• Title/Summary/Keyword: Hazard Model

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Early Bowel Complications Following Radiotherapy of Uterine Cervi)( Carcinoma (자궁경부암의 방사선치료 후 급성 장관 합병증)

  • Kim, Won-Dong
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.129-135
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    • 1999
  • Purpose : This study evaluated early bowel complications in cervix cancer patients, following external radiotherapy (ERT and high dose rate intracavitary radiation (HDR ICR). Factors affecting the risk of developing early bowel complications and its incidence are analyzed and discussed Materials and Methods : The study is the retrospective review of 66 patients who received radiotherapy at Chungbuk National University Hospital from April 1994 to December 1998. The patients underwent 41.4 or 50.4 Gy ERT according to FIGO stage and tumor size, then A point dose was boosted to 71.4 or 74.4 Gy using a remotely controlled afterloading Buchler HDR ICR. The EORTC/RTOG morbidity criteria were used to grade early bowel complications, which are valid from day 1, the commencement of therapy, through day 90. The actuarial incidence, severity of complications were investigated and clinical pretreatment factors relevant to complications were found through univariate (Wilcoxon) and multivariate (Cox proportional hazard model) analysis. Results : Of the 66 patients, 30 patients (46$\%$) developed early bowel complications; 25 patients (38$\%$) with grade 1 or 2, 4 patients (0$\%$) with grade 3 and 1 patient (2$\%$) with grade 4. The complications usually began to occur 3 weeks after the commencement of radiotherapy. The actuarial incidence of early bowel complications was 41$\%$ at 10 weeks. The early bowel complications were associated significantly with an old age and a history of previous abdomino-pelvic surgery. All three patients who had a protracted overall treatment time (about 2 weeks) due to severe bowel complication, suffered from pelvic recurrences. Conclusion : Forty six percent of patients experienced early bowel complications, most of which were grade 1 or 2 and relieved spontaneously or by medication. The patients with an old age or a previous surgery have a high probability of early complications and they may be less compliant with planned radiotherapy. So more careful precaution is necessary for these patients.

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The Role of Postoperative External Irradiation for the Incompletely Resected Meningiomas (불완전절제된 수막종에서 수술 후 방사선치료의 역할)

  • Kim Tae-Hyun;Yang Dae-Sik;Kim Chul-Young;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.85-91
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    • 2000
  • Purpose : The aim of this study is to look for the possible efficacy of postoperative external irradiation for incompletely resected meningiomas. Methods and Materials : From August 198: to January 1997, forty-four patients with intracranial meningioma were treated by postoperative external irradiation. Of the 44 meningiomas, 18 transitional, 13 meningotheliomatous, 6 hemangiopericytic, 4 atypical, 2 fibroblastic and 1 malignant meningioma were identified. We classified all patients into two groups by the histology. The benign group was consisted of the meningotheliomatous, transitional and fibroblastic types. The malignant group was consisted of the atypical, hemangiopericytic and malignat types. In the means of surgery, 37 patients were resected incompletely and 7 patients were managed by biopsy only. After surgery, all patients were received postoperative external irradiation. Radiotherapy was deliverd using Co-60 or 4 MV photon beam to a total dose of 50 to 65 Gy (mean dose 57.4 Gy) with a 1.8 to 2 Gy per fraction. The median follow-up was 48 months (range : 21 $\~$ 101 months). Multivariate analysis of the Influence by age, sex, location, histology and radiation dose on local control has been done using Cox's proportional hazard model. Results : 5-year local control rate was 93.8$\%$ for the benign histology and 51.8$\%$ for the malignant histology (p=0.0110) and overall local control rate at 5 years was 87.4$\%$. The analysis of the prognostic factors, such as age, sex, location, and radiation dose were not significant except for the histology. Conclusion : Adjuvant postoperative external irradiation appears to be significantly improved local control in the patients with incompletely resected meningiomas.

