furthermore, it is possible to establish a treatment plan that can protect surrounding normal organs more effectively while satisfying the inclusion of PTV dose. Long-term follow-up of many patients is necessary to confirm the clinical efficacy of Modified Hybrid-VMAT.

• Korean Journal of Environmental Agriculture
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• v.37 no.4
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• pp.291-301
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• 2018

BACKGROUND: Rice is one of the main sources for inorganic arsenic among the consumed crops in the world population's diet. Arsenic is classified into Group 1 as it is carcinogenic for humans, according to the IARC. This study was carried out to assess dietary exposure risk of inorganic arsenic in husked rice and polished rice to the Korean population health. METHODS AND RESULTS: Total arsenic was determined using microwave device and ICP-MS. Inorganic arsenic was determined by ICP-MS coupled with HPLC system. The HPLC-ICP-MS analysis was optimized based on the limit of detection, limit of quantitation, and recovery ratio to be $0.73-1.24{\mu}g/kg$, $2.41-4.09{\mu}g/kg$, and 96.5-98.9%, respectively. The inorganic arsenic concentrations of daily exposure (included in body weight) were $4.97{\times}10^{-3}$ (${\geq}20$ years old) $-1.36{\times}10^{-2}$ (${\leq}2$ years old) ${\mu}g/kg\;b.w./day$ (PTWI 0.23-0.63%) by the husked rice, and $1.39{\times}10^{-1}$ (${\geq}20$ years old) $-3.21{\times}10^{-1}$ (${\leq}2$ years old) ${\mu}g/kg\;b.w./day$ (PTWI 6.47-15.00%) by the polished rice. CONCLUSION: The levels of overall exposure to total and inorganic arsenic by the husked and polished rice were far lower than the recommended levels of The Joint FAO/WHO Expert Committee on Food Additives (JECFA), indicating of little possibility of risk.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.29 no.4
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• pp.14-26
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• 2011

Imdaejeong Wonlim is located on the verge of Sangsa Village in Sapyeong-ri, Daepyeong-myeon, Hwasun-gun Gyeongsangnam-do toward Northwest. It was planned by Sa-ae, Minjuhyeon in 1862 on the basis of Gobanwon built by Nam Eongi in 16th century against the backdrop of Mt. Bongjeong and facing Sapyeong Stream. As water flows from west to east in the shape of crane, this area is a propitious site standing for prosperity and happiness. This area shows a distinct feature of Wonlim surrounding the Imdaejeong with multi layers as consisting of 5 districts - front yard where landmark stone with engraved letters of 'Janggujiso of Master Sa-ea' and junipers are harmoniously arranged, internal garden of upper pavilion ranging from a pavilion to square pond with a little island in the middle, Sugyeongwon of under pavilionu consisting of 2 ponds with a painting of three taoist hermits, forest of Mt. Bonggeong and external garden including Sapyeong Stream and farmland. According to documentation and the results of on-site investigation, it is certainly proved that Imdaejeong Wonlim was motivated by Byeoseo Wonlim which realized the idea of 'going back to hometown after resignation' following the motives of Janggujiso, a hideout aimed to accomplish the ideology, 'training mind and fostering innate nature,' on the peaceful site surrounded by water and mountain, as well as motives of Sesimcheo(洗心處) to be unified with morality of Mother Nature, etc. In addition, it implies various imaginary landscapes such as Pihangji, Eupcheongdang, square pond with an island and painting of three Taoist hermits based on a notion that 'the further scent flies away, the fresher it becomes,' which is originated from Aelyeonseol(愛蓮說). In terms of technique of natural landscape treatment, divers techniques are found in Imdaejeong Wonlim such as distant view of Mt. Bongjeong, pulling view with an intention of transparent beauty of moonlight, circle view of natural and cultural sceneries on every side, borrowed scenary of pastoral rural life adopted as an opposite view, looked view of Sulyundaero, over looked view of pond, static view in pavilion and paths, close view of water space such as stream and pond, mushroom-and-umbrella like view of Imdaejeong, vista of pond surrounded by willows, imaginary view of engraved letters meaning 'widen knowledge by studying objectives' and selected view to comprise sunrise and sunset at the same time. In the beginning of construction, various plants seemed to be planted, albeit different from now, such as Ginkgo biloba, Phyllostachys spp., Salix spp., Pinus densiflora, Abies holophylla, Morus bombycis, Juglans mandschurica, Paulownia coreana, Prunus mume, Nelumbo nucifera, etc. Generally, it reflected dignity of Confucianism or beared aspect of semantic landscape implying Taoist taste and idea of Phoenix wishing a prosperity in the future. Furthermore, a diversity of planting methods were pursued for such as liner planting for the periphery of pond, bosquet planting and circle planting adopted around the pavilion, spot planting using green trees, solitary planting of monumentally planted Paulownia coreana and opposite planting presenting the Abies holophylla into yin and yang.

