• Title/Summary/Keyword: Differences in Differences

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Effects of NG-monomethyl-L-arginine and L-arginine on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion after cerebral hypoxia-ischemia in newborn piglets (급성 저산소성 허혈성 뇌손상이 유발된 신생자돈에서 재산소-재관류기 동안 NG-monomethyl-L-arginine과 L-arginine이 뇌의 혈역학 및 에너지 대사에 미치는 영향)

  • Ko, Sun Young;Kang, Saem;Chang, Yun Sil;Park, Eun Ae;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.317-325
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    • 2006
  • Purpose : This study was carried out to elucidate the effects of nitric oxide synthase(NOS) inhibitor, NG-monomethyl-L-arginine(L-NMMA) and nitric oxide precursor, L-arginine(L-Arg) on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion(RR) after hypoxia-ischemia(HI) in newborn piglets. Methods : Twenty-eight newborn piglets were divided into 4 groups; Sham normal control(NC), experimental control(EC), L-NMMA(HI & RR with L-NMMA), and L-Arg(HI & RR with L-Arg) groups. HI was induced by occlusion of bilateral common carotid arteries and simultaneously breathing with 8 percent oxygen for 30 mins, and followed RR by release of carotid occlusion and normoxic ventilation for one hour. All groups were monitored with cerebral hemodynamics and cytochrome $aa_3$ (Cyt $aa_3$) using near infrared spectroscopy(NIRS). $Na^+$, $K^+$-ATPase activity, lipid peroxidation products, and tissue high energy phosphate levels were determined biochemically in the cerebral cortex. Results : In experimental groups, mean arterial blood pressure, $PaO_2$, and pH decreased, and base excess and blood lactate level increased after HI compared to NC group(P<0.05). These variables subsequently returned to baseline after RR except pH. There were no differences among the experimental groups. In NIRS, oxidized hemoglobin($HbO_2$) decreased and hemoglobin(Hb) increased during HI(P<0.05) but returned to base line immediately after RR; 40 min after RR, the $HbO_2$ had decreased significantly compared to NC group(P<0.05). Changes of Cyt $aa_3$ decreased significantly compared to NC after HI and recovered at the end of the experiment. Significantly reduced cerebral cortical cell membrane $Na^+$, $K^+$-ATPase activity and increased lipid peroxidation products(P<0.05) were not improved with L-NMMA or L-Arg. Conclusion : These findings suggest that NO is not involved in the mechanism of HI and RR brain damage during the early acute phase of RR.

Neuroprotective Effect of Cyclosporin A on Spinal Cord Ischemic Injury in Rabbits (토끼를 이용한 척수 허혈 손상 모델에서 Cyclosporin A의 척수 손상에 대한 보호 효과)

  • Shin Yoon-Cheol;Choe Ghee-Young;Kim Won-Gon
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.739-748
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    • 2006
  • Background: The purpose of this study is to ascertain the neuroprotective effect of cyclosporin A on the 25-min surgical ischemia model in the spinal cords of rabbits with neuropathological correlation and histoimmunochemical analyses, Material and Method: Thirty-two New Zealand white rabbits were randomly divided into four groups: Rabbits were randomly divided into four groups: the control 12 group (n=8), the control 17 group (n=8), the cyclosporin Cs2 group (n=8), and the cyclosporin Cs7 group (n=8). The 12 group underwent a 25-min aortic cross- clamp without intervention and were sacrificed on the 2nd day postoperatively, while the 17 group underwent a 25- min of aortic cross-clamp without intervention and were sacrificed on the 7th day postoperatively. The Cs2 group received cyclosporin A (25 mg/kg) intravenously 15 min after the 25-min cross-clamp and were sacrificed on the End day postoperatively, while the Cs7 group received cyclosporin A (25 mg/kg) intravenously 15 min after the 25-min cross-clamp and were sacrificed on the 7th day postoperatively. The rabbits underwent 25-min surgical aortic cross-clamp. Neurologic functions were evaluated on the 2nd day and 7th postoperative day using Tarlov scoring system. After scoring neurologic function, all rabbits were sacrificed for histopathologic observation. Result: All rabbits survived the experimental procedure. The values of Tarlov score did not show any differences between the control and cyclosporin groups on the 2nd day. The scores of group Cs7 ($2.75{\pm}0.89$) were significantly higher than those of group 17 ($1.25{\pm}1.39$) on the 7th day (p<0,05). On the histologic exanminations, specimens of the spinal cord showed necrosis and apoptosis. The pathologic scores of group Cs7 ($1,0{\pm}0.53$) was less than those of group 17 ($2.13{\pm}1.36$, p<0.05). TUNEL staing showed apoptosis of the specimen in group 12 and Cs2 but there was no stastically significant difference between groups on the score. There were more overexpression of HSP70 and nNOS in cyclosporine group than in control group. Conclusion: We think that cyclosporin A may decrease neuronal cell death with induced upregulation of HSP70 against 25-min ischemia of the spiral cord in the rabbit.

