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Conservative Surgery and Primary Radiotherapy for Early Bresst Cancer: Yonsei Cancer Center Experience (조기 유방암에서 보존적 수술후 방사선치료: 연세암센터 경험)

  • Suh Chang Ok;Lee Hy De;Lee Kyung Sik;Jung Woo Hee;Oh Ki Keun;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.337-347
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    • 1994
  • Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation in 1991 and treated one hundred and fourty patients during the next three years. Purpose : To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five Patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results : Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven Patients were N0 and 27 patients were Nl. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occured at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation pneumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer is Proven to be safe and comfortable treatment method without any major complication. Long-term follow up is needed to evaluate our treatment results in terms of loco-regional control rate, survival rate, and cosmetic effect.

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Obturation efficiency of non-standardized gutta-percha cone in curved root canals prepared with 0.06 taper nickel-titanium instruments (0.06-경사도의 니켈-티타늄 기구로 형성된 레진 만곡근관에서 비표준화 GUTTA-PERCHA CONE의 근관충전 효율)

  • Lee, Eun-Ah;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.30 no.2
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    • pp.79-85
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    • 2005
  • The purpose of this study was to evaluate the obturation efficiency of a non-standardized gutta-percha cone in curved root canals prepared with 0.06 taper nickel-titanium instruments. Sixty simulated curved root canals in clear resin blocks were prepared with crown-down technique using 0.06 taper rotary $ProTaper^{TM}$and ProFile (Dentsply-Maillefer) until apical canal was size 30. Root canals were randomly divided into 4 groups of 15 blocks and obturated with cold-laterally compacted gutta-percha technique by using either a non-standardized size medium gutta-percha cone or an ISO-standardized size 30 one as a master cone. Gutta-percha area ratio were calculated at apical levels of 1, 3 and 5 mm using AutoCAD 2000 after cross-sectioning, and the data were analyzed with one-way and two-way ANOVAs and Duncan's multiple range test. Non-standardized size medium cone groups showed significantly higher gutta-percha area ratio than standardized cone groups at all apical levels (p < 0.01). Non-standardized cone groups used significantly less accessory cones than standardized cone groups (p < 0.01).

Military Competition and Arms Control in Space (우주상 군비경쟁과 군비통제)

  • Shin, Dong-Chun;Cho, Hong-Je
    • The Korean Journal of Air & Space Law and Policy
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    • v.26 no.2
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    • pp.203-237
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    • 2011
  • Since USSR successfully launched its satellite "Sputnik"in 1957, many countries including US and USSR began military use of space, and engaged in arms race in space, which is against spirit and ideals of peaceful use of space as common heritage of mankind stipulated in many treaties such as Outer Space Treaty. With worsening Cold War between East and Western Bloc, this military use of space and arms race in space has been intensifying. Regarding the ideals of peaceful use of space, it is interpreted that military use of space is possible unless it does not have the purpose of aggression. The military use of space may have diverse forms such as attacking satellites in space, or attacking from satellites, making use of present and future technologies available which should include the use of nuclear and kinetic/hyper-speed weapons, laser, particle beams, near explosion, disturbance weapons in different directions (i.e., surface to space, space to space, and space to surface). Arms control is being implemented by the efforts of many countries in different formalities including legislature of international treaties under the auspices of UNCOPUOS and prohibition of weapons of mass destruction. Taking outstanding examples aiming at arms control by international community, there are confidence building measures (CBM), strengthening implementation of existing treaties, partial ban of nuclear tests, countryand regional approach, comprehensive approach and measures having legally binding force. While U.S. has surpassed other countries concerned in the area of military useof space, it withdrew from OST in early 2000s, thereby raising concern of international community. It requires concerted efforts of cooperationand implementation by international society to make sure peace of mankind and environmental conservation through arms control in space. Observing de facto possession of nuclear weapons by North Korea following series of nuclear tests and launching satellites, and efforts of launching rockets by South Korea, it is strongly needed for both countries to take part in arms control efforts by international community.

