• Radiation Oncology Journal
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• v.15 no.4
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• pp.349-356
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• 1997

Purpose : To evaluate the efficacy of hyperfractionated radiation therapy in carcinoma of the cervix, especially on huge exophytic and endophytic stage Ib, IIa and IIb Materials and Materials : Fourty one patients with carcinoma of the cervix treated with hyperfractionated radiation therapy at the Department of Therapeutic Radiology, Dongsan Hospital, Keimyung University. School of Medicine from Jul, 1991 to Apr, 1994. According to FIGO s1aging system, therewere stage Ib (3 patients) IIa (6 patients) with exophytic ($\geq$5cm in dinmeter) and huge endophytic mass. and IIb (32 patients) with median age of 55 yeavs old. Radiation therapy consisted of hyperfractionated external irradition to the whole pelvis (120cGy/fraction, 2 fraction/day (minimum interval of 6 hours), 3600-5520cGy) and boost parametrial doses (for a total of 4480-6480cGy) with midline shield $(4\times10cm)$, and combined with intracavitary irradiation (up to 7480-8520cGy in Ib, IIa and 8480-9980cGy in IIb to point A). The maximum and mean follow up durations were 70 and 47 months respectively . Results : Five year local control rate was $78\%$ and the actuarial overall five year survival rate was $66.1\%$ for all patients, $44.4\%$ for stage Ib, IIa and $71.4\%$ for stage IIb. In bulky IIb (above 5cm in tumor size, 11 patients) five year local control rate and five rear survival rate was $88.9\%,\;73\%$ respectively Pelvic lymph node status (negative : $74\%,\;positive:25\%$, p=0.0015) was significant Prognostic factor affecting to five rear survival rate. There was marginally significant survival difference by total dose to A point ($>84Gy\;:\;70\%,\;>84Gy\;:\;42.8\%$, p=0.1). We consider that the difference of total dose to A point by stage (mean Ib,IIa : 79Gy. IIb 89Gy P=0.001) is one of the causes in worse local control and survival of Ib,IIa than IIb The overall recurrence rate was $39\%$ (16/41). The rates of local failure alone. distant failure alone. and combined local and distant failure were $9.7\%,\;19.5\%,\;and\;9.7\%$, respectively. Two Patients developed leukopenia ($\geq$ grade 3) and Three patients develoued grade 3 gastrointestinal complication. Above grade 3 complication was not noted. There was no treatment related death noted. Conclusion : We thought that it may be necessary to increase A point dose to more than 85Gy in hyperfractionated radiotherapy of huge exophytic and endophvtic stage Ib,IIa. We considered that hyperfractionated radiation therapy may be tolerable in huge exophytic and endophytic stage IIb cervical carcinoma with acceptable morbidity and possible survival gain but this was results in small patient group and will be confirmed by long term follow up in many patients.

• Korean Journal of Agricultural Science
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• v.4 no.1
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• pp.94-104
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• 1977

