• Radiation Oncology Journal
• /
• v.14 no.1
• /
• pp.9-15
• /
• 1996

Purpose: The traditional approach with surgery and/or radiotherapy(RT) for advanced head and neck cancer Provides anticipated cure rates of $10-65\%$ depending on stages and sites. Recently, combined modality with chemotherapy have been extensively investigated in attempts to improve survival and local control. We retrospectively analysed our experience of 31 patients with advanced head and neck cancer. Materials and Methods : November 1983 to October 1994. 31 Patients with Stage III and IV squamous cell head and neck cancer were treated with RT. Sixteen patients were treated with RT alone, and IS patients were treated with combined RT plus chemotherapy. All patients were treated with 4-MV LINAC and radiation dose ranged from 5000 cGy to 7760 cGy (median 7010 cGy). In combined group, 7 patients were treated with cisplatin plus 5-FU 2 patients were treated with methotrexate plus leucovorin plus 5-FU plus cisplatin or carboplatin, and 6 patients were treated with cisplatin as a radiosensitizer. Results : Median follow up period was 16 months (range 4-134 months). The major responses (CR+PR) were noted in 10 patient ($66.6\%$) of the RT alone group and 14 patient ($93.3\%$) of the chemoradiation group. There was no statistical difference in CR rate between the two groups The overall survival rates at 5 years were $23.4\%$ in the radiation alone group, $23.5\%$ in the chemoradiation group Disease-free survival rates at 3 years were $44.5\%$ in the radiation alone group, $40\%$ in the chemoradiation group. There was no statistical differences in overall survival rates and disease-free survival rates between the two groups. Local recurrences occurred in $71.5\%$ of the radiation alone group, $72.7\%$ of the chemoradiation group and distant metastasis occurred in $14.4\%$ of radiation alone group, $9.1\%$ of the chemoradiation group. The frequencies of complications were comparable in both groups except hematologic toxicity Conclusion : Total response rates in the combined chemotherapy and radiotherapy was relatively higher than radiotherapy alone. But our result failed to show any survival benefit of the combined chemotherapy and radiotherapy. The accrual of large number of patients and long term follow-un may be necessary to confirm the present result of combined chemotherapy and radiotherapy.

• Radiation Oncology Journal
• /
• v.15 no.4
• /
• pp.379-385
• /
• 1997

Purpose : Ovarian dysgerminoma is a highly radiosensitive malignant tumor occurring in young age group. The conventional treatment was total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by radiotherapy. We retrospectively analyzed the treatment results of Patients who had received radiotherapy in the era before chemotherapy was widely used. Material and Method : Twenty two patients with ovarian dysgerminoma were treated at the Department of Therapeutic Radiology, Seoul National University Hospital between August, 1980 and May, 1991. Four patients were excluded from this study, because three patients received incomplete treatment and one received combined chemotherapy. Sixteen patients received postoperative radiotherapy and two patients had radical radiotherapy as tumor was unresectable. Median follow-up period was 99 months (range, 51-178) Median age was 22 years (range, 11-42). Among the postoperatively treated patients, three Patients were in stage IA, eight in stage IC, two in stage II, and three in stage III. One patient had Turner's syndrome. Radiotherapy was performed with high energy photon (telecobalt unit or linear accelerator, either 6MV or 10MV), The radiation dose to the whole abdomen was 1950-2100cGy (median, 2000) and 1050-2520cGy was added to the whole pelvis, the total dose to the whole pelvis was 3000-4500cGy (median, 3500). Prophylactic Paraaortic area irradiation was done in six Patients (dose range, 900-1500cGy). One patient who had positive Paraaortic node, received radiation dose of 1620cGy, followed by additional 900cGy to the gross mass with shrinking field. Total dose to the paraaortic node was 4470cGy. Six patients, including one who had paraaortic node metastasis, received Prophylactic irradiation to mediastinum and supraclavicular area (2520cGy). Of the two patients with unresectable tumors who received radical radiotherapy, one was in stage III and the other was in stage IV with left supraclavicular lymph node metastasis. The stage III patient received radiation to the whole abdomen (2000cGy), followed by boost to whole pelvis (2070cGy) and paraaortic area (2450cGy). Stage IV patient received radiation to the whole abdomen (2000cGy), followed by radiation to the whole pelvis and paraaortic area (2400cGy), mediastinum (2520cGy) , and left supraclavicular area (3550cGy) .Results : The 5 year local control rate was $100\%$ in patients who received postoperative adiuvant radiotherapy after total abdominal hysterectomy and bilateral salpingo-oophorectomy. Only one patient in stage III who did not receive prophylactic irradiation to mediastinum developed mediastinal metastasis. but was salvaged by chemotherapy. So. the 5 year overall survival rate uras also $100\%$. Two patients who received radiation only, are alive without disease at 112 and 155 months. Conclusion : Postoperntive adjuvant radiotherapy as well as radical radiotherapy in unresectable ovarian dysgerminoma was very effective. aut chemotherapy is also an effective treatment modality We now recomrneifd chemotherapy for Patients who need to save their ovarian functien and reserve radiotherapv fov chemo-resistant tumor or recurrence alter che motherapy.