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Acute Renal Failure after On-pump Coronary Artery Bypass Surgery (체외순환하 시행한 관상동맥우회술 후 발생한 급성신부전증)

  • Jin, Ung;Jo, Min-Seop;Park, Chan-Beom;Sa, Young-Jo;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.416-422
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    • 2004
  • Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002, We checked the preoperative factors; sex, age, history of previous serum creationism over 2.0 mg/㎗, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors: IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/㎗. Result: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/㎗ in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6,4%) in the patients whose creatinine level have not increased over 2.0 mg/㎗. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/㎗ are diabetes, the history of previous serum creatinine over 2.0 mg/㎗ and left ventricular ejection fraction. Conclusion: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2,0 mg/㎗ and left ventricular ejection fraction. Postoperative ARF could De the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.

Colombia Border Area Refugees: Centered on Venezuela, Panama, and Ecuador Border Areas (콜롬비아 국경지역 난민증가 원인: 베네수엘라, 파나마 그리고 에콰도르 접경지역 강제실향민을 중심으로)

  • Cha, Kyung-Mi
    • Journal of International Area Studies (JIAS)
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    • v.15 no.1
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    • pp.109-134
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    • 2011
  • Drug-related crime has increased in spite of visible results of Uribe government's hard-line policies on drug eradication and illegally armed organizations which were pursued under U.S. support, without the accompaniment of quantity change in drug cultivation and trade. Military disputes of left-right illegally armed communities surrounding illegal crop cultivation rights were rather intensified, and the number of refugees was increased through enforced displaced people. The 2005 refugee registration committee RUPD reports that 3,316,862 people, 7.3% of total population, were refugees. In particular, the number of refugees presented a large increase rate of 624% when compared to the past year due to enforced displaced people. Main discharge areas of enforced displaced people are connected with drug crime and activities of illegally armed organizations, and are places of increased armed disputes in the process of occupied territory expansion of illegally armed communities and militia. Undiscriminated attacks were executed on farmers in the process of occupation of illegal crop cultivation sites by illegally armed organization and militia to emit enforced displaced people, who moved to border areas by crossing national borders. Enforced displaced people were restricted to certain areas before the appearance of Uribe administration. However, enforced displaced people not only presented quantitative expansion, but also showed tendency of nationwide expansion after national security policy was pursued. With the closing of the Amazon area, previously the main route of drug trade, activity base of illegally armed organizations was moved to the Pacific region, and Panama border area experienced refugee increase due to the new policy of enforced displaced people. This study aims to understand the actual condition and cause for the increase in refugees in Colombia based on border areas of Venezuela, which is the nation of highest dispersion of Columbian refugees, Panama, which has appeared as a new destination for refugees after the 90s, and Ecuador, which has experienced sudden refugee increase in 2000.

Christian Educational Proposals for Revitalizing Research on North Korea's 'education' (북한 '교육' 연구 활성화를 위한 기독교교육적 제언)

  • Ham, Seung su
    • Journal of Christian Education in Korea
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    • v.71
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    • pp.305-340
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    • 2022
  • This study was started to suggest the direction of Christian educational development to revitalize North Korea's 'education' research. Since the two Koreas have experienced heterogeneity in almost all elements of society, such as politics, economy, society, culture, and education, during the period of division in 1977, true unification depends on laying the foundation for social integration that can overcome the sense of heterogeneity between the two Koreas. This is why North Korea's "education" research is needed. Education is the foundation for transferring culture and history, and for bringing about the survival, transformation, and community of society and since it is the mission of Korean churches and Christian educators to establish the direction of North Korean "education" research, North Korean "education" research is very important. Despite this importance, 'North Korean research' in the field of Christian education has not been properly conducted. Research on the "Christian Unification Education Program" that can be used in churches is actively taking place, but research on the macro level of presenting post-unification education blueprints is rare. This study was started to suggest the direction of Christian educational development to revitalize North Korea's 'education' research. For the study, the characteristics of 'North Korea Research' were analyzed according to generational classification. As a result of the study, recent research on North Korea has been expanding in research topics and methodologies, and recent studies have been differentiated into microscopic studies that deviate from existing research trends at a macro level and view North Korea's daily life. The characteristics of 'North Korean education research' are summarized by period. The research on North Korean education, which began in earnest in the 1970s, was divided into the period of start(70s), transition(80s), leap(90s), expansion(2000s), and development(2010s~). and research characteristics for each period were analyzed. Through this, early North Korean education research was also conducted in the policy aspect of the country, and the characteristics of political and social studies were strong, but recent studies have confirmed that the subjects and contents are diversifying. Based on these studies, the pending issues and issues of North Korean education research in the field of Christian education were analyzed. The study of North Korea in the field of Christian education, which began in the 1980s, has been conducted in the engineering aspect of 'development of unification education programs for churches'. However, studies on Christian unification education and North Korean education itself, which can be used in public education sites including Christian schools, have yet to be sufficient. Nevertheless, the diversification of research in the field of Christian education can be evaluated as a positive change. Based on these studies, it was proposed to establish a de-ideological research foundation, secure primary research data(Raw Data), activate research topics and research methodologies, and strengthen research capabilities in the direction of development to revitalize North Korean research in the field of Christian education. I hope this study will trigger various follow-up studies and help Korean churches that must achieve unification.

