• Radiation Oncology Journal
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• v.15 no.2
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• pp.113-119
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• 1997

Purpose : Radical gastrectomy is main treatment of gastric cancer. But the result is not satisfactory with surgery alone. Most of pattern of failure remain locoregional recurrence. To improve 5 year survival postoperative chemotherapy with or without radiotherapy has been used. We analyzed patients with stage III and IV stomach cancer who had radical operation and received postoperative radiation therapy combined with or without chemotherapy retrospectively. Material and Method : From March 1985 to June 1993, 68 patients treated with curative resection and received postoperative adiuvant radiotherapy with 36Gy or more were evaluated. Median age was 60 years(range 28-66 yrs) . Patients were followed from 3 to 133 months with median follow up of 48 months. Thirty seven patients had non signet ring adenocarcinoma, 29 signet ring cell, 2 other cell. Patients with stage IIIA, IIIB, IV disease were 19, 25 and 24 respectively Chemotherapy was given to all patients except two. Results : Five-year overall survival and disease-free survival rate were 36.6% and 33.6%, respectively. Prognostic factor affecting survival were assessed. High ratio of jnvolved/dissected Iymph node, signet ring histology showed Poor Prognosis with statistical significance. Presence of residual tumor after surgery, stageIV. split course of radiation therapy, age, number of involved Iymph node, number of Iymph node dissection and grade of tumor affected survival without statistical significance, Type of chemotherapy did not affect survival. Recurrence was documented in 34 patients. High recurrence was seen in omentum and peritoneum with 23.5%, and remnant stomach, anastomosis site, A-loop and I-loop had also high recurrence with 13.2%. In field locoregional recurrence was 20.7% and total distant metastases were 39.7%. Total intraabdominal failure was 47.1% and extraabdominal failure was 13.2%. Treatment toxicity was considered to be acceptable. 22.1% of patients had grade 3 and only 1 patient had grade 4 leukopenia. Six Patients(8.8%) had weigh loss more than 10%. Conclusion : Treatment toxicity was acceptable with combined treatment with chemotherapy and radiotherapy. Locoregional recurrence was relatively low compared to distant failure with addition of irradiation. Peritoneal and omental seeding was high Five-rear surival was increased with combined modality. Radiation may eradicate minimal residual disease and improve survival, To evaluate role of radiation Prospective randomized study employing chemotherapy alone and chemotherapy plus radiation is necessary. Futhermore to reduce intraabdominal failure, role of intraabdominal chemotherapy in addition to combined chemotherapy plus radiation has to be explored.

• Journal of Korean Neurosurgical Society
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• v.61 no.3
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• pp.415-423
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• 2018

Objective : To identify the perioperative factors associated with instrument failure in patients undergoing a partial corpectomy with instrumentation (PCI) for spinal metastasis. Methods : We assessed the one hundred twenty-four patients with who underwent PCI for a metastatic spine from 1987 to 2011. Outcome measure was the risk factor related to implantation failure. The preoperative factors analyzed were age, sex, ambulation, American Spinal Injury Association grade, bone mineral density, use of steroid, primary tumor site, number of vertebrae with metastasis, extra-bone metastasis, preoperative adjuvant chemotherapy, and preoperative spinal radiotherapy. The intraoperative factors were the number of fixed vertebrae, fixation in osteolytic vertebrae, bone grafting, and type of surgical approach. The postoperative factors included postoperative adjuvant chemotherapy and spinal radiotherapy. This study was supported by the National Research Foundation grant funded by government. There were no study-specific biases related to conflicts of interest. Results : There were 15 instrumentation failures (15/124, 12.1%). Preoperative ambulatory status and primary tumor site were not significantly related to the development of implant failure. There were no significant associations between insertion of a bone graft into the partial corpectomy site and instrumentation failure. The preoperative and operative factors analyzed were not significantly related to instrumentation failure. In univariable and multivariable analyses, postoperative spinal radiotherapy was the only significant variable related to instrumentation failure (p=0.049 and 0.050, respectively). Conclusion : When performing PCI in patients with spinal metastasis followed by postoperative spinal radiotherapy, the surgeon may consider the possibility of instrumentation failure and find other strategies for augmentation than the use of a bone graft for fusion.