In order to investigate the effects of mechanical transplanting on the rice, four rice varieties including Jo-saing Tongil were planted in case nursering bed for three times with 10 days interval beginning from April 16. Fourty days old seedlings were transplanted with rice-transplanter, and growth habits of seedlings in bed and rice plants in main field and yield were examined and summerized as follows: 1. The plant height and number of leaves of the 40 days old seedling in case nursery bed were appeared to be less than those of seedlings grown in ordinary nursery bed. In case nursery, the plant height and number of leaves of seedlings grown in case nursery were apparently higher than those of seedlings grown in upland case nursery. 2. The root of 40 days old seedlings were cut to investigate the rooting ability of seedlings, and the rooting ability of the seedlings grown in the case nursery bed were apparently lower in the rooting ability compared with the seedlings grown in ordinary nursery bed. The rooting ability of the seedlings grown in the lowland case nursery was higher than that of the seedlings grown in the upland case nursery. 3. The tip of leaves of the varieties derived from Indica type were becoming yellow and yellow-red in color 25 to 30 days after planted in the case nursery bed. Those varieties was almost stopped growth. 4. The seedlings transplanted by transplanter had shown more than five to seven days of delay in rooting, compared with the seedlings transplanted by ordinary method. The heading dates was delayed five to seven days when transplanter was used, even though the delay of heading dates was a little different depending on the varieties. 5. The yields of unhulled rice were a little lower than that of Yusin variety which was hand planted. When mechanically transplanted, the yield of Tongil variety was highest in the plot where seedlings were transplanted on May 26. When transplanted on June 15, Milyang#15 was highest in yield, indicating the importance of varietal selection in mechanical transplantation. 6. The rice transplanter could transplant from 73 to 108 seedlings per $3.3m^2$. If the seeds of rice were evenly planted in the bed, the two-row rice transplanter could be used five to six times more effectively with less than one percent of missing plant compared with the hand transplanting. This suggests that rice transplanter could be utilized in the mono cropping area. 7. Since the time of transplantings in the double-cropping area is rather limitted, mechanical transplantation might be possible without reducings yield providing better adapted varieties and improved case-nursery techniques.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1143-1153
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• 1998

Background : Recent outbreaks of pulmonary disease due to drug-resistant strains of Mycobacterium Tuberculosis have resulted in significant morbidity and mortality in patients worldwide. We reviewed our experience to evaluate the effects of pulmonary resection on the management of multidrug-resistant tuberculosis. Method : A retrospective review was performed of 41 patients undergoing pulmonary resection for multidrug-resistant tuberculosis between January 1993 and December 1997. We divided these into 3 groups according to the radiologic findings : (1) patients who have reasonably localized lesion (Localized Lesion Group ; LLG) (2) patients who have cavitary lesions after pulmonary resection on chest roentgenogram (Remained Cavity Group : RCG) (3) patients who have Remained infiltrative lesions postoperatively (Remained infiltrative group : RIG). We evaluated the negative conversion rate after resection and overall response rate of the groups. Then they were compared with the results of the chemotherapy on the multi drug-resistant tuberculosis which has been outcome by Goble et al. Goble et al reported that negative conversion rate was 65% and overall response rate, 56% over a mean period of 5.1 months. Results : Seventy five point six percent were men and 24.4% women with a median age of 31 years (range, 16 to 60 years). Although the patients were treated preoperatively with multidrug regimens in an effort to reduce the mycobacterial burden, 22 of 41 were still sputum culture positive at the time of surgery. 20 of 22 patients(90.9%, p<0.01) responded which is defined as negative sputum cultures within 2 months postoperative. Of 26 patients with the sufficient follow up data, 19 have Remained sputum culture negative for a mean duration of 25.7 months (73.1%, p<0.05). The bulk of the disease was manifest in one lung, but lesser amounts of contralateral disease were demonstrated in 15, consisted of 8 in RIG and 7 in RCG, of 41. 12 of 12 patients (100%, p<0.01) who were sputum positive at the time of surgery in LLG converted successfully. 14 of 15 patients (93.3%, p<0.05) with the follow up have completed treatment and not relapsed for a mean period of 25. 7 months. The mean length of postoperative drug therapy of LLG was 12.2 months. In RIG, postoperative negative conversion rate was 83.3% which was not significant statistically. There was a statistical significance in overall response rate (100%, p<0.05) of RIG for a mean period of 24.4 months with a mean length of postoperative chemotherapy, 11.8 months. In RCG a statistically lower overall response rate (14.3%, p<0.01) has been revealed for a mean duration of follow up, 24.2 months. A negative conversion rate of RCG was 75% which was not significant statistically. Conclusion : Surgery plays an important role in the management of patients with multidrug-resistant Mycobacterium tuberculosis infection. Aggressive pulmonary resection should be performed for resistant Mycobacterium tuberculosis infection to avoid treatment failure or relapse. Especially all cavitary lesions on preoperative chest roentgenogram should be resected completely. If all of them could not be resected perfectly, you should not open the thorax.