Effects of a Blend of Prunus Mume Extract as an Alternative to Antibiotics on Growth Performance, Activity of Digestive Enzymes and Microflora Population in Broiler Chickens (항생제 대체 사료첨가제로서 매실추출 혼합물이 육계의 성장, 소화 효소 활성도 및 장내 미생물 균총에 미치는 영향)

  • Ko, Y.H.;Yang, H.Y.;Kang, S.Y.;Kim, E.S.;Jang, I.S.
    • Journal of Animal Science and Technology
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    • v.49 no.5
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    • pp.611-620
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    • 2007
  • The current study was designed to define whether a blend of prunus mume extract(25%) containing lactic acid(75%) and grape seed extract(10ppm) could affect in vitro antimicrobial activity and growth performance, intestinal microflora, plasma biochemical profiles and digestive enzymes activities in broiler chickens. In paper disc agar diffusion test, we clearly observed antimicrobial activity against E. coli in response to prunus mume extract or a blend of prunus mume extract. For in vivo test, a total of ninety six 3-d-old male broiler chicks were assigned to basal diet(CON), basal diet supplemented with antibiotics (ANTI) and 0.5% a blend of prunus mume extract(PRNUS) until 35 days of age. Throughout the entire experimental period(3-35 days), there were no differences in BW and FCR between the birds fed the basal diet with antibiotics and the diet supplemented with a blend of prunus mume. However, ANTI group showed a significant increase in BW and total gain compared to CON group. The weights of digestive organs such as the pancreas and mucosal tissues were not affected by dietary treatments. There was no difference in plasma levels of glucose, cholesterol, AST and ALT activity. However, triglyceride in plasma increased(P<0.05) in the birds fed the diet supplemented with 0.5% a blend of prunus mume extract compared to those fed antibiotics supplemented diet. The activities of pancreatic trypsin and amylase, and intestinal hydrolase including disaccharidase were not affected by dietary treatment. The colony forming units(CFU) of lactobacillus in the lower ileal-cecum of the birds fed the diet supplemented with a blend of prunus mume extract was significantly(P<0.05) higher than that of birds fed antibiotic supplemented diet without affecting the CFU of E. coli. In conclusion, the birds fed the diet supplemented a blend of prunus mume as an alternative to antibiotics showed a similar growth performance and an significant increase in lactobacillus population compared with the birds fed basal and antibiotics supplemented diets.

A Study 0n the Improvement of the domestic in producing area organizations According to the change retail environment: Focused on organized, scaled, Specialization. (농산물 소매유통환경 변화에 따른 국내 산지유통조직 개선방안에 관한 연구: 조직화·규모화·전문화를 중심으로)