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Monitoring Bacillus cereus and Aerobic Bacteria in Raw Infant Formula and Microbial Quality Control during Manufacturing (영.유아용 식품원료의 Bacillus cereus와 일반세균 모니터링 및 제조공정 중 미생물 품질제어)

  • Jung, Woo-Young;Eom, Joon-Ho;Kim, Byeong-Jo;Ju, In-Sun;Kim, Chang-Soo;Kim, Mi-Ra;Byun, Jung-A;Park, You-Gyoung;Son, Sang-Hyuck;Lee, Eun-Mi;Jung, Rae-Seok;Na, Mi-Ae;Yuk, Dong-Yeon;Gang, Ji-Yeon;Heo, Ok-Sun;Yoon, Min-Ho
    • Korean Journal of Food Science and Technology
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    • v.42 no.4
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    • pp.494-501
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    • 2010
  • The purpose of this study was to examine the presence of Bacillus cereus, aerobic bacteria and coliforms in the raw material of infant formulas and investigate the manufacturing process in terms of microbial safety. Among ten kinds of raw infant formula material samples (n=20), Bacillus cereus appeared in two (n=4). Aerobic bacteria were not detected in raw infant formula material or maximum 4.15 log CFU/g. Eleven species of aerobic bacteria were isolated and 76% of them were Sphingomonas paucimobilis, Pseudomonas fluorescens, Rhizobium radiobactor, or Stenotrophomonas maltophilia. A Pearson's correlation analysis revealed that the most influential factors for detecting Bacillus cereus were aerobic bacteria and coliforms. In other words, when the measured values of aerobic bacteria and coliforms were higher, the possibility that Bacillus cereus would appear increased. In a regression model to predict Bacillus cereus, the rate of appearance was correlated with aerobic bacteria and coliforms, and its contribution rate for effectiveness was 86%. Improving microbial quality control by pasteurization, spray dry, popping and extrusion resulted in a decrease in the numbers of Bacillus cereus, aerobic bacteria and coliforms in the raw materials. The results suggest that a hazard analysis and critical control point system might be effective for reducing microbiological contamination.

Abdominal Obesity in Relation to the Incidence of Type 2 Diabetes Mellitus and Impaired Fasting Glucose among some Korean Adults: A Retrospective Cohort Study (복부비만이 제2형 당뇨병 및 공복혈당장애 발생에 미치는 영향: 후향적 코호트 연구)

  • Ryu, Seung-Ho;Beck, Sung-Ho;Kim, Dong-Il;Suh, Byung-Seong;Kim, Woon-Sool;Sung, Ki-Chul;Chang, Yoo-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.4
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    • pp.359-365
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    • 2004
  • Objectives : This study was performed to determine whether an increase in abdominal obesity is an independent risk factor for impaired fasting glucose and type 2 DM. Methods : Among 24,212 adults over 30 years who undertook comprehensive medical screening examinations from Jan to Dec 1999, in a university hospital in Seoul, a total of 11,183 subjects were selected who had no DM at baseline and who were followed up more than once by Dec 2002. The average follow up period was 2.4 (${\pm}0.5$) years. DM was defined as having a fasting glucose level $\geq$ 126mg/dl, and impaired fasting glucose as showing a fasting glucose level between 110 and 125 mg/dl. Body weight, height and waist circumference (WC) were simultaneously measured with blood sampling. The relative risks (RRs) for DM and impaired fasting glucose by WC were calculated using Cox proportional hazard model. Ageadjusted rates were estimated by direct standardization using a reference population of 2000 from 30 to 80 years. Results : The average age of the subjects was 41.7 (${\pm}7.0$) years; males 41.2 (${\pm}6.5$) and females 45.6 (${\pm}9.2$). RRs for type 2 DM by WC with the reference group of WC < 80cm were as follows: 2.66 (95%, CI $0.55{\sim}12.8$) for WC of $80{\sim}89cm$ in men, 5.92 (95%, CI $1.08{\sim}32.3$) for WC $\geq$ 90 cm in men, and 2.64 (95%, CI $0.23{\sim}29.8$) for WC of $80{\sim}89cm$ in females. RRs for impaired fasting glucose by WC were 3.03 (95%, CI $2.18{\sim}4.22$) for WC $80{\sim}89cm$ in men, 6.10 (95%, CI $4.25{\sim}8.75$) for WC $\geq$ 90cm in men, and 1.56 (95%, CI $0.43{\sim}5.67$) for WC $80{\sim}89cm$ in women, and 8.08 (95%, CI $2.22{\sim}29.4$) for WC $\geq$ 90cm in females. These results remained significant after adjustment for age, BMI and fasting glucose concentrations at baseline in both sexes. Annual increment of more than 1 cm in WC was associated with the development of DM and impaired fasting glucose independently of age, sex, BMI, or presence of abdominal obesity. Conclusion : In Korean adults, abdominal obesity increased the risk for the development of type 2 diabetes and impaired fasting glucose. This result supports many other prospective studies suggesting abdominal obesity as a risk factor for type 2 diabetes.