• Journal of Preventive Medicine and Public Health
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• v.24 no.2 s.34
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• pp.232-242
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• 1991

To determine the incidence rate of child battering and related factors, a questionnaire survey was Conducted on 1,255 children in 4th and 5th grades of two elementary schools (one in the upper economic class area with 519 students and the other in the lower economic class area with 504 students) in Taegu and two schools in rural areas of Kyungpook province (120 and 112 students, respectively) from 1st May to 10th May 1990. Total number of children who were battered during one-month period (1-30 April 1990) prior to the survey was 918 (73.1%). Among the battered children 87 (6.9%) were severely battered (twice or more in a month by kicking or more severe method) and 831 children (66.2%) were moderately battered (all other battering than severe battering). The percentage of battered children and degree of battering were not significantly different between two schools in Taegu and between urban and rural areas. Common reasons for battering were disobediance (61.9%), making troubles (34.9%), and poor school performance (33.3%). However, 16.1% of severely battered children responded that the perpetrators battered them to wreak their anger and 5.7% of them did not know the reason why they were battered. A majority of the battered children (65%) regretted their fault after being battered but 20.7% of the severely battered children wanted to run away and 9.2% of them had an urge to commit suicide. While most of the physical injuries due to battering were minor as bruise (52.7%) but some of them were severe, e.g., bone fracture (2.5%), skin laceration (1.5%), and loss of consciousness. (0.2%). The common psycho-behavioral complaints of the severely battered children were unwillingness to study (31%), unwillingness to live (17.2%), and reluctance to go home (13.8%). The incidence rate of severe battering was significantly higher (p=0.018) among the children living in a quarter attached to a store (14.0%) than the children living in an apartment (6.6%) and individual house (6.2%). The incidence rate of severe battering was higher among children living in a rental house (8.4%) than children living in their own house 6.3%) (p=0.005). The children of father only working (5.1%) and mother only working (4.5%) had a lower incidence rate of severe battering than the children of both parents working (9.1%) and both parents unemployed (20.7%) (p=0.006). More children were battered when there was a sick family member (80.8%) compared with the children without a sick family member (71.4%) (p=0.001). The incidence rates of severe and moderate battering increased as the frequency of quarreling between mother and father increased (P=0.000). The percentage of unbattered children was higher among children whose father's occupation was professional (39.4%) than that of the total study subjects (26.9%) (p<0.001).

• Radiation Oncology Journal
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• v.20 no.3
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• pp.237-245
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• 2002