Postoperative Adjuvant Chemotherapy and Chemoradiation for Rectal Cancer (직장암의 근치적 절제술 후 보조 화학요법과 보조 화학방사선 병용요법)

  • Lee Kang Kyoo;Park Kyung Ran;Lee Ik Jae;Kim Ik Yong;Sim Kwang Yong;Kim Dae Sung;Lee Jong Young
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.334-342
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    • 2002
  • Purpose : The aim of this study was to determine if postoperative adjuvant chemotherapy (CT) alone and concurrent chemoradiation (CCRT), following radical surgery, improved the disease free survival (DFS) and overall survival (OS) in rectal cancer AJCC stage II and III patients. Materials and Methods : A total of 144 patients with AJCC stage II and III rectal cancer who had had radical surgery between 1989 and 1999 were included in the study. Of these patients, 72 had been treated with postoperative CT, and the other 72 with postoperative CCRT. The chemotherapy regimen consisted of oral UFT on a daily basis for $1\~12$ months (median 12 months) or 5-FU ($500\;mg/m^2$ for 5 days) intravenous (IV) chemotherapy with 4 week intervals for $1\~18$ cycles (median 6 cycles). Radiation of 4,500 cGy was delivered to the surgical bed and regional pelvic lymph nodes area, followed by $540\~1,440\;cGy$ (median 540 cGy) boost to the surgical bed. The follow-up period ranged from 20 to 150 months, with a median of 44 months. Results : The 5-year OS was $60.9\%\;and\;68.9\%$ (p=0.0915), and the 5-year DFS was $56.1\%\;and\;63.8\%$ (p=0.3510) for postoperative CT and postoperative CCRT, respectively. In the stage nm patients, the 5-year OS was $71.1\%\;and\;92.2\%$, and the 5-year DFS was $57.3\%\;and\;85.4\%$ for postoperative CT and CCRT, respectively. The OS was significantly improved (p=0.0379) but the DFS was not with postoperative CCRT compared to the postoperative CT (p=0.1482). In the stage III patients, the 5-year OS was $52.0\%\;and\;55.0\%$, and the 5-year DFS was $47.8\%\;and\;49.8\%$ for postoperative CT and postoperative CCRT. There were no statistically significant differences between postoperative CT and CCRT (p=0.4280 and p=0.7891) in OS and DFS. The locoregional relapses were $16.7\%\;and\;12.5\%$ for postoperative CT and CCRT, respectively. The distant relapses were $25.0\%\;and\;26.4\%$ for postoperative CT and CCRT, respectively. Conclusion : These results showed that postoperative CCRT compared with CT alone improved OS in stage II patients. Although there was no statistical significance, the addition of postoperative RT to CT reduced locoregional relapses compared to CT alone.