• Korean Journal of Ecology and Environment
• /
• v.45 no.2
• /
• pp.158-173
• /
• 2012

The objectives of this study were to analyze the longitudinal gradient and temporal variations of water quality in Daecheong Reservoir in relation to the major inflowing streams from the watershed, during 2001~2010. For the study, we selected 7 main-stream sites of the reservoir along the main axis of the reservoir, from the headwater to the dam and 8 tributary streams. In-reservoir nutrients of TN and TP showed longitudinal declines from the headwater to the dam, which results in a distinct zonation of the riverine ($R_z$, M1~M3), transition ($T_z$, M4~M6), and lacustrine zone ($L_z$, M7) in water quality, as shown in other foreign reservoirs. Chlorophyll-a (CHL) and BOD as an indicator of organic matter, were maximum in the $T_z$. Concentration of total phosphorus (TP) was the highest (8.52 $mg\;L^{-1}$) on March in the $R_z$, and was the highest (165 ${\mu}g\;L^{-1}$) in the $L_z$ on July. Values of TN was the maximum (377 ${\mu}g\;L^{-1}$) on August in the $R_z$, and was the highest (3.76 $mg\;L^{-1}$) in the $L_z$ on August. Ionic dilution was evident during September~October, after the monsoon rain. The mean ratios of TN : TP, as an indicator of limiting factor, were 88, which indicates that nitrogen is a surplus for phytoplankton growth in this system. Nutrient analysis of inflowing streams showed that major nutrient sources were headwater streams of T1~T2 and Ockcheon-Stream of T5, and the most influential inflowing stream to the reservoir was T5, which is located in the mid-reservoir, and is directly influenced by the waste-water treatment plants. The key parameters, influenced by the monsoon rain, were TP and suspended solids (SS). Empirical models of trophic variables indicated that variations of CHL in the $R_z$ ($R^2$=0.044, p=0.264) and $T_z$ ($R^2$=0.126, p=0.054) were not accounted by TN, but were significant (p=0.032) in the $L_z$. The variation of the log-transformed $I_r$-CHL was not accounted ($R^2$=0.258, p=0.110) by $I_w$-TN of inflowing streams, but was determined ($R^2$=0.567, p=0.005) by $I_w$-TP of inflowing streams. In other words, TP inputs from the inflowing streams were the major determinants on the in-reservoir phytoplankton growth. Regression analysis of TN : TP suggested that the ratio was determined by P, rather than N. Overall, our data suggest that TP and suspended solids, during the summer flood period, should be reduced from the eutrophication control and P-input from Ockcheon-Stream should be controlled for water quality improvement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.29 no.6
• /
• pp.421-429
• /
• 2003

Purpose : Neoadjuvant chemotherapy is commonly used to treat cancer patients as adjunct treatment, but if the microvascular tissue transfer is performed simulataneously with cancer resection surgery, the induction chemotherapy might affect the survival rate of vascularized free flap. Our study will focus on the effect of induction chemotherapy on the free flaps which were made on white rat abdomen after injection of 5-FU. Materials and Methods: The experimental rat groups were divided into three groups (total 24 rats) as a normal control group, 24 hrs group after 5-FU injection, 3 days group after 5-FU injection. Inferior abdominal island flaps of 8 Sprague Dawley rats on each group were made and immediately were induced into an ischemic state by clamping the supplying inferior epigastric artery and vein with microvascular clamp for a hour to induce a similiar free flap circumstance, then the inferior abdominal skin flaps were reperfused by releasing the clamps. The flaps on abdomen were repositioned and sutured. The experimental data for flap survival rate was collected by digital photo taking, analysed by computer image program to compare with the flap luminosity. The rats were sacrificed at 3 days, 5 days, 7 days after flap preparation and specimens of the flap were taken and stained with H-E staining. The microscopic finding was made under magnification of 200 and 400. Results: 1. Gross findings on each groups showed the healing condition was good as following sequences; normal, 24 hrs group after chemotherapy, 3 days group after chemotherpy. 2. The values of flap luminosity for evaluation of flap survival rate also showed the same sequences as gross findings of healing state. 3. The microscopic findings of epidermis necrosis, inflammation state, dermis fibrosis, vessel change, fatty tissue layer thinning were compared with each group. The 3 days group after chemotherapy showed remarkably poor healing condition compared to other groups. Conclusion: Chemotherapy agents affected the healing process of free flap, but healing condition was recovered spontaneously as post-injection periods passed out. In opposite to our expectation, 3 days group showed the bad flap condition in comparing with 24 hours group which was considered as immatured body circulation state of chemotherapy agent. It showed that 3 weeks in human being after chemotherapy was not proper as timing of microvascular tissue transfer if 3 days group in rat was considered as same healing period of 3 weeks in human being. More delayed healing timing than 3 weeks might be required in clinical application of free tissue transfer.