• Radiation Oncology Journal
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• v.29 no.4
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• pp.252-259
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• 2011

Purpose: To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer. Materials and Methods: Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy. Results: The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; P = 0.038), lymph node dissection extent (HR, 0.201; P = 0.002). and maintenance oral chemotherapy (HR, 2.964; P = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%). Conclusion: The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.

• Steel and Composite Structures
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• v.22 no.4
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• pp.797-820
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• 2016

This paper simulates the hysteretic behavior of steel reinforced recycled concrete (SRRC) columns under cyclic loads using OpenSees software. The effective fiber model and displacement-based beam-column element in OpenSees is applied to each SRRC columns. The Concrete01 material model for recycled aggregate concrete (RAC) and Steel02 material model is proposed to perform the numerical simulation of columns. The constitutive models of RAC, profile steel and rebars in columns were assigned to each fiber element. Based on the modelling method, the analytical models of SRRC columns are established. It shows that the calculated hysteresis loops of most SRRC columns agree well with the test curves. In addition, the parameter studies (i.e., strength grade of RAC, stirrups strength, steel strength and steel ratio) on seismic performance of SRRC columns were also investigated in detail by OpenSees. The calculation results of parameter analysis show that SRRC columns suffered from flexural failure has good seismic performance through the reasonable design. The ductility and bearing capacity of columns increases as the increasing magnitude of steel strength, steel ratio and stirrups strength. Although the bearing capacity of columns increases as the strength grade of RAC increases, the ductility and energy dissipation capacity decreases gradually. Based on the test and numerical results, the flexural failure mechanism of SRRC columns were analysed in detail. The computing theories of the normal section of bearing capacity for the eccentrically loaded columns were adopted to calculate the nominal bending strength of SRRC columns subjected to vertical axial force under lateral cyclic loads. The calculation formulas of horizontal bearing capacity for SRRC columns were proposed based on their nominal bending strength.

• Yonsei Medical Journal
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• v.59 no.9
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• pp.1049-1056
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• 2018

Purpose: Local recurrence is the most common cause of failure in retroperitoneal soft tissue sarcoma patients after surgical resection. Postoperative radiotherapy (PORT) is infrequently used due to its high complication risk. We investigated the efficacy of PORT using modern techniques in patients with retroperitoneal soft tissue sarcoma. Materials and Methods: Eighty patients, who underwent surgical resection for non-metastatic primary retroperitoneal soft tissue sarcoma at the Yonsei Cancer Center between 1994 and 2015, were retrospectively reviewed. Thirty-eight (47.5%) patients received PORT: three-dimensional conformal radiotherapy in 29 and intensity-modulated radiotherapy in nine patients. Local failure-free survival (LFFS), overall survival (OS), and RT-related toxicities were investigated. Results: Median follow-up was 37.1 months (range, 5.8-207.9). Treatment failure occurred in 47 (58.8%) patients including local recurrence in 33 (41.3%), distant metastasis in eight (10%), and both occurred in six (7.5%) patients. The 2-year and 5-year LFFS rates were 63.9% and 47.9%, respectively. The 2-year and 5-year OS rates were 87.5% and 71.1%. The 5-year LFFS rate was significantly higher in PORT group than in no-PORT group (74.2% vs. 24.3%, p<0.001). In multivariate analysis, PORT was the only independent prognostic factor for LFFS. However, there was no significant correlation between RT dose and LFFS. OS showed no significant difference between the two groups. Grade ${\leq}2$ acute toxicities were observed in 63% of patients, but no acute toxicity ${\geq}$ grade 3 was observed. Conclusion: PORT using modern technique markedly reduced local recurrence in retroperitoneal sarcoma patients, with low toxicity. The optimal RT technique, in terms of RT dose and target volume, should be further investigated.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.37 no.3
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• pp.585-592
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• 2017