The Role of External Irradiation for the Locally Advanced Papillary Thyroid Cancers (국소적으로 진행된 갑상선 유두암에서의 방사선치료의 역할)

  • Kim Tae-Hyun;Yang Dae-Sik;Kim Chul-Yong;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.187-194
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    • 1999
  • Purpose : The aim of this study is to look for the possible efficacy of external irradiation for locally advanced papillary thyroid cancers (stage pT4 or Nl ). Methods and Materials : From August 1981 through September 1997, 91 Patients with locally advanced papillary thyroid cancers (stage pT4 or Nl ) have been treated with external irradiation and followed up at our clinic. All of the patients have been treated with surgical resection. After surgery, 23 patients received postoperative external irradiation with or without ablative radioiodine therapy, whereas the other 68 patients were treated with ablative radioiodine therapy alone. Distributions of sex, age, and stage were comparable in both irradiated and nonirradiated groups. Multivariate analysis of the influence by age, sex, stage, ablative radioiodine therapy and external irradiation on local control were peformed by using Cox's proportional hazard model. Results : Overall survival rates at 7 years were of no significant difference in both groups. There were $98.1\%$ for no RT group and $90\%$ for RT group (p=0.506). 5-year local control rates were significantly different, these were $95.2\%$ for RT group and $67.5\%$ for no RT group (p=0.0408). An analysis of the prognostic factors, age, sex, stage, and RAI were not significant variables, except for the external irradiation. Conclusion : Adjuvant postoperative external irradiation did not affect overall survival, but significantly improved local control in the patients with locally advanced papillary thyroid cancers (stage pT4 or lympy node involvement).

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The physical geography in general:yesterday and tomorrow (자연지리학 일반: 회고와 전망)

  • Son, Ill
    • Journal of the Korean Geographical Society
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    • v.31 no.2
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    • pp.138-159
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    • 1996
  • There has been a tendency for Geomorphology and Climatology to be dominant in Physical Geography for 50 years in Korea. Physical Geography is concerned with the study of the totality of natural environment through the integrated approaches. But, an overall direction or a certain paradigm could not be found, because major sub-divisions of Physical Geography have been studied individually and the subjects and the approaches in studying Physical Geography are enormously diverse. A consensus of opinion could not also exist in deciding what kind of the sub-divisions should be included in the physical geography in general and how those should be summarized. Furthermore it would be considered imprudent to survey the studies of Physical Geography besides those of Geomorphology and Climatology due to the small number of researchers. Assuming that the rest of Physical Geographical studies with the exception of Geomorphological and Climatological studies are the Physical Geography in general, the studies of Physical Geogrpahy in general are summarized and several aspects are drown out as follows. First the descliption of all possible factors of natural environments was the pattern of early studies of Physical Geography and the tendency is maintained in the various kinds of research and project reports. Recently Physical Geographers have published several introductory textbooks or research monographs. In those books, however, the integrated approaches to Physical Geography were not suggested and the relationship between man and nature are dealt with in the elementary level. Second, the authentic soil studies of Physical Geographers are insignificant, because the studies of soil in Physical Geography have been mostly considered as the subsidiary means of Geomorphology Summarizing the studies of Soil Gegraphy by physical geographers and other Pedologists, the subjects are classified as soil-forming processes, soil erosions, soil in the tidal flat and reclaimed land, and soil pollution. Physical Geographers have focused upon the soil-forming processes in order to elucidate the geomorphic processes and the past climatic environment. The results of other subjects are trifling. Thirdy Byogeygrayhers and the results of studies are extremely of small number and the studies of Biogeography in Korea lines in the starting point. But, Biogeography could be a more unifying theme for the Physical-human Geography interface, and it would be expected to play an active part in the field of environmental conservation and resource management. Forth, the studies of Hydrogeography (Geographical Hydrology) in Korea have run through the studies of water balance and the morphometric studies such as the drainage network analysis and the relations of various kinds of morphometric elements in river. Recently, the hydrological model have introduced and developed to predict the flow of sediment, discharge, and ground water. The growth of groundwater studies is worthy of close attention. Finally, the studies on environmental problems was no mole than the general description about environmental destruction, resource development, environmental conservation, etc. until 1970s. The ecological perspectives on the relationship between man and nature were suggested in some studies of natural hazard. The new environmentalism having been introduced since 1980s. Human geographers have lead the studies of Environmental Perception. Environmental Ethics, Environmental Sociology, environmental policy. The Physical geographers have stay out of phase with the climate of the time and concentrate upon the publication of introductory textbooks. Recently, several studies on the human interference and modification of natural environments have been made an attempt in the fields of Geomorphology and climatology. Summarizing the studies of Physical Geography for 50 years in Korea, the integrated approaches inherent in Physical Geography disappeared little by little and the majol sub-divisions of Physical Ceography have develop in connection with the nearby earth sciences such as Geology, Meteorology, Pedology, Biology, Hydrology, etc been rediscovered by non-geographers under the guise of environmental science. It is expected that Physical Geography would revive as the dominant subject to cope with environmental problems, rearming with the innate integrated approaches.