  • Kim, Dae-Yun
    • The Journal of Industrial Distribution & Business
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    • v.2 no.2
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    • pp.5-14
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    • 2011
  • Opening agricultural market expansion, reduced purchases through wholesale markets, expanding the influence large retailers of consumer's market such as changes in the distribution system to the farmer's market conditions are changing rapidly. Because of this, retailers of the scaled and chain-store operations was centered on distribution environmental changes of the consumer market place. In producing area due to changes in market conditions in the agricultural production of in producing area distribution organization and the size distribution can not be put off no longer challenge is imminent. If it do not raise forces banded together, the producer is bound to remain as the weak. To support the distribution of this production was introduced in 2000 enable the Activation Project of in producing area distribution. Recent in producing area Changes of Agricultural conditions in order to cope with the Small-scale farmers and small individual farmers are becoming Scaled and specialized. Also, is specific to each item and regional is showing aspects. Government support for Activation Project of in producing area distribution is greatly improved, but in terms of competitiveness on the market still is showing the limitations. The most common of these problems, the market response if in producing area producer's organization and scale of the problem. Equipped for the purpose of consumer market place responsiveness unreasonable propelled outward from the Painter-sized weakens the organizational power. also, Difficult to succeed organizational size is a dissolution or anything within a few years, farmers around the best producer organizations, such as deviation occurs is exposed to a variety of issues. In this study, previous studies refer to the recent changes in agricultural retail environment, background and needs of organization·scaled, Determine the status of the domestic in producing area organizations and derived Problems, look into Domestic and overseas of in producing area organization with best practices for enhancing the competitiveness of the proposed improvement are intended to. In the future, in producing area distribution policy would like to provide direction to the development. The results of the study showed the follwing : 1) enhance utilization and orrganized through the diversification of the agricultural Collection systems. 2) Scaled to achieve through Items of specialized a wide area marketing. 3) Management operating units, such as installation and operating that overseas the best practices " Comite Economique Agricole Regional 'Fruits et Legumes' de Bretagne". 4) To establish a support system that in producing area distribution organization model development for appropriate domestic. In particular, in case of domestic in producing area distribution organization, through the analysis of various case study that a successful organization and scaled. The process of the various challenges arising in organizational scaled and generalization, and by the way he goes about trying to overcome is required. At the end of the study's limitations and future research directions suggested.

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REMINERALIZATION DEPTH OF CPP-ACP ON DEMINERALIZATION HUMAN ENAMEL IN VITRO (탈회된 법랑질에서 CPP-ACP의 재광화 깊이)

  • Choi, Han-Ju;Choi, Yeong-Chul;Kim, Kwang-Chul;Choi, Sung-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.278-286
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    • 2008
  • Many studies regarding Casein phosphopeptides-amorphous calcium phosphate(CPP-ACP) have demonstrated the remineralization ability on the demineralized enamel surface. A question is still remained that how deep can the calcium (Ca) and phosphorus (P) ions supplied by the CPP-ACP paste penetrate into the enamel subsurface. The aims of this study were to measure the penetrating depth of Ca and P ions in the demineralized human enamel in vitro, and were to determine the amount and depth of Ca and P ions according to the duration. The amount and depth of Ca and P ions were measured by microscopic observation with Field Emission Scanning Electron Microscopy (FE-SEM; LEO SUPRA 55, Carl Zeiss, Germany) and Energy Dispersive X-ray Spectrometer (EDS; GENESIS 2000, EDAX, USA: Linescan of Calcium and Phosphorus). Freshly extracted four human 1st premolars were obtained from the Dept. of Pediatric Dent., Kyung Hee Univ. Buccal surfaces of the 1st premolars were covered with nail varnish to form a window on the middle third of buccal surface. All of the teeth with enamel windows were immersed in a solution of 0.1 M lactic acid, Carbopol C907 (carboxypolymethylene BF Goodrich, Cleveland, OH, USA) at pH 4.8, and then incubated for 7 days. Each tooth crown was sawn in half through the midline of buccal window along the long axis of premolar. The four blocks of premolars were immersed in a 10-times diluted solution of CPP-ACP paste (Tooth Mousse, GC Corp., Tokyo, Japan) for 1, 2, 3 and 5 weeks while the rests were immersed in a placebo solution (distilled water) for the same duration. Each specimen was embedded in epoxy resin, and was sectioned perpendicular to the window, using a water-cooled diamond blade saw. The spectrum density indices of Ca and P were measured in the sound, de- and remineralized enamels by FE-SEM and EDS. The Student's t test was performed to compare the Spectrum Density Indices (SDI) of sound, re-and demineralized enamels, and to compare the differences among the durations. Followings are the conclusion : 1. The penetration depth of the remineralizing ions (Ca & P) of CPP-ACP paste is related to the depth of demineralized enamel (approximately $1050{\sim}1350{\mu}m$). It is revealed that the penetration depth of both ions reaches full thickness of decalcification and even slightly into the sound enamel. 2. The Ca & P levels of remineralized enamels in 1, 2 weeks were significantly higher than those of the sound enamels (p<0.05). 3. No statistically significant difference of Ca & P levels was found in relation with the increasing duration of remineralization (p>0.05).