Most sewer lines buried in the city are likely to be collapsed due to serious aging. Also, due to the high concentration of development and high population density and traffic, the collapse of the sewer will cause enormous social and economic damage. Therefore, proactive maintenance is required to prevent accidents caused by deteriorated sewer pipe. In order to utilize limited budget effectively, risk-based prioritization methods should be proposed that simultaneously consider the consequence of failure and the probability of failure. In this study, the method of risk-based prioritization of sewer was examined by reviewing various cases of overseas studies and applied to the urban sub-catchment. First, the impact factors that can be secured through the sewer GIS DB in Seoul were derived, and the weight, sub-criteria, and impact score of each impact factor were determined and the consequence of failure was calculated by weight sum method. In addition, the probability of failure was calculated by dividing the service life by the estimated useful life, and the consequence of failure and the probability of failure were classified into five grades by the Jenks natural breaks classification method. The prioritization method was applied to sub-catchment in the Seoul to derive a risk matrix and a risk grade. As a result, 26% of all subjects were selected as the inspection priority subjects with 4-5 risk grade. Therefore, using the risk-based CCTV prioritization methodology, it will be possible to systematically determine the objects that need investigation first.

• Journal of Korean Academy of Nursing
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• v.3 no.1
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• pp.53-66
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• 1972

There is an urgent need to improve the tool predicting success or failure of academic achievement of nursing in Korea so as to identify as early as possible those students who should receive special instruction and to improve screening procedures for admission of nursing. The main purpose of this study is to identify the correlation between the grade point averages of courses learned and their psychological test characteristics in a baccalaureate nursing program. All 240 students, except freshmen, enrolled in Nursing Department of Seoul National University in the spring semester, 1972, participated in this study. All of the subjects completed the psychometric tests such as interest test, personality test and test of self-concept. Total grade point averages, grade point averages of general education subjects, of supporting science courses and of professional education subjects were used as performance criteria of the students. Through the calculation of product-moment correlation coefficients between the test scores and four grade point averages of each class and of total subjects, the following findings and recommendations were obtained. 1. There was so much variation in characteristics of interest test correlated with academic achievement of nursing students in each class. 2. Since the school objectives, curriculum and teaching strategies may affect predictive efficiency of characteristics of students'interest test, interest test must-be utilized in a homogeneous group in order to predict school achievement. 3. Characteristics of interest test positively correlated at significant level with total grade point averages of all subjects were scientific interest-biological, scientific interest-physical, and humanitarian interest. Scientific interest-physics: was the only characteristic positively correlated at significant level with total grade point averages and grade point averages of professional courses. 4. There were various patterns in characteristics of personality test correlated with school achievement of nursing students by class pattern and personality maturation as they progress toward higher classes. 5. A characteristic of personality test, responsibility, is in high positive correlation with academic achievement in the upper division of classes. 6. Responsibility was the sole personality factor positively correlated at significant level with total grade point averages and grade point averages of nursing courses in the total number of students. 7. There were very different correlation coefficients between characteristics of self-concept test and academic achievement according to the type of each class and type of courses they learned. 8. Characteristics of self-concept test positively correlated at significant level with total grade point averages and grade point averages of nursing courses of all students were physical self and row variability. Those who have positive concept on their own physical status and who are deficient in self-concept were higher in total grade point averages and grade point averages of professional courses than other students. 9. Scores of professional courses offered in freshmen and sophomore classes were in positive correlation with limited number of characteristics of psychological tests. In pursuit of a tool predicting successful academic achievement of nursing students, their G.P.A. during the junior and senior year of nursing will serve as the more reasonable criteria. 10. Junior students of this school were in higher positive correlation with many psychological factors than other classes.