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Initial results from spatially averaged coherency, frequency-wavenumber, and horizontal to vertical spectrum ratio microtremor survey methods for site hazard study at Launceston, Tasmania (Tasmania 의 Launceston 시의 위험 지역 분석을 위한 공간적 평균 일관성, 주파수-파수, 수평과 수직 스펙트럼의 비율을 이용한 상신 진동 탐사법의 일차적 결과)

  • Claprood, Maxime;Asten, Michael W.
    • Geophysics and Geophysical Exploration
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    • v.12 no.1
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    • pp.132-142
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    • 2009
  • The Tamar rift valley runs through the City of Launceston, Tasmania. Damage has occurred to city buildings due to earthquake activity in Bass Strait. The presence of the ancient valley, the Tamar valley, in-filled with soft sediments that vary rapidly in thickness from 0 to 250mover a few hundreds metres, is thought to induce a 2D resonance pattern, amplifying the surface motions over the valley and in Launceston. Spatially averaged coherency (SPAC), frequency-wavenumber (FK) and horizontal to vertical spectrum ratio (HVSR) microtremor survey methods are combined to identify and characterise site effects over the Tamar valley. Passive seismic array measurements acquired at seven selected sites were analysed with SPAC to estimate shear wave velocity (slowness) depth profiles. SPAC was then combined with HVSR to improve the resolution of these profiles in the sediments to an approximate depth of 125 m. Results show that sediments thicknesses vary significantly throughout Launceston. The top layer is composed of as much as 20m of very soft Quaternary alluvial sediments with a velocity from 50 m/s to 125 m/s. Shear-wave velocities in the deeper Tertiary sediment fill of the Tamar valley, with thicknesses from 0 to 250m vary from 400 m/s to 750 m/s. Results obtained using SPAC are presented at two selected sites (GUN and KPK) that agree well with dispersion curves interpreted with FK analysis. FK interpretation is, however, limited to a narrower range of frequencies than SPAC and seems to overestimate the shear wave velocity at lower frequencies. Observed HVSR are also compared with the results obtained by SPAC, assuming a layered earth model, and provide additional constraints on the shear wave slowness profiles at these sites. The combined SPAC and HVSR analysis confirms the hypothesis of a layered geology at the GUN site and indicates the presence of a 2D resonance pattern across the Tamar valley at the KPK site.

An Analysis of Prognostic Factors in the Uterine Cervical Cancer Patients (자궁경부암 환자의 예후인자에 관한 분석)

  • Yang, Dae-Sik;Yoon, Won-Sub;Kim, Tae-Hyun;Kim, Chul-Yong;Choi, Myung-Sun
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.300-308
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    • 2000
  • Purpose :The aim of this study is to analysis of suwival and recurrence rates of the uterine cervical carcinoma patients whom received the radiation therapy respectively. The prognostic factors, such as Papanicolaou (Pap) smear, carcinoembriogenic antigen (CEA) and squamous cell carcinoma (SCC) antigen has been studied. Methods and Materials : From January 1981 to December 1998, eight-hundred twenty-seven uterine carvical cancer patients were treat with radiation therapy. All of the patients were divided into two groups : the radiation therapy only (S2l patients) group and the postoperative radiation therapy (326 patients) group. The age, treatment modality, clinical stage, histopathology, recurrence, follow-up Pap smears, CEA and SCC antigen were used as parameters for the evaluation. The prognostic factors such as survival and recurrence rates were peformed with the Kaplan-Meier method and the Cox hazard model, respectively. Median rollow-up was 38.6 months. Results :On the radiation therapy only group, 314 patients (60$\%$) achieved complete response (CR), 47 patients (9$\%$) showed local recurrence (LR), 78 patients (15$\%$) developed distant metastasis (DM). On the Postoperative radiation therapy group, showed 276 Patients (85$\%$) CR, 8 Patients (2$\%$) LR, 37 Patients (11$\%$) DM. The 5-year survival and recurrence rates was evaluated for all parameters. The statistically significant factors for the survival rate in univariate analysis were clinical stage (p=0.0001), treatment modality (p=0.0010), recurrence (p=0.0001), Pap smear (p=0.0329), CEA (p=0.0001) and SCC antigen (p=0.0001). Conclusion: This study indicated that after treatment, the follow-up studies of Pap smear, CEA and SCC antigen were significant parameter and prediction factors for the survival and recurrence of the uterine cervical carcinoma.