• Radiation Oncology Journal
• /
• v.22 no.2
• /
• pp.115-123
• /
• 2004

Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

• Clinical and Experimental Pediatrics
• /
• v.45 no.10
• /
• pp.1204-1212
• /
• 2002

Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm $H_2O$ within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was $5.4{\pm}0.5cm$ $H_2O$. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.2
• /
• pp.241-250
• /
• 1997

Objective : Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. Method : Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X -ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. Results : The ratio between male and female was 4 : 1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 130patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees. Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%)got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. Conclusion : In the case of weight loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs even though drug sensitivity results show sensitivity to some of them. Proper time for surgical intervention should not be delayed.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.12 no.2
• /
• pp.116-121
• /
• 1983

A study was conducted to evaluate the effect of $^{60}CO-{\gamma}$ irradiation on the preservation on Satauma mandarin in Cheju Island. Four varieties (S. m. early, S. m. Komezawa, S. m. Hayashi and S. m. Aoshima) were irradiated using 10,000Ci, $^{60}CO-{\gamma}$ ray with dosages of 0, 50, 100 and 150Krad. During 92 days of storage the effects of irradiation on mandarin porperties were as follows: At the end of storage period the accumulated fruit rotting percentage were S. m. Komezawa($T_2$);74.32%, S. m. early($T_1$);69.67%, S. m. Aoshima($T_4$);64.33% and S. m. Hayashi ($T_3$);61.79%. The rottings steadily increased from the early stage of storage and rapid spoilage continued after 59 days of irradiation. A high corelation existed between fruit rotting and varieties ($T_3$;Y=0.78x-15.30, $T_4$;Y=0.79x-12.29, $T_1$;Y=0.93x-9.01 and $T_2$;Y=0.79x-13.49) High dosages(100 and 150 Krad)improved fruit preservation during the mid storage stage. However 76 days after high dose irradiation there was no significant difference a rotting between irradiated fruit and the control. Irradiation decreased acidity of fruit during storage (p<0.01). The mean acidities of examined varieties were $T_1$;1.01%, $T_3$;1.01%, $T_4$;0.84% and $T_2$;0.77%. A significant differences were observed in acidity between varieties and dosages(P<0.01) With one exception in all treatments. the increase in free and total sugar content was not statestically significant. The exception was the 50 Krad treatment where the total sugar content decreased. $T_1$ and $T_4$ showed slightly higher value of than Brix $T_2$ and $T_3$, and were significantly(P<0.01) decreased by higher dosage. The ascorbic acid content in all treatments decreased with length of storage and also decreased significantly with a higher dosage.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.13 no.3
• /
• pp.251-258
• /
• 1984

In order to improve the physical properties on moisture sorption of spray dried red ginseng extract powder (SD-RGEP), the various additives and coating agents were treated, and solubility, sedimentation rate and storage stability of RGEPs treated were investigated. For the moisture-proofing, additive itself was effective in the order casein>dextrin>starch>avicell, but RGEPs treated with additives were effective in the order cord oil+tween-40>starch>casein. But there was no significant difference between RGEP treated less than 1% additive and the moisture-proofing. The coating effect of AEA and CAP on RGEP could not be recognized for the moisture-proofing, whereas that of HPC, corn oil, lecithin and HPC+corn oil was proved to be very effective for the moisture-proofing of RGEP. Also it is required to control the initial moisture content of RGEP. The sedimentation rate of RGEP nontreated was 65.1 seconds, whereas that of RGEPs coated with 1% HPC, 1% corn oil, 1% lecithin and 1% HPC+0.5% corn oil was in the range of 96.2 to 114.3 seconds. The sedimentation rate of RGEPs coated was 1.5 to 1.8 times higher than that of RGEP nontreated, and there was significant difference between solubility and sedimentation rate. Therefore it was no matter for the keeping quality. The sorption rates of RGEPs coated with lecithin $(0.5{\sim}1.0%$), corn oil(0.8%) and cellulose acetate (0.8%) were ranged 54 to 56%, 51 to 55% and 52 to 54%, respectively, and it is found that the moisture-proofing effect of RGEPs coated was about 2 times higher than that of RGEP nontreated. From the result of storage experiment during 3 months under the maltreated condition of $48{\pm}2^{\circ}C$, 75% RH, the moisture sorption of RGEPs coated with corn oil$(0.5{\sim}1.0%$), cellulose acetate(DES, $0.5{\sim}0.8%$) and lecithin (DES, 1.0%) was not at all observed. Therefore it is considered that the circulating period of RGEPs coated with these coating agents could to give more than 3 years.