Clinical Characteristics of the Patients with Mycobacterium avium Complex Pulmonary Disease (Mycobacterium avium complex 폐질환 환자의 임상적 특징)

  • Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Jeon, Ik Soo;Pyun, Yu Jang;Ham, Hyoung Suk;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Han, Daehee;Kim, Tae Sung;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.33-44
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    • 2003
  • Background : Mycobacterium avium complex(MAC) is the most common respiratory pathogen in nontuberculous mycobacterial pulmonary disease. This study described the clinical characteristics of the patients with pulmonary disease caused by MAC. Materials and Methods : The clinical characteristics of 24 patients with pulmonary disease caused by the MAC, who fulfilled the 1997 American Thoracic Society diagnostic criteria for nontuberculous mycobacterial pulmonary disease, were retrospectively analyzed. Results : Fourteen patients(58%) were male and the median age at diagnosis was 61 years(range 46-75). Of the 24 patients, 16(67%) had a M. intracellulare infection, 7(29%) had a M. avium infection and one patient was not identified. Coughing (92%) and sputum (88%) were most frequently observed symptoms. The sputum smear for acid-fast bacilli was positive in 17(71%) patients. Fourteen(58%) patients had the upper lobe cavitary form and 10(42%) patients had the nodular bronchiectatic form. In a comparison between the patients with the upper lobe cavitary form and those with the nodular bronchiectatic form, significant differences were found according to sex(male 86% vs. 20%, p=0.003), smoking history(79% vs. 10%, p=0.008), the presence of an underlying disease(64% vs. 20%, p=0.036), the pulmonary function(% forced vital capacity, median 71% vs. 88%, p=0.022; % forced expiratory volume in one second, median 69% vs. 89%, p=0.051) and bilateral disease at chest radiography(29% vs. 90%, p=0.005). The time from the onset of symptoms to diagnosis was longer in those with the nodular bronchiectatic form(median 72 months, range 8-132) than those with the upper lobe cavitary form(median 22 months, range 6-60) Conclusions : MAC pulmonary disease occurs in two distinct populations with two distinct clinical presentations. For a correct diagnosis of MAC pulmonary disease, knowledge of the diverse clinical and radiological findings is essential.

A Study of the Effect of Model Characteristics on Purchasing intentions and Brand Attitudes (광고모델 특성이 구매의도와 브랜드태도에 미치는 영향)

  • Kim, Sung-Duck;Youn, Myoung-Kil;Kim, Ki-Soo
    • Journal of Distribution Science
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    • v.10 no.4
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    • pp.47-53
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    • 2012
  • Businesses make use of advertising strategy using models to give consumers efficient product information. Modern advertisements often make use of models for greater reminiscence to create messages and remind viewers of the product. The purpose of this study was to examine the characteristics of each type of model. The subjects were 230 college students in their twenties or older, and the material was collected from October 20, 2011 to November 5, 2011 to examine the effects of model characteristics on buying intention as well as attitude toward a brand. A questionnaire survey was used; investigators gave one copy to each interviewee. The study investigated the characteristics of each model using a questionnaire of each 40 copies with five kinds of photographs. The characteristics of models had great influence on buying intention and attitude toward the brand: First, factor 2 (being honest and virtuous and having good credit and a good press assessment) and factor 3 (being interesting and a good communicator and creating good memories) had great influence on buying intention. Factor 2 was explained by reliability, and factor 3 by the efficiency of the model in creating a feeling. Second, factors 1 (being attractive, smart, unique, friendly, loved by others, and popular), 2, and 3 influenced attitude toward brand. Factor 1 encapsulated the outgoing characteristics of a model, factor 2 was based on reliability, and factor 3 was based on the efficiency of the model in creating a feeling. The model's positive effects on buying intention and attitudes toward brand shall be examined. For their positive influence on buying intention, reliability and efficiency shall be given attention. For their positive influence on attitude toward brand, creating a good impression, having outgoing characteristics, being reliable, and efficiency shall be given attention. The findings were as follows: Model characteristics influencing buying intention were similar to those influencing attitude toward brand. The differences were as follows. First, reliability and efficiency influenced buying intention. When customers were asked to consider the influence on buying intention of an advertisement, regardless of the strength of the buying intention, they considered these two characteristics. Customers decided to buy based not only on the credibility of the product as presented in the advertisement but also the transmission of the contents of the advertisement. Second, outgoing characteristics, reliability, and efficiency influenced attitude toward a brand. The attitude toward a brand was said to be the attitude toward the business. The attitude is produced even after buying, so businesses view it as very important. The attitude might vary depending upon the model used rather than the brand. Therefore, a model with outgoing characteristics was thought to be important. Therefore, attitude toward a brand whose model influenced buying intention as well as attitude toward brand had outgoing characteristics. The result is that an image the model was related to attitude toward the brand. As such, customers would buy the goods advertised. However, an outgoing image of a model was also important to create a positive attitude toward a business brand. For instance, talent Park Gyeong-Rim's photo was used to promote cosmetics about 10 years ago. When she worked as a model of cosmetics products, she had to make compensation for losses and damages because she made a mistake on a talk show program. At that time, customers who had bought the cosmetics product asked for refunds of several billion won. As such, models who are said to be the face of the businesses they represent can play an important role. To advertise in the most attractive and effective way, the current image of a model should be investigated by examining current activities and news articles after selecting the model, and the model's efficiency and attitude toward the brand should be examined. Factors that stimulate customers' buying decisions can be used to plan advertisement that have positive influence on a brand. This study had the limitation of investigating mainly college students and there were insufficient copies of the questionnaire. The investigation was not done widely but in detail so that a concrete investigation could not be done. Further studies shall supplement these shortcomings and discuss new directions.