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Antecedents of Manufacturer's Private Label Program Engagement : A Focus on Strategic Market Management Perspective (제조업체 Private Labels 도입의 선행요인 : 전략적 시장관리 관점을 중심으로)

  • Lim, Chae-Un;Yi, Ho-Taek
    • Journal of Distribution Research
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    • v.17 no.1
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    • pp.65-86
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    • 2012
  • The $20^{th}$ century was the era of manufacturer brands which built higher brand equity for consumers. Consumers moved from generic products of inconsistent quality produced by local factories in the $19^{th}$ century to branded products from global manufacturers and manufacturer brands reached consumers through distributors and retailers. Retailers were relatively small compared to their largest suppliers. However, sometime in the 1970s, things began to slowly change as retailers started to develop their own national chains and began international expansion, and consolidation of the retail industry from mom-and-pop stores to global players was well under way (Kumar and Steenkamp 2007, p.2) In South Korea, since the middle of the 1990s, the bulking up of retailers that started then has changed the balance of power between manufacturers and retailers. Retailer private labels, generally referred to as own labels, store brands, distributors own private-label, home brand or own label brand have also been performing strongly in every single local market (Bushman 1993; De Wulf et al. 2005). Private labels now account for one out of every five items sold every day in U.S. supermarkets, drug chains, and mass merchandisers (Kumar and Steenkamp 2007), and the market share in Western Europe is even larger (Euromonitor 2007). In the UK, grocery market share of private labels grew from 39% of sales in 2008 to 41% in 2010 (Marian 2010). Planet Retail (2007, p.1) recently concluded that "[PLs] are set for accelerated growth, with the majority of the world's leading grocers increasing their own label penetration." Private labels have gained wide attention both in the academic literature and popular business press and there is a glowing academic research to the perspective of manufacturers and retailers. Empirical research on private labels has mainly studies the factors explaining private labels market shares across product categories and/or retail chains (Dahr and Hoch 1997; Hoch and Banerji, 1993), factors influencing the private labels proneness of consumers (Baltas and Doyle 1998; Burton et al. 1998; Richardson et al. 1996) and factors how to react brand manufacturers towards PLs (Dunne and Narasimhan 1999; Hoch 1996; Quelch and Harding 1996; Verhoef et al. 2000). Nevertheless, empirical research on factors influencing the production in terms of a manufacturer-retailer is rather anecdotal than theory-based. The objective of this paper is to bridge the gap in these two types of research and explore the factors which influence on manufacturer's private label production based on two competing theories: S-C-P (Structure - Conduct - Performance) paradigm and resource-based theory. In order to do so, the authors used in-depth interview with marketing managers, reviewed retail press and research and presents the conceptual framework that integrates the major determinants of private labels production. From a manufacturer's perspective, supplying private labels often starts on a strategic basis. When a manufacturer engages in private labels, the manufacturer does not have to spend on advertising, retailer promotions or maintain a dedicated sales force. Moreover, if a manufacturer has weak marketing capabilities, the manufacturer can make use of retailer's marketing capability to produce private labels and lessen its marketing cost and increases its profit margin. Figure 1. is the theoretical framework based on a strategic market management perspective, integrated concept of both S-C-P paradigm and resource-based theory. The model includes one mediate variable, marketing capabilities, and the other moderate variable, competitive intensity. Manufacturer's national brand reputation, firm's marketing investment, and product portfolio, which are hypothesized to positively affected manufacturer's marketing capabilities. Then, marketing capabilities has negatively effected on private label production. Moderating effects of competitive intensity are hypothesized on the relationship between marketing capabilities and private label production. To verify the proposed research model and hypotheses, data were collected from 192 manufacturers (212 responses) who are producing private labels in South Korea. Cronbach's alpha test, explanatory / comfirmatory factor analysis, and correlation analysis were employed to validate hypotheses. The following results were drawing using structural equation modeling and all hypotheses are supported. Findings indicate that manufacturer's private label production is strongly related to its marketing capabilities. Consumer marketing capabilities, in turn, is directly connected with the 3 strategic factors (e.g., marketing investment, manufacturer's national brand reputation, and product portfolio). It is moderated by competitive intensity between marketing capabilities and private label production. In conclusion, this research may be the first study to investigate the reasons manufacturers engage in private labels based on two competing theoretic views, S-C-P paradigm and resource-based theory. The private label phenomenon has received growing attention by marketing scholars. In many industries, private labels represent formidable competition to manufacturer brands and manufacturers have a dilemma with selling to as well as competing with their retailers. The current study suggests key factors when manufacturers consider engaging in private label production.

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