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Validation of initial nutrition screening tool for hospitalized patients (입원 환자용 초기 영양검색도구의 타당도 검증)

  • Kim, Hye-Suk;Lee, Seonheui;Kim, Hyesook;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.52 no.4
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    • pp.332-341
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    • 2019
  • Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

Validation of the physical activity classification table for Korean youth and assessment of total energy expenditure, estimated energy requirement and physical activity in Korean children and adolescents (한국 소아청소년을 위한 신체활동분류표의 타당도 평가 및 이를 이용한 일일 총에너지소비량, 에너지필요추정량과 신체활동 평가)

  • Ji-Yeon Gwak;Myung-Hee Kim;Jonghoon Park;Kazuko Ishikawa-Takata;Eun-Kyung Kim
    • Journal of Nutrition and Health
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    • v.56 no.1
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    • pp.35-53
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    • 2023
  • Purpose: The purpose of the first part of this study was to evaluate the validity of the physical activity classification table for youth (Youth-PACT). The second part of this study was aimed at comparing the estimated energy requirement (EER) with the total energy expenditure (TEE) and evaluating the physical activity patterns of Korean children and adolescents. Methods: The subjects of the first part of the study were 17 children aged 10 to 12 years, and their total energy expenditure (TEEDLW) was measured using the double labeled water (DLW) method. A total of 166 children and adolescents aged 6-18 years participated in the second part of this study. Their resting energy expenditure (REE) was measured using indirect calorimetry and the TEEYouth-PACT and physical activity level were calculated by applying the Youth-PACT to the physical activity diary prepared by the subjects. Results: In the first part of this study, there were no significant differences between the TEEDLW and the TEEYouth-PACT. The TEEYouth-PACT accurately predicted TEEDLW in 37.5% of the subjects. In the second part of the study, the rates at which EER accurately predicted TEE YouthPACT and overestimated TEE Youth-PACT were 29.6% and 47.3%, respectively. The time spent based on intensity of physical activity and the physical activity categories which were obtained using Youth-PACT showed different patterns according to sex and age group. Age showed significant positive correlations with REE, TEE, and the time spent in sedentary behavior, but age was significantly negatively correlated with REE/body weight, TEE/body weight, and the time spent in low-intensity and high-intensity activities. Conclusion: The results of this study showed that the Youth-PACT can be used to evaluate the TEE and PAL of children and adolescents. However, further studies are needed to validate the TEEYouth-PACT and to set the EER for children and adolescents.

Clinical Usefulness of Implanted Fiducial Markers for Hypofractionated Radiotherapy of Prostate Cancer (전립선암의 소분할 방사선치료 시에 위치표지자 삽입의 유용성)

  • Choi, Young-Min;Ahn, Sung-Hwan;Lee, Hyung-Sik;Hur, Won-Joo;Yoon, Jin-Han;Kim, Tae-Hyo;Kim, Soo-Dong;Yun, Seong-Guk
    • Radiation Oncology Journal
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    • v.29 no.2
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    • pp.91-98
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    • 2011
  • Purpose: To assess the usefulness of implanted fiducial markers in the setup of hypofractionated radiotherapy for prostate cancer patients by comparing a fiducial marker matched setup with a pelvic bone match. Materials and Methods: Four prostate cancer patients treated with definitive hypofractionated radiotherapy between September 2009 and August 2010 were enrolled in this study. Three gold fiducial markers were implanted into the prostate and through the rectum under ultrasound guidance around a week before radiotherapy. Glycerin enemas were given prior to each radiotherapy planning CT and every radiotherapy session. Hypofractionated radiotherapy was planned for a total dose of 59.5 Gy in daily 3.5 Gy with using the Novalis system. Orthogonal kV X-rays were taken before radiotherapy. Treatment positions were adjusted according to the results from the fusion of the fiducial markers on digitally reconstructed radiographs of a radiotherapy plan with those on orthogonal kV X-rays. When the difference in the coordinates from the fiducial marker fusion was less than 1 mm, the patient position was approved for radiotherapy. A virtual bone matching was carried out at the fiducial marker matched position, and then a setup difference between the fiducial marker matching and bone matching was evaluated. Results: Three patients received a planned 17-fractionated radiotherapy and the rest underwent 16 fractionations. The setup error of the fiducial marker matching was $0.94{\pm}0.62$ mm (range, 0.09 to 3.01 mm; median, 0.81 mm), and the means of the lateral, craniocaudal, and anteroposterior errors were $0.39{\pm}0.34$ mm, $0.46{\pm}0.34$ mm, and $0.57{\pm}0.59$ mm, respectively. The setup error of the pelvic bony matching was $3.15{\pm}2.03$ mm (range, 0.25 to 8.23 mm; median, 2.95 mm), and the error of craniocaudal direction ($2.29{\pm}1.95$ mm) was significantly larger than those of anteroposterior ($1.73{\pm}1.31$ mm) and lateral directions ($0.45{\pm}0.37$ mm), respectively (p<0.05). Incidences of over 3 mm and 5 mm in setup difference among the fractionations were 1.5% and 0% in the fiducial marker matching, respectively, and 49.3% and 17.9% in the pelvic bone matching, respectively. Conclusion: The more precise setup of hypofractionated radiotherapy for prostate cancer patients is feasible with the implanted fiducial marker matching compared with the pelvic bony matching. Therefore, a less marginal expansion of planning target volume produces less radiation exposure to adjacent normal tissues, which could ultimately make hypofractionated radiotherapy safer.