• MISULJARYO - National Museum of Korea Art Journal
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• v.100
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• pp.50-80
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• 2021

This paper critically examines the history of the theories connected to the Wongaksa Temple Pagoda that have developed over the last 100 years focusing on the original number of stories the pagoda would have reached. Part II of this paper retraces the dynamic process of the rediscovery of the Wongaksa Temple Pagoda by Westerners who traveled to Korea during the port-opening period. Koreans at the time viewed the Wongaksa Temple Pagoda as an object of no particular appeal or even as an eyesore. However, Westerners appreciated it as a wonder or magnificent sight. Since these Westerners had almost no prior knowledge of Buddhist pagodas, they were able to write objective travelogues. At the time, these visitors generally accepted the theory common among Joseon intellectuals that Wongaksa Temple Pagoda once had thirteen stories. Part III focuses on Japanese government-affiliated scholars' academic research on the Wongaksa Temple Pagoda after the proclamation of the Korean Empire and the Japanese Government-General of Korea's subsequent management of the pagoda as a cultural property during the colonial era. It also discusses issues with Japanese academic research and management. In particular, this portion sheds light on the shift in theories about the original number of stories of the Wongaksa Temple Pagoda from the ten-story theory supported by Sekino Tadashi (關野 貞), whose ideas have held a great influence on this issue over the last 100 years, to the thirteen-story theory and then to the idea that it had more than thirteen. Finally, Part IV addresses the change from the multi-story theory to the ten-story theory in the years after Korea's liberation from Japan until 1962. Moreover, it highlights how Korean intellectuals of the Japanese colonial era predominantly accepted the thirteen-story theory. Since 1962, a considerable quantity of significant research on the Wongaksa Temple Pagoda has been published. However, since most of these studies have applied the ten-story theory suggested in 1962, they are not individually discussed in this paper. This retracing of the history of theories about the Wongaksa Temple Pagoda has verified that although there are reasonable grounds for supporting the thirteen-story theory, it has not been proved in the last 100 years. Moreover, the number of pagoda stories has not been fully discussed in academia. The common theory that both Wongaksa Temple Pagoda and Gyeongcheonsa Temple Pagoda were ten-story pagodas was first formulated by Sekino Tadashi 100 years ago. Since the abrasion of the Wongaksa Temple Stele was so severe the inscriptions on the stele were almost illegible, Sekino argued that the Wongaksa Temple Pagoda was a ten-story pagoda based on an architectural analysis of the then-current condition of the pagoda. Immediately after Sekino presented his argument, a woodblock-printed version of the inscriptions on the Wongaksa Temple Stele was found. This version included a phrase that a thirteen-story pagoda had been erected. In a similar vein, the Dongguk yeoji seungnam (Geographic Encyclopedia of Korea) published by the orders of King Seongjong in the late fifteenth century documented that Gyeongcheonsa Temple Pagoda, the model for the Wongaksa Temple Pagoda, was also a thirteen-story pagoda. The Wongaksa Temple Stele erected on the orders of King Sejo after the establishment of the Wongaksa Temple Pagoda evidently shows that Sekino's ten-story premise is flawed. Sekino himself wrote that "as [the pagoda] consists of a three-story stereobate and a ten-story body, people call it a thirteen-story pagoda," although he viewed the number of stories of the pagoda body as that of the entire pagoda. The inscriptions on the Wongaksa Temple Stele also clearly indicate that the king ordered the construction of the Wongaksa Temple Pagoda as a thirteen-story pagoda. Although unprecedented, this thirteen-story pagoda comprised a ten-story pagoda body over a three-story stereobate. Why would King Sejo have built a thirteen-story pagoda in an unusual form consisting of a ten-story body on top of a three-story stereobate? In order to fully understand King Sejo's intention in building a thirteen-story pagoda, analyzing the Wongaksa Temple Pagoda is necessary. This begins with the restoration of its original name. I disprove Sekino's ten-story theory built upon flawed premises and an eclectic over-thirteen-story theory and urge applying the thirteen-story theory, as the inscriptions on the Wongaksa Temple Stele stated that the pagoda was originally built as a thirteen-story pagoda.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.33 no.1
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• pp.52-64
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• 2015

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

• Radiation Oncology Journal
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• v.17 no.2
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• pp.100-107
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• 1999

Purpose: This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Materials and Methods Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45~67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in T2, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal Iymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intravenous cis-Platin (100 mg/m$^{2}$) on day 1 and oral Etoposide (50 mg/m$^{2}$/day) on days 1 through 14 with 4 weeks' interval. Surgery was followed after the pre-operative re-evaluation including chest CT scan in 3 weeks of the completion of the concurrent chemoradiotherapy if there was no evidence of disease progression. Results : Full dose radiation therapy was administered to all the 15 patients. Planned two cycles of chemotherapy was completed in 11 patients and one cycle was given to four. One treatment related death of acute respiratory distress syndrome occurred In 15 days of surgery. Hospital admission was required in three patients including one with radiation pneumonitis and two with neutropenic fever. Hematologic complications and other acute complications including esophagitis were tolerable. Resection rate was 92.3% (12/l3) in 13 patients excluding two patients who refused surgery. Pleural seeding was found in one patient after thoracotomy and tumor resection was not feasible. Post-operative tumor stagings were pT0 in 3 patients, pTl in 6, and pT2 in 3. Lymph node status findings were pN0 in 8 patients, pN1 in 1, and pN2 in 3. Pathologic tumor down-staging was 61.5% (8/13) including complete response in three patients ($23.7%). Tumor stage was unchanged in four patients (30.8%) and progression was in one (7.7%). Conclusions : Pre-operative concurrent chemoradiotherapy for Stage IIIA (N2) non-small cell lung cancer demonstrated satisfactory results with no increased severe acute complications. This treatment shceme deserves more patinet accrual with long-term follow-up.