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Prognostic Factors for Local Control in Early Glottic Cancer Treated with Radiation Therapy (방사선치료를 받은 조기 성문암 환자의 국소 종양 제어에 관한 예후 인자)

  • Chung Woong-Ki;Ahn Sung Ja;Nam Taek Keun;Nah Byung Sik;Cho Jae-Shik;Lim Sang-Chull
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.226-232
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    • 2000
  • Purpose :This study was performed to find out the prognostic factors affecting local control in early glottic cancer treated with radiation therapy alone. Materials and Methods :We analysed 37 patients of histologically confirmed early glottic cancer treated at Chonnam National University Hospital between July Im and December 1995, retrospectively. Age of patients ranged from 30 to 73 years (median; 59 years). Thirty-five (95$\%$) patients were male. Histological type was all squamous cell carcinoma. According to the staging system of 1997 American Joint Committee on Cancer, 37 patients were restaged as follows: Tla; U (73$\%$), Tlb; 3 (8$\%$), 72: 7 (19$\%$). Radiation therapy was done using 6 MV X-ray of linear accelerator The range of total radiation dose delivered to the glottic lesion was between 5,040 cGy and 7,020 cGy (median; 6,600 cGy). Median follow-up period was U months. local control rates were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of control rates between comparable groups. Multivariate analysis using Cox proportional hazard model was done to find out prognostic factors affecting local control. Results:5 year survival rate of 37 patients was 89$\%$. Local control rate of 37 patients was 74$\%$ in 5 years. We included age, 7-stage, anterior commissure involvement, fraction size, total radiation dose, treatment time of radiotherapy as potential prognostic factors in univariate and multivariate analysis. As a result, treatment time had statistical significance in local control rate in both univariate (p=0.026) and multivariate (p=0.017) analysis. Complication was not recorded except one patient with hypothyroidism. Conclusion :This study revealed that overall treatment time of radiation was a significant factor affecting local control rate.

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Postoperative Radiotherapy in Malignant Tumors of the Parotid Gland (이하선 악성종양의 수술 후 방사선 치료)

  • Chung Woong-Ki;Ahn Sung Ja;Nam Taek Ken;Chung Kyung-Ae;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.251-258
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    • 1998
  • Purpose : This study was performed to analyze the factors affecting local control in malignant tumors of the parotid gland treated with surgery and postoperative radiation. Materials and methods : Twenty-six patients were treated for malignant tumors of the parotid gland from 1986 to 1995 at Department of Therapeutic Radiology, Chonnam University Hospital. Age of the patients ranged from 14 to 72 years (median : 55 years). Histologically 10 patients of mucoepidermoid carcinoma, 7 of squamous cell carcinoma, 4 of acinic cell carcinoma, 4 of adenoid cystic carcinoma and 1 of adenocarcinoma were treated. Total parotidectomy was performd in 15 of 26 patients, superficial in 7, subtotal in 4. Facial nerve was sacrificed in 5 patients. Postoperatively 4 patients had residual disease, 4 had positive resection margin. Radiation was delivered through an ipsilateral wedged pair of photon in 11 patients. High energy electron beam was mixed with photon in 15 patients. Electron beam dose ranged from 900 cGy to 3800 cGy (median 1700 cGy). Total radiation dose ranged from 5000 cGy to 7560 cGy (median : 6020 cGy). Minimum follow-up period was 2 years. Local control and survival rate were calculated using Kaplan-Meier method. Generalized Wilcoxon test and Cox proportional hazard model were used to test factors affecting local control. Results : Five (19$\%$) of 26 patients had local recurrence. Five year local control rate was 77$\%$. Overall five year survival rate was 70$\%$. Sex, age, tumor size, surgical involvement of cervical lymph node, involvement of resection margin, surgical invasion of nerve, and total dose were analyzed as suggested factors affecting local control rate. Among them patients with tumor size less than 4 cm (p=0.002) and negative resection margin (p=0.011) were associated with better local control rates in univariate analysis. Multivariate analysis showed only tumor size factor is associated with local control rate (p=0.022). Conclusion : This study suggested that tumor size is important in local control of malignant tumors of parotid gland.

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