Alteration and Mineralization in the Xiaoxinancha Porphyry Copper Deposit, Yianbin, China: Fluid Inclusion and Sulfur Isotope Study (중국 연변 쇼시난차 반암동 광상의 광화작용 및 변질작용: 유체포유물 및 황동위원소 연구)

  • Seong-Taek Yun;Chil-Sup So;Bai-Lu Jin;Chul-Ho Heo;Seung-Jun Youm
    • Economic and Environmental Geology
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    • v.35 no.3
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    • pp.211-220
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    • 2002
  • The Xiaoxinancha Cu-Au deposit in the Jilin province, located in NNE 800 km of Beijing, is hosted by diorite. The ore mineralization of Xiaoxinancha Cu-Au deposit show a stockwork occurrence that is concentrated on the potassic and phyllic alteration zones. The Xiaoxinancha Cu-Au deposit in the south is being mined with its reserves grading 0.8% Cu, 3.64 g/t Au and 16.8 g/t Ag and in the north, grading 0.63% Cu, 3.80 g/t Au and 6.8 glt Ag. The alteration assemblage occurs as a supergene blanket over deposit. Hydrothermal alteration at the Xiaoxinancha Cu-Au deposit is centered about the stock and was extensively related to the emplacement of the stock. Early hydrothermal alteration was dominantly potassic and followed by propylitic alteration. Chalcocite, often associated with hematite, account for the ore-grade copper, while chalcopyrite, bornite, quartz, epidote, chlorite and calcite constitute the typical gangue assemblage. Other minor opaque phases include pyrite, marcasite, native gold, electrum, hessite, hedleyite, volynskite, galenobismutite, covellite and goethite. Fluid inclusion data indicate that the formation of this porphyry copper deposit is thought to be a result of cooling followed by mixing with dilute and cooler meteoric water with time. In stage II vein, early boiling occurred at 497$^{\circ}$C was succeeded by the occurrence of halite-bearing type III fluid inclusion with homogenization temperature as much as 100$^{\circ}$C lower. The salinities of type 1II fluid inclusion in stage II vein are 54.3 to 66.9 wt.% NaCI + KCI equiv. at 383$^{\circ}$ to 495$^{\circ}$C, indicating the formation depth less than 1 km. Type I cupriferous fluids in stage III vein have the homogenization temperatures and salinity of 168$^{\circ}$ to 365$^{\circ}$C and 1.1 to 9.0 wt.% NaCI equiv. These fluid inclusions in stage III veins were trapped in quartz veins containing highly fractured breccia, indicating the predominance of boiling evidence. This corresponds to hydrostatic pressure of 50 to 80 bars. The $\delta$$^{34}S$ value of sulfide minerals increase slightly with paragenetic time and yield calculated $\delta$$^{34}S_{H2S}$ values of 0.8 to 3.7$\textperthousand$. There is no mineralogical evidence that fugacity of oxygen decreased, and it is thought that the oxygen fugacity of the mineralizing fluids have been buffered through reaction with magnetite. We interpreted the range of the calculated $\delta$$^{34}S_{H2S}$ values for sulfides to represent the incorporation of sulfur from two sources into the Xiaoxinancha Cu-Au hydrothermal fluids: (1) an isotopically light source with a $\delta$$^{34}S$ value of I to 2$\textperthousand$, probably a Mesozoic granitoid related to the ore mineralization. We can infer from the fact that diorite as the host rock in the Xiaoxinancha Cu-Au deposit area intruded plagiogranite; (2) an isotopically heavier source with a $\delta$$^{34}S$ value of > 4.0$\textperthousand$, probably the local porphyry.