Purpose : This study was conducted to evaluate the treatment results, prognostic factors, and complication rates after high dose rate (HDR) brachytherapy in patients with uterine cervix cancer who were treated with curative aim. Materials and Methods : Of 269 cervix cancer patients treated at the department of radiation oncology, Samsung Medical Center from September 1994 to July 1998, the 106 who were treated with radical radio-therapy were analyzed. The median age was 61 years (range 22 to 89). All patients except 4 with carcinoma in situ (CIS) were given external beam radiotherapy (range $30.6\~50.4\;Gy$ to whole pelvis) and HDR brachytherapy. The common regimens of HDR brachytherapy were a total dose of $24\~28\;Gy$ with $6\~7$ fractions to point A at two fractions per week. The median overall treatment time was 55 days (range 44 to 104) in patients given both external beam radiotherapy and HDR brachytherapy. Results : Early responses of radiotherapy were evaluated by gynecologic examination and follow-up MRI 1 month after radiotherapy. Treatment responses were complete remission in 72 patients, partial response in 33 and no response in 1. The overall survival (OS) rate of all patients was $82\%,\;and\;73\%$, and the disease free survival (DFS) rate was $72\%,\;and\;69\%$, at 3, and 5 years, respectively. The pelvic control rate (PCR) was $79\%$ at both 3 and 5 years. According to the FIGO stage,3 and 5 year OS were $100\%\;and\;50\%$ in CIS/IA, $100\%\;and\;100%$ in IB, $83\%\;and\;69\%$ in IIA, $87\%\;and\;80\%$ in IIB, and $62\%\;and\;62\%$ in III, respectively. The 3 year OS in 4 patients with stage IVA was $100\%$. Three-year DFS were $80\%$ in CIS/IA, $88\%$ in IB, $100\%$ in IIA, $64\%$ in IIB, $58\%$ in III, and $75\%$ in IVA. Three-year PCR were $100\%$ in CIS/IA, $94\%$ in IB, $100\%$ in IIA, $84\%$ in IIB, $69\%$ in III, and $50\%$ in IVA. By univariate analysis, FIGO stage and treatment response were significant factors for OS. The significant factors for DFS were age, FIGO stage, treatment response and overall treatment time (OTT). For pelvic control rate, treatment response and OTT were significant factors. By multivariate analysis, FIGO stage had a borderline significance for OS (p=0.0825) and treatment response had a borderline significance for DFS (0=0.0872). A total of 14 patients $(13\%)$ experienced rectal bleeding, which occurred from 3 to 44 months (median, 13 months) after the completion of radiotherapy. Conclusion : HDR brachytherapy protocol of Samsung Medical Center combined with properly optimal external beam pelvic irradiation is a safe and effective treatment for patients with uterine cervix cancer. The authors found that OTT of less than 55 days had a positive impact on pelvic control and survival rate.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.247-256
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• 2008

Purpose: The purpose of this study is to evaluate anal sphincter preservation rates, survival rates, and prognostic factors in patients with rectal cancer treated with preoperative chemoradiotherapy. Materials and Methods: One hundred fifty patients with pathologic confirmed rectal cancer and treated by preoperative chemoradiotherapy between January 1999 and June 2007. Of the 150 patients, the 82 who completed the scheduled chemoradiotherapy, received definitive surgery at our hospital, and did not have distant metastasis upon initial diagnosis were enrolled in this study. The radiation dose delivered to the whole pelvis ranged from 41.4 to 46.0 Gy (median 44.0 Gy) using daily fractions of $1.8{\sim}2.0\;Gy$ at 5 days per week and a boost dose to the primary tumor and high risk area up to a total of $43.2{\sim}54\;Gy$ (median 50.4 Gy). Sixty patients (80.5%) received 5-fluorouracil, leucovorin, and cisplatin, while 16 patients (19.5%) were administered 5-fluorouracil and leucovorin every 4 weeks concurrently during radiotherapy. Surgery was performed for 3 to 45 weeks (median 7 weeks) after completion of chemoradiotherapy. Results: The sphincter preservation rates for all patients were 73.2% (60/82). Of the 48 patients whose tumor was located at less than 5 cm away from the anal verge, 31 (64.6%) underwent sphincter-saving surgery. Moreover, of the 34 patients whose tumor was located at greater than or equal to 5 cm away from the anal verge, 29 (85.3%) were able to preserve their anal sphincter. A pathologic complete response was achieved in 14.6% (12/82) of all patients. The downstaging rates were 42.7% (35/82) for the T stage, 75.5% (37/49) for the N stage, and 67.1% (55/82) for the overall stages. The median follow-up period was 38 months (range $11{\sim}107$ months). The overall 5-year survival, disease-free survival, and locoregional control rates were 67.4%, 58.9% and 84.4%, respectively. The 5-year overall survival rates based on the pathologic stage were 100% for stage 0 (n=12), 59.1% for stage I (n=16), 78.6% for stage II (n=30), 36.9% for stage III (n=23), and one patient with pathologic stage IV was alive for 43 months (p=0.02). The 5-year disease-free survival rates were 77.8% for stage 0, 63.6% for stage I, 58.9% for stage II, 51.1% for stage III, and 0% for stage IV (p<0.001). The 5-year locoregional control rates were 88.9% for stage 0, 93.8% for stage I, 91.1% for stage II, 68.2% for stage III, and one patient with pathologic stage IV was alive without local recurrence (p=0.01). The results of a multivariate analysis with age (${\leq}55$ vs. >55), clinical stage (I+II vs. III), radiotherapy to surgery interval (${\leq}6$ weeks vs. >6 weeks), operation type (sphincter preservation vs. no preservation), pathologic T stage, pathologic N stage, pathologic overall stage (0 vs. I+II vs. III+IV), and pathologic response (complete vs. non-CR), only age and pathologic N stage were significant predictors of overall survival, pathologic overall stage for disease-free survival, and pathologic N stage for locoregional control rates, respectively. Recurrence was observed in 25 patients (local recurrence in 10 patients, distant metastasis in 13 patients, and both in 2 patients). Acute hematologic toxicity ($\geq$grade 3) during chemoradiotherapy was observed in 2 patients, while skin toxicity was observed in 1 patient. Complications developing within 60 days after surgery and required admission or surgical intervention, were observed in 11 patients: anastomotic leakage in 5 patients, pelvic abscess in 2 patients, and others in 4 patients. Conclusion: Preoperative chemoradiotherapy was an effective modality to achieve downstaging and sphincter preservation in rectal cancer cases with a relatively low toxicity. Pathologic N stage was a statistically significant prognostic factor for survival and locoregional control and so, more intensified postoperative adjuvant chemotherapy should be considered in these patients.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.10
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• pp.1594-1606
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• 2014