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Comparison of the Perception of Meals and Nutrition Knowledge in General and Vocational High Schools (인문계·실업계 고등학생의 식사에 대한 인식과 영양지식 비교)

  • Yun, Eun-Jung;Chung, Hae-Young
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.9
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    • pp.1244-1255
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    • 2011
  • The purpose of this study was to compare the perception of meals and nutrition knowledge among high school students in Seoul. A survey was carried out on 548 male/female students in general and vocational high schools. The general high school students showed higher frequency of breakfast than the vocational high school students (p<0.001). As for the reasons for eating alone, the general high school students showed high frequency of 'busy', whereas the vocational high school students revealed high frequency of 'irregular meal times' (p<0.001). Concerning the habit of eating alone, 'irregular meal times (25.0%)', 'unbalanced diet (22.4%)', and 'instant food (16.6%)' were observed in that order (p<0.01). The percentage of high school students who regarded family meals as meals eaten with every member of their family was 70.6% (p<0.05). The percentage of general high school students who ate family meals was 61.8% and that of vocational high school students was 50.0% (p<0.01). When agreement with attitudes, environment, and participation in family meals was evaluated using a Likert scale (strongly agree 5 points, strongly disagree 1 point), the general high school students showed a higher level of agreement than the vocational high school students, and the results showed a significantly higher level of agreement as the frequency of family meals increased. Likewise, the groups who scored a higher level of nutrition knowledge had positive attitudes, environment, and participation in family meals with significant differences.

The micro-tensile bond strength of two-step self-etch adhesive to ground enamel with and without prior acid-etching (산부식 전처리에 따른 2단계 자가부식 접착제의 연마 법랑질에 대한 미세인장결합강도)