Element Dispersion and Wallrock Alteration from Samgwang Deposit (삼광광상의 모암변질과 원소분산)

  • Yoo, Bong-Chul;Lee, Gil-Jae;Lee, Jong-Kil;Ji, Eun-Kyung;Lee, Hyun-Koo
    • Economic and Environmental Geology
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    • v.42 no.3
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    • pp.177-193
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    • 2009
  • The Samgwang deposit consists of eight massive mesothermal quartz veins that filled NE and NW-striking fractures along fault zones in Precambrian granitic gneiss of the Gyeonggi massif. The mineralogy and paragenesis of the veins allow two separate discrete mineralization episodes(stage I=quartz and calcite stage, stage II-calcite stage) to be recognized, temporally separated by a major faulting event. The ore minerals are contained within quartz and calcite associated with fracturing and healing of veins that occurred during both mineralization episodes. The hydrothermal alteration of stage I is sericitization, chloritization, carbonitization, pyritization, silicification and argillization. Sericitic zone occurs near and at quartz vein and include mainly sericite, quartz, and minor illite, carbonates and chlorite. Chloritic zone occurs far from quartz vein and is composed of mainly chlorite, quartz and minor sericite, carbonates and epidote. Fe/(Fe+Mg) ratios of sericite and chlorite range 0.45 to 0.50(0.48$\pm$0.02) and 0.74 to 0.81(0.77$\pm$0.03), and belong to muscovite-petzite series and brunsvigite, respectiveIy. Calculated $Al_{IV}$-FE/(FE+Mg) diagrams of sericite and chlorite suggest that this can be a reliable indicator of alteration temperature in Au-Ag deposits. Calculated activities of chlorite end member are $a3(Fe_5Al_2Si_3O_{10}(OH)_6$=0.0275${\sim}$0.0413, $a2(Mg_5Al_2Si_3O_{10}(OH)_6$=1.18E-10${\sim}$7.79E-7, $a1(Mg_6Si_4O_{10}(OH)_6$=4.92E-10${\sim}$9.29E-7. It suggest that chlorite from the Samgwang deposit is iron-rich chlorite formed due to decreasing temperature from high temperature(T>450$^{\circ}C$). Calculated ${\alpha}Na^+$, ${\alpha}K^+$, ${\alpha}Ca^{2+}$, ${\alpha}Mg^{2+}$ and pH values during wallrock alteration are 0.0476($400^{\circ}C$), 0.0863($350^{\circ}C$), 0.0154($400^{\circ}C$), 0.0231($350^{\circ}C$), 2.42E-11($400^{\circ}C$), 7.07E-10($350^{\circ}C$), 1.59E-12($400^{\circ}C$), 1.77E-11($350^{\circ}C$), 5.4${\sim}$6.4($400^{\circ}C$), 5.3${\sim}$5.7($350^{\circ}C$)respectively. Gain elements(enrichment elements) during wallrock alteration are $TiO_2$, $Fe_2O_3(T)$,CaO, MnO, MgO, As, Ag, Cu, Zn, Ni, Co, W, V, Br, Cs, Rb, Sc, Bi, Nb, Sb, Se, Sn and Lu. Elements(Ag, As, Zn, Sc, Sb, Rb, S, $CO_2$) represents a potential tools for exploration in mesothermal and epithermal gold-silver deposits.