• Journal of Global Scholars of Marketing Science
• /
• v.17 no.2
• /
• pp.31-54
• /
• 2007

The exchange between buyers and sellers in the industrial market is changing from short-term to long-term relationships. Long-term relationships are governed mainly by formal contracts or informal agreements, but many scholars are now asserting that controlling relationship by using formal contracts under environmental dynamism is inappropriate. In this case, partners will depend on each other's flexibility or interdependence. The former, flexibility, provides a general frame of reference, order, and standards against which to guide and assess appropriate behavior in dynamic and ambiguous situations, thus motivating the value-oriented performance goals shared between partners. It is based on social sacrifices, which can potentially minimize any opportunistic behaviors. The later, interdependence, means that each firm possesses a high level of dependence in an dynamic channel relationship. When interdependence is high in magnitude and symmetric, each firm enjoys a high level of power and the bonds between the firms should be reasonably strong. Strong shared power is likely to promote commitment because of the common interests, attention, and support found in such channel relationships. This study deals with environmental dynamism in high-tech industry. Firms in the high-tech industry regard it as a key success factor to successfully cope with environmental changes. However, due to the lack of studies dealing with environmental dynamism and supply chain commitment in the high-tech industry, it is very difficult to find effective strategies to cope with them. This paper presents the results of an empirical study on the relationship between environmental dynamism and supply chain commitment in the high-tech industry. We examined the effects of consumer, competitor, and technological dynamism on supply chain commitment. Additionally, we examined the moderating effects of flexibility and dependence of supply chains. This study was confined to the type of high-tech industry which has the characteristics of rapid technology change and short product lifecycle. Flexibility among the firms of this industry, having the characteristic of hard and fast growth, is more important here than among any other industry. Thus, a variety of environmental dynamism can affect a supply chain relationship. The industries targeted industries were electronic parts, metal product, computer, electric machine, automobile, and medical precision manufacturing industries. Data was collected as follows. During the survey, the researchers managed to obtain the list of parts suppliers of 2 companies, N and L, with an international competitiveness in the mobile phone manufacturing industry; and of the suppliers in a business relationship with S company, a semiconductor manufacturing company. They were asked to respond to the survey via telephone and e-mail. During the two month period of February-April 2006, we were able to collect data from 44 companies. The respondents were restricted to direct dealing authorities and subcontractor company (the supplier) staff with at least three months of dealing experience with a manufacture (an industrial material buyer). The measurement validation procedures included scale reliability; discriminant and convergent validity were used to validate measures. Also, the reliability measurements traditionally employed, such as the Cronbach's alpha, were used. All the reliabilities were greater than.70. A series of exploratory factor analyses was conducted. We conducted confirmatory factor analyses to assess the validity of our measurements. A series of chi-square difference tests were conducted so that the discriminant validity could be ensured. For each pair, we estimated two models-an unconstrained model and a constrained model-and compared the two model fits. All these tests supported discriminant validity. Also, all items loaded significantly on their respective constructs, providing support for convergent validity. We then examined composite reliability and average variance extracted (AVE). The composite reliability of each construct was greater than.70. The AVE of each construct was greater than.50. According to the multiple regression analysis, customer dynamism had a negative effect and competitor dynamism had a positive effect on a supplier's commitment. In addition, flexibility and dependence had significant moderating effects on customer and competitor dynamism. On the other hand, all hypotheses about technological dynamism had no significant effects on commitment. In other words, technological dynamism had no direct effect on supplier's commitment and was not moderated by the flexibility and dependence of the supply chain. This study makes its contribution in the point of view that this is a rare study on environmental dynamism and supply chain commitment in the field of high-tech industry. Especially, this study verified the effects of three sectors of environmental dynamism on supplier's commitment. Also, it empirically tested how the effects were moderated by flexibility and dependence. The results showed that flexibility and interdependence had a role to strengthen supplier's commitment under environmental dynamism in high-tech industry. Thus relationship managers in high-tech industry should make supply chain relationship flexible and interdependent. The limitations of the study are as follows; First, about the research setting, the study was conducted with high-tech industry, in which the direction of the change in the power balance of supply chain dyads is usually determined by manufacturers. So we have a difficulty with generalization. We need to control the power structure between partners in a future study. Secondly, about flexibility, we treated it throughout the paper as positive, but it can also be negative, i.e. violating an agreement or moving, but in the wrong direction, etc. Therefore we need to investigate the multi-dimensionality of flexibility in future research.