• Radiation Oncology Journal
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• v.15 no.1
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• pp.1-10
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• 1997

Purpose : To evaluate the role of radiotherapy in the management of incompletely resected supratentorial low grade astrocytoma with the analysis of the survival, the Pattern of failure, and the prognostic variables affecting survival. Material and methods : Between January 1990 and December 1995, fifty-one patients with supratentorial low grade astrocytoma received radiotherapy after subtotal resection(16 patients) or stereotactic biopsy(35 patients) at Asan Medical Center, External radiotherapy was done by conventional fractionation with the total dose of 4820cGy to 6000cGy(median 5580cGy) and partial brain volume. The follow-up was done from 6 to 79 months(median 48 months) Result : Overall actuarial survival rate at 2 and 5 years were $83.4\%\;and\;54.8\%$, respectively. Progression free survival at 2 and 5 years were $67.4\%\;and\;48.7\%$, respectively The significant prognostic factors affecting overall survival rate were the performance status, 1 stage, histologic subtype, radiation field and radiation response. The major pattern of failure was local failure, such as Progressive disease and primary site recurrence in 23 patients $(45.1\%)$. Progression free survivors excluding 2 patients were physically and intellectually intact without major neurologic deficit. Conclusion : Although the follow-up period of this study was relatively short, overall actuarial and progression free survival rate were encouraging. Patients with good performance status, lower T stage, pilocytic subtype, patients treated with small radiation field and radiation responder showed better survival. As the local failure was the major pattern of failure, the various efforts to decrease the local failure is necessary.

• Korean Journal of Child Studies
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• v.38 no.1
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• pp.185-203
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• 2017

Objective: The present study examined the perspectives of grandparents raising their grandchildren in an attempt to better understand grandparents' child-rearing experience while providing kinship foster care to their primary-grade grandchildren. Methods: Data were collected through individual in-depth interviews with eight grandparents who have raised one or two primary-grade (ages 8-10) grandchildren using a qualitative approach. Results: First, the participants viewed the reason for their kinship foster care as a failure for caring for their own children and accepted the present grandparent-care provision as their responsibility. Second, the participants communicated constant struggles with their own health and grandchild-care as well as positive/negative emotions associated with the care provision. Third, most of the participants did not fully understand the developmental needs of their primary-grade grandchildren. Fourth, the participants articulated concerns for their primary-grade grandchildren's learning, peer interactions, school adjustment, and extra-curricular activities. Lastly, the participants all agreed on hoping to raise grandchildren with good personality traits as members of a society and to have them fill the gap from the loss of their parents. Conclusion: Although most participants accepted the current circumstances as their obligation, they still noted difficulties in child-care provision. Given the developmental needs of grandchildren and the resource needs of grandparents, proper and continuous intervention approaches should be developed/provided.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.46-52
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• 1997

Urinary tract infection (UTI) in children has been known to be a cause of renal damage, leading to scar formation, hypertension and renal failure. And vesico-ureteral reflex (VUR), frequently accompanying UTI in young children, has been incriminated as the main factor causing scar formation. This retrospective study has been undertaken to see the relationship among UTI, VUR and renal scar formation. Study population consisted of 291 children (boy 134, girl 42) with UTI, who have been admitted to the Pediatric Department of Kyungpook University Hospital during 6 1/2 year period from January 1990 to June 1996. VUR was diagnosed by VCUG and renal scar by ultrasonogram, DMSA scan (or DMSA SPECT) and IVP. The following result were obtained. Sexual difference showed male predominance (male to female, 134:42) below 1 year of age, and female predominance (male to female, 11:35) over 5 years of age were rioted. VUR has been found in 64 children (22%) and the degree of reflux, classfied by the method proposed by 'International Reflux Study in Children', were as follows ; Grade I : 4.0%, Grade II : 3.0%, Grade III : 2.7%, Grade IV : 5.8% and Grade V : 6.2%. There was no sexual difference E.coli was the most predominant infecting agent occurring in 167 children (57%), and end-stage renal failure was diagnosed at the time of first admission in 5 children with Grade V VUR. Renal scar has been noted in 49 out of 582 kidneys (8.4%), and the incidence of scar foramation according to the degree of VUR were as follow ; Grade 0 (No reflux) : 1.2%, Grade I : 6.7%, Grade II 27.3%, Grade III 29.4%, Grade IV : 57.1%, and Grade V : 100%. In summary, present study shows that renal scar formation in UTI has close correlation with the severity of VUR occurring more frequently in severe reflux, so that early diagnosis and proper treatment of UTI and VUR is of paramount importance in preventing renal damage in children with UTI.