Determination of Therapeutic Dose of I-131 for First High Dose Radioiodine Therapy in Patients with Differentiated Thyroid Cancer: Comparison of Usefulness between Pathological Staging, Serum Thyroglobulin Level and Finding of I-123 Whole Body Scan (분화 갑상선암 수술 후 최초 고용량 방사성옥소 치료시 투여용량 결정: 병리적 병기, 혈청 갑상선글로불린치와 I-123 전신 스캔의 유용성 비교)

  • Jeong, Hwan-Jeong;Lim, Seok-Tae;Youn, Hyun-Jo;Sohn, Myung-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.301-306
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    • 2008
  • Purpose: Recently, a number of patients needed total thyroidectomy and high dose radioiodine therapy (HD-RAI) get increased more. The aim of this study is to evaluate whether pathological staging (PS) and serum thyroglobulin (sTG) level could replace the diagnostic I-123 scan for the determination of therapeutic dose of HD-RAI in patients with differentiated thyroid cancer. Materials and Methods: Fifty eight patients (M:F=13;45, age $44.5{\pm}11.5\;yrs$) who underwent total thyroidectomy and central or regional lymph node dissection due to differentiated thyroid cancer were enrolled. Diagnostic scan of I-123 and sTG assay were also performed on off state of thyroid hormone. The therapeutic doses of I-131 (TD) were determined by the extent of uptakes on diagnostic I-123 scan as a gold standard. PS was graded by the criteria recommended in 6th edition of AJCC cancer staging manual except consideration of age. For comparison of the determination of therapeutic doses, PS and sTG were compared with the results of I-123 scan. Results: All patients were underwent HD-RAI. Among them, five patients (8.6%) were treated with 100 mCi of I-131, fourty three (74.1%) with 150 mCi, six (10.3%) with 180 mCi, three (5.2%) with 200 mCi, and one (1.7%) with 250 mCi, respectively. On the assessment of PS, average TDs were $154{\pm}25\;mCi$ in stage I (n=9), $175{\pm}50\;mCi$ in stage II (n=4), $149{\pm}21\;mCi$ in stage III (n=38), and $161{\pm}20\;mCi$ in stage IV (n=7). The statistical significance was not shown between PS and TD (p=0.169). Among fifty two patients who had available sTG, 25 patients (48.1%) having below 2 ng/mL of sTG were treated with $149{\pm}26\;mCi$ of I-131, 9 patients (17.3%) having $2{\leq}\;sTG\;<5\;ng/mL$ with $156{\pm}17\;mCi$, 5 patients (9.6%) having $5{\leq}\;sTG\;<10\;ng/mL$ with $156{\pm}13\;mCi$, 7 patients (13.5%) having $10{\leq}sTG\;<50\;ng/mL$ with $147{\pm}24\;mCi$, and 6 patients (11.5%) having above 50 ng/mL with $175{\pm}42\;mCi$. The statistical significance between sTG level and TD (p=0.252) was not shown. Conclusion: In conclusion, PS and sTG could not replace the determination of TD using I-123 scan for first HD-RAI in patients with differentiated thyroid cancer.

A Study of Feasibility of Dipole-dipole Electric Method to Metallic Ore-deposit Exploration in Korea (국내 금속광 탐사를 위한 쌍극자-쌍극자 전기탐사의 적용성 연구)

  • Min, Dong-Joo;Jung, Hyun-Key;Park, Sam-Gyu;Chon, Hyo-Taek;Kwak, Na-Eun
    • Geophysics and Geophysical Exploration
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    • v.11 no.3
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    • pp.250-262
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    • 2008
  • In order to assess the feasibility of the dipole-dipole electric method to the investigation of metallic ore deposit, both field data simulation and inversion are carried out for several simplified ore deposit models. Our interest is in a vein-type model, because most of the ore deposits (more than 70%) exist in a vein type in Korea. Based on the fact that the width of the vein-type ore deposits ranges from tens of centimeters to 2m, we change the width and the material property of the vein, and we use 40m-electrode spacing for our test. For the vein-type model with too small width, the low resistivity zone is not detected, even though the resistivity of the vein amounts to 1/300 of that of the surrounding rock. Considering a wide electrode interval and cell size used in the inversion, it is natural that the size of the low resistivity zone is overestimated. We also perform field data simulation and inversion for a vein-type model with surrounding hydrothermal alteration zones, which is a typical structure in an epithermal ore deposits. In the model, the material properties are assumed on the basis of resistivity values directly observed in a mine originated from an epithermal ore deposits. From this simulation, we can also note that the high resistivity value of the vein does not affect the results when the width of the vein is narrow. This indicates that our main target should be surrounding hydrothermal alteration zones rather than veins in field survey. From these results, we can summarize that when the vein is placed at the deep part and the difference of resistivity values between the vein and the surrounding rock is not large enough, we cannot detect low resistivity zone and interpret the subsurface structures incorrectly using the electric method performed at the surface. Although this work is a little simple, it can be used as references for field survey design and field data Interpretation. If we perform field data simulation and inversion for a number of models and provide some references, they will be helpful in real field survey and interpretation.