  • Kim, You-Lee;Kim, Jee-Hwan;Shim, June-Sung;Kim, Kwang-Mahn;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.148-156
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    • 2008
  • Statement of problems: Self-etch adhesives exhibit some clinical benefits such as ease of manipulation and reduced technique-sensitivity. Nevertheless, some concern remains regarding the bonding effectiveness of self-etch adhesives to enamel, in particular when so-called 'mild' self-etch adhesives are employed. This study compared the microtensile bond strengths to ground enamel of the two-step self-etch adhesive Clearfil SE Bond (Kuraray) to the three-step etch-and- rinse adhesive Scotchbond Multi-Purpose (3M ESPE) and the one-step self-etch adhesive iBond (Heraeus Kulzer). Purpose: The purpose of this study was to determine the effect of a preceding phosphoric acid conditioning step on the bonding effectiveness of a two-step self-etch adhesive to ground enamel. Material and methods: The two-step self-etch adhesive Clearfil SE Bond non-etch group, Clearfil SE Bond etch group with prior 35% phosphoric acid etching, and the one-step self-etch adhesive iBond group were used as experimental groups. The three-step etch-and-rinse adhesive Scotchbond Multi-Purpose was used as a control group. The facial surfaces of bovine incisors were divided in four equal parts cruciformly, and randomly distributed into each group. The facial surface of each incisor was ground with 800-grit silicon carbide paper. Each adhesive group was applied according to the manufacturer's instructions to ground enamel, after which the surface was built up using Light-Core (Bisco). After storage in distilled water at $37^{\circ}C$ for 1 week, the restored teeth were sectioned into enamel beams approximately 0.8*0.8mm in cross section using a low speed precision diamond saw (TOPMET Metsaw-LS). After storage in distilled water at $37^{\circ}C$ for 1 month, 3 months, microtensile bond strength evaluations were performed using microspecimens. The microtensile bond strength (MPa) was derived by dividing the imposed force (N) at time of fracture by the bond area ($mm^2$). The mode of failure at the interface was determined with a microscope (Microscope-B nocular, Nikon). The data of microtensile bond strength were statistically analyzed using a one-way ANOVA, followed by Least Significant Difference Post Hoc Test at a significance level of 5%. Results: The mean microtensile bond strength after 1 month of storage showed no statistically significant difference between all adhesive groups (P>0.05). After 3 months of storage, adhesion to ground enamel of iBond was not significantly different from Clearfil SE Bond etch (P>>0.05), while Clearfil SE Bond non-etch and Scotchbond Multi-Purpose demonstrated significantly lower bond strengths (P<0.05), with no significant differences between the two adhesives. Conclusion: In this study the microtensile bond strength to ground enamel of two-step self-etch adhesive Clearfil SE Bond was not significantly different from three-step etch-and-rinse adhesive Scotchbond Multi-Purpose, and prior etching with 35% phosphoric acid significantly increased the bonding effectiveness of Clearfil SE Bond to enamel at 3 months.

Comparison of the Dietary Pattern, Nutrient Intakes, and Blood Parameters According to Body Mass Index (BMI) of College Women in Seoul Area (서울지역 여대생의 BMI를 기준으로 식생활, 영양섭취상태 및 혈액인자 비교 연구)

  • Choi, Kyung-Soon;Shin, Kyung-Ok;Chung, Keun-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.12
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    • pp.1589-1598
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    • 2008
  • The objective of this study was to investigate the effect of obesity on health by analyzing the factors which are related to obesity through the questionnaires on the dietary pattern, nutrient intake and physical measurements. The subjects, 419 college women aged 20 to 24 year-old, were randomly selected from Seoul and data were collected during March to May, 2008 and classified as under underweight, normal weight, and obesity groups according to BMI. However, weight, skeletal muscle mass, body fat mass, fat free mass, percentage of body fat, and waist to hip ratio showed significant differences among all the groups (p<0.05). In the obese group, 77.8% ate fat-rich foods such as galbi and samgyopsal more than two times per week, 66.7% ate vegetables other than kimchi (p<0.05) as compared to the underweight and normal groups by mini dietary assessment (p<0.05). The cholesterol intakes of the underweight, normal weight, and obese groups were $164.67{\pm}114.52mg/dL$, $143.31{\pm}99.58mg/dL$, and $121.92{\pm}54.91mg/dL$, respectively, and the obese group had a significantly lower intake than the other groups (p<0.05). The serum total cholesterol levels of the underweight, normal, and obese groups were $177.04{\pm}26.36mg/dL$, $189.46{\pm}29.05mg/dL$, and $170.00{\pm}12.75mg/dL$, respectively, and the obese group showed lower total cholesterol level than the other groups (p<0.05). The triacylglycerol level of the obese group ($132.00{\pm}64.60mg/dL$) was significantly higher than the other two groups (p<0.05). The HDL-cholesterol levels of the underweight, normal weight, and obese groups were $51.92{\pm}9.39mg/dL$, $59.20{\pm}13.53mg/dL$, and $43.00{\pm}8.98mg/dL$, respectively, showing that the obese subjects had significantly lower HDL-cholesterol levels as compared to the subjects in the other groups (p<0.05). The HDL-C/LDL-C ratios of the underweight ($0.52{\pm}0.45$) and normal weight ($0.59{\pm}0.23$) groups were higher than the ratio of the obese group ($0.41{\pm}0.06$). Total cholesterol were positively correlated with LDL-cholesterol (r=0.768, p<0.01), but triacylglycerol were adversely correlated with HDL-cholesterol. In conclusion, our results show that college-aged women in Seoul should be encouraged to amend their overall dietary habits, make a dietary plan that fits their individual needs, and maintain an effective exercise schedule.