The purpose of this study was to examine safety accidents related to school foodservice, working and operating environments of school foodservice, status and awareness of safety education, educational needs, and information on qualitative improvement of school foodservice. The subjects in this study were 234 cooks in charge of cooking at elementary and secondary schools in Chungbuk. A survey was conducted from July 30 to August 8, 2012, and among 202 questionnaires gathered, 194 completed questionnaires were analyzed. Statistical analyses were performed on data utilizing the SPSS version 19.0. The main results of this study were as follows: 44.3% of workers experienced safety accidents. The most frequent safety accident was 'once' (60.5%), and most safety accidents took place between June and August (31.4%). The time at which most safety accidents happened was between 8 and 11 am. Most safety accidents happened during cooking (52.3%) and while using a soup pot or frying pot (52.4%). The most common accidents were 'burns', 'wrist and arm pain', and 'slips and falls'. Respondents who experienced safety accidents replied that 57.6% of employees dealt with injuries at their own expense, and only 35.3% utilized industrial accident insurance. In terms of the operating environment, the score for 'offering information and application' was highest (3.76 points), whereas that for 'security of budget' was lowest (1.77 points). As for accident education, employees received safety education approximately 3.45 times and 5.10 hours per year. Improving the working environment of school foodservice cooks requires administrative and financial support. Furthermore, educational materials and guidelines based on the working environment and safety accident status of school foodservice cooks are required in order to minimize potential risk factors and control safety accidents in school foodservice.

• Tuberculosis and Respiratory Diseases
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• v.41 no.2
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• pp.103-110
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• 1994

To find out the predictors of nocturnal arterial oxygen desaturation in patients with respiratory diseases, transcutaneous oxygen saturation($StcO_2$) monitoring studies using a pulse oximeter were performed during sleep in 20 patients. $StcO_2$ was decreased more than 4% from the baseline value in 18 patients(90%) and more than 10%("Desaturator") in 8(40%). Five of the seven patients(71.4%) with awake $PaO_2$<60mmHg and three of the thirteen patients(23.1%) with awake $PaO_2{\geq}60mmHg$ were "desaturators". The awake $PaO_2/FIO_2$ and $PaO_2/PAO_2$ could distinguish "desaturator" from "nondesaturator", and $PaO_2,\;SaO_2$ or $StcO_2$ could not. These results suggest that the nocturnal oxygen desaturation depends on the severity of the underlying disease rather than the baseline $PaO_2$. Anthropomorphic and lung function factors could not separate between "desaturator" and "non-desaturator", and about a quater of patients with a wake $PaO_2{\geq}60mmHg$ developed significant desaturation. Therefore, it is necessary to monitor the nocturnal arterial oxygen saturation in patients with respiratory diseases regardless of their severity of airflow obstruction or awake $PaO_2$.