THE BOND CHARACTERISTICS OF PORCELAIN FUSED BY TITANIUM SURFACE MODIFICATION (타이타늄의 표면개질에 따른 도재 결합 특성)

  • Choi, Taek-Huw;Park, Sang-Won;Vang, Mong-Sook;Yang, Hong-So;Park, Ha-Ok;Lim, Hyun-Pil;Oh, Gye-Jeong;Kim, Hyun-Seung;Lee, Kwang-Min;Lee, Kyung-Ku
    • The Journal of Korean Academy of Prosthodontics
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    • v.45 no.2
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    • pp.169-181
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    • 2007
  • Statement of problem: Titanium is well known as a proper metal for the dental restorations, because it has an excellent biocompatibility, resistance to corrosion, and mechanical property. However, adhesion between titanium and dental porcelains is related to the diffusion of oxygen to the reaction layers formed on cast-titanium surfaces during porcelain firing and those oxidized layers make the adhesion difficult to be formed. Many studies using mechanical, chemical and physical methods to enhance the titanium-ceramic adhesion have been actively performed. Purpose: This study meant to comparatively analyse the adhesion characteristics depending on different titanium surface coatings after coating the casts and wrought titanium surfaces with Au and TiN. Material and method: In this study, the titanium specimens (CP-Ti, Grade 2, Kobe still Co. Japan) were categorized into cast and wrought titanium. The wrought titanium was cast by using the MgO-based investment(Selevest CB, Selec). The cast and wrought titanium were treated with Au coating($ParaOne^{(R)}$., Gold Ion Sputter, Model PS-1200) and TiN coating(ATEC system, Korea) and the ultra low fusing dental porcelain was fused and fired onto the samples. Biaxial flection test was done on the fired samples and the porcelain was separated. The adhesion characteristics of porcelain and titanium after firing and the specimen surfaces before and after the porcelain fracture test were observed with SEM. The atomic percent of Si on all sample surfaces was comparatively analysed by EDS. In addition, the constituents of specimen surface layers after the porcelain fracture and the formed compound were evaluated by X-ray diffraction diagnosis. Result: The results of this study were obtained as follows : 1. The surface characteristics of cast and wrought titanium after surface treatment(Au, TiN, $Al_2O_3$ sandblasting) were similar and each cast and wrought titanium showed similar bonding characteristics. 2. Before and after the biaxial flection test, the highest atomic weight change of Si component was found in $Al_2O_3$ sandblasted wrought titanium(28.6at.% $\rightarrow$ 8.3at.%). On the other hand, the least change was seen in Au-Pd-In alloy(24.5at.% $\rightarrow$ 9.1at.%). 3. Much amount of Si components was uniformly distributed in Au and TiN coated titanium, but less amount of Si's was unevenly dispersed on Al2O3 sandblasting surfaces. 4. In X-ray diffraction diagnosis after porcelain debonding, we could see $Au_2Ti$ compound and TiN coating layers on Au and TiN coated surfaces and $TiO_2$, typical oxide of titanium, on all titanium surfaces. 5. Debonding of porcelain on cast and wrought titanium surface after the biaxial flection is considered as a result of adhesion deterioration between coating layers and titanium surfaces. We found that there are both adhesive failure and cohesive failure at the same time. Conclusion: These results showed that the titanium-ceramic adhesion could be improved by coating cast and wrought titanium surfaces with Au and TiN when making porcelain fused to metal crowns. In order to use porcelain fused to titanium clinically, it is considered that coating technique to enhance the bonding strength between coating kKlayers and titanium surfaces should be developed first.