Health Status and Use of Health Care Services of the Elderly Utilizing Senior citizen Centers (경로당 노인의 건강상태와 건강관리서비스 이용 관련요인 분석)

  • Shin, Sun-Hye;Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.99-113
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    • 2002
  • For this study a sample of 205 people, 66 males and 139 females, over 65 years of age, residing in C-gu of S-si and utilizing senior centers, were selected, The objective of the study was to provide basic data for health promotion program development provided by health centers. A questionnaire was used to collect date on general characteristics, health status, social health status and utilization rate for health services. The instruments used in this study were the Lawton scale, to measure daily routine function, the MMSE-K developed by Folstein and modified to fit the Korea situation, for mental health status, and the CES-Dtool developed by Radloff, for emotional health status. the SPSS Window program was used to calculate percentages. Tests of significance were done using t-test and ANOVA. Multiple regression analysis was used to identify variables influencing the use of health services. The results are as follows : Of those utilizing senior citizen centers, 40.9% of males and 17.3% of the female thought they were healthy. The average score for IADL was 7.4. The daily routine of female respondents consisted of buying household articles and drugs, and other IADLs such as riding the bus or subway alone. These resulted in a higher score compared to males. For emotional health, 7.6% of the males reported depression compared to 21.6% of the females. For mental health, 48.5% of the males and 28.8% of the females were found to be in the group suspicious for dementia. On social health, 57.6% of the males and 62.6% of the females reported no intimate human relations. Of those older people who had close human relations, 52.5% of the males indicated a friend as the closest person and 53.8% of the females, their children. On use of health services, there was a significantly higher need for mobile medical care services treatment for those with lower education levels and status of window/widower. There was a significantly higher need for health exmination services for those with lower levels of exercise, greater satisfaction with sleep, higher levels of oral health care, and higher social contacts. In conclusion, there is a need to provide varied programs for the promotion of health, along with parallel resolution of social, psychological and economic issues. It is recommended that health services for elderly people provided by the health centers be implemented with full recognition of these characteristics and differences.

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A Prospective Randomized Trial Comparing the Seciuence of Adiuvant Chemotherapy and Radiotherapy following Curative Resection of Stage II, III Rectal Cancer (직장암의 근치적 수술 루 방사선치료와 화학요법의 순서에 대한 고찰 -전향적 무작위 3상 임상연구 중간 결과 보고-)

  • Kim Kyoung Ju;Kim Jong Hoon;Choi Eun Kyung;Chang Hyesook;Ahn Seung Do;Lee Je Hwan;Kim Jin Cheon;Yu Chang Sik
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.17-25
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    • 2000
  • Purpose : To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and III rectal cancer who had undergone curative resection were randomized to 'early radiotherapy group (arm I)' or' late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. Materials and Methods . From January 1996 to March 1999, 313 patients with curatively resected stages II and III rectal cancer have been randomized to' early' or' late' radiation therapy group and received combined chemotherapy (5-FU 375 mg/m$^{2}$/day, ieucovorin 20 mg/m$^{2}$, IV bolus daily Dl-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/s weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was peformed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. Results :Local recurrence occurred in 11 patients (9.7$\%$) for arm I and 9 patients (8$\%$) for arm 11. There was no significant difference between both groups ( p=0.64). However, distant metastasis was found in 22 patients (19.5$\%$) for arm I and 35 patients (31.0$\%$) for arm II and which showed statistically significant difference between the two groups ( p=0.046). And neither 3-year disease-free survival (70.2$\%$ vs 59.2$\%$, p=0.2) nor overall survival (89.4$\%$ vs 88.0$\%$, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3$\%$ and 79.9$\%$ respectively but leukopenia more than RTOG grade 3 was only 2.1$\%$ and 6.0$\%$ respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2$\%$ vs 41.6$\%$, p=0.02) but this complication was controlled with supportive cares. Conclusion : Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy after curative resection for rectal cancer, local recurrence rate was low with combined chemoradlotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.

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