• Radiation Oncology Journal
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• v.14 no.1
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• pp.25-31
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• 1996

Purpose : To evaluate the potential advantage for 'sandwich' technique radiotherapy compared to Postoperative radiotherapy in resectable rectal cancer. Materials and Methods : Between January 1989 and Mar 1994, 60 patients with resectable rectal cancer were treated at Inje University Seoul and Sanggye Paik Hospital. Fifty one patients were available for analysis: 20 patients were treated with sandwich technique radiotherapy and 31 patients were treated with Postoperative radiotherapy. In sandwich technique radiotherapy(RT), Patients were treated with preoperative RT 1500 cGy/5fx, followed by immediate curative resection. Patients staged as Astler-Coiler B2, C were considered for postoperative RT with 2500-4500 cGy. in postoperative RT total radiation dose of 4500-6120 cGy, 180 cGy daily at 4-Sweets was delivered. Patients were followed for median period of 25 months. Results : The overall 5-year survival rates for sandwich RT group and postoperative RT group were $60\%$ and $71\%$, respectively(p>0.05). The 5-rear disease free survival rates for each group were $63\%$. There was no difference in local failure rate between two groups($11\%$ versus $7\%$) Incidence of distant metastasis was $11\%$(2/20) in the sandwich technique RT group and $20\%$(6/31) in the postoperative RT group(p>0.05). The frequencies of acute and chronic complications were comparable in both groups. Conclusion : The sandwich technique radiotherapy group shows local recurrence and survival similar to those of Postoperative RT alone group but reduced distant metastasis compared to Postoperative RT group. But long term follow-up and large number of patients is needed to make an any firm conclusion regarding the value of this sandwich technique RT.

• Journal of agricultural medicine and community health
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• v.30 no.2
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• pp.213-225
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• 2005

Objectives: This study was carried out to evaluate the socio-demographic, style of living, and health related behaviors of community residents between urban and rural areas in Jeonbuk province. Methods: The data was obtained from 2,086 residents who lived in Jeonbuk province from July to September 2001 which included 1,238 residents in urban area and 848 residents in rural area. Results: The results were as follows; There were significant differences socio-demographic characteristics including occupation and educational level of the populations between urban and rural areas. In the urban populations, housewives, professional classes, and people who received collage graduate education were significantly higher, people who were engaged in the primary industries and lower educational classes(below middle school), in contrast, were significantly lower than in the rural populations. In the practice of health behavior, consumption of health foods and amount of exercise in urban populations were significantly higher than in the rural, whereas the state of health, prevalence of chronic disease, Body Mass Index(BMI), consumption of ethanol and cigarette, and hours of sleep were not significantly different between the urban and rural populations. In the eating habits, rate of surfeit, vaccination of hepatitis B, and screening of cancer in the urban populations were significantly higher than in the rural, rate of regular meal, taste of salted food, consumption of vegetables, in contrast. were significantly lower than in the rural. But, consumption of coffee, intake of meat, and periodic medical checkup were not significantly different between urban and rural communities. Logistic regression analysis revealed that the factors associated with subjective thought on health state were sex, age, occupation, educational level, exercise, and consumption of coffee. Logistic regression analysis to find related factor with prevalence of chronic disease was conducted. As a results, age, educational level, BMI, intake of meat, screening of cancer, and consumption of health foods were related to prevalence of chronic disease. Conclusions: The study showed that special attention to device the health plan are necessary and it suggested that consideration of regional differences are required to provide the community health projects.