A Study on Animation Character Face Design System Based on Physiognomic Judgment of Character Study in the Cosmic Dual Forces and the Five Elements Thoughts (음양오행(陰陽五行)사상의 관상학에 기반한 애니메이션 캐릭터 얼굴 설계 시스템 연구)

  • Hong, Soo-Hyeon;Kim, Jae-Ho
    • Journal of Korea Multimedia Society
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    • v.9 no.7
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    • pp.872-893
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    • 2006
  • In this study, I classify the elements of physiognomic judgment of character with regard to form and meaning from a visual perspective based on physiognomic judgment of character study in 'the cosmic dual forces and the Five Elements theory'. Individual characters for each type are designed using graphic data. Based on that, design system of individual characters for each personality type is investigated using Neural Network system. Faces with O-Haeng (Five Elements) shapes are shown to constitute the system with ${\pm}0.3%$ degree of error tolerance for the non-loaming input data. For the shapes of Chinese characters 'tree, fire, soil, gold and water', their MSE(Mean Square Error) are 0.3, 0.3, 0.2, 0.5, 0.2. It seems to be the best regarding the scoring system which ranges from 0 to 5. Therefore, this system might be regarded to produce the most accurate facial shape of character automatically when we input character's personality we desire to make.

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Genetic Environments of Hydrothermal Vein Deposits in the Pacitan District, East Java, Indonesia (인도네시아 동부자바 빠찌딴(Pacitan) 광화대 열수 맥상 광상의 성인 연구)

  • Choi, Seon-Gyu;So, Chil-Sup;Choi, Sang-Hoon;Han, Jin-Kyun
    • Economic and Environmental Geology
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    • v.28 no.2
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    • pp.109-121
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    • 1995
  • The hydrothermal vein type deposits which comprise the Kasihan, Jompong and Gempol mineralized areas are primarily copper and zinc deposits, but they are also associated with lead and/or gold mineralization. The deposits occur within the Tertiary sedimentary and volcanic rocks in the Southern Mountain zone of the eastern Java island, Indonesia. Mineralization can be separated into two or three distinct stages (pre-and/or post- ore mineralization stages and main ore mineralization stage) which took place mainly along pre-existing fault breccia zones. The main phase of mineralization (the main ore stage) can be usually classified into three substages (early, middle and late) according to ore mineral assemblages, paragenesis, textures and their chemical compositions. Ore mineralogy and paragenesis of the three areas in the district are different from each other. Pyrite, pyrrhotite (/arsenopyrite), iron-rich (up to 20.5 mole % FeS) sphalerite and (Cu-)Pb-Bi sulfosalts are characteristic of the deposits in the Kasihan (/Jompong) area. On the other hand, pyrite + hematite + magnetite + iron-poor (2.7 to 3.6 mole % FeS) sphalerite assemblage is restricted to the Gempol area. Fluid inclusion data suggest that fluids of the main ore stage evolved from initial high temperatures (near $350^{\circ}C$) to later lower temperatures (near $200^{\circ}C$) with salinities ranging from 0.8 to 10.1 equiv. wt. percent NaCl. Each area represents a separate hydrothermal system: the mineralization at Kasihan and Jompong were largely due to early fluid boiling coupled with later cooling and dilution, whereas the mineralization at Gempol was mainly resulted from cooling and dilution by an influx of cooler meteoric waters. Fluid inclusion evidence of boiling indicates that pressures of ${\geq}95$ to 255 bars (${\geq}95$ bars for the Gempol area: $\approx$ 120 to 170 bars for the Jompong area: $\approx$ 140 to 255 bars for the Kasihan area) during portions of main ore stage mineralization. Equilibrium thermodynamic interpretation indicates that the evolution trends of the temperature versus fS2 variation of ore stage fluids in the Pacitan district follow two fashions: ore fluids at Kasihan and Jompong changed from the pyrite-pyrrhotite sulfidation stage towards pyritehematite- magnetite state, whereas those at Gempol evolved nearly along pyrite-hematite-magnetite reaction curve with decreasing temperature. The sulfur isotope compositions of sulfide minerals are consistent with an igneous source of sulfur with a ${\delta}^{34}S_{{\Sigma}s}$ value of about 3.3 per mil. The oxygen and hydrogen isotopic compositions of the fluids in each area indicate a progressive shift from the dominance of highly exchanged meteoric water at early hydrothermal systems towards an un- or less-exchanged meteoric water at later hydrothermal systems.

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