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Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

  • Yavuzcan, Ali;Caglar, Mete;Ozgu, Emre;Ustun, Yusuf;Dilbaz, Serdar;Ozdemir, Ismail;Yildiz, Elif;Gungor, Tayfun;Kumru, Selahattin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5455-5459
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    • 2013
  • Background: The risk of malignancy index (RMI) for the evaluation of adnexal masses is a sensitive tool in certain populations. The best cut off value for RMI 1, 2 and 3 is 200. The cut off value of RMI-4 to differentiate benign from malignant lesions is 450. Our aim was to evaluate the efficiency of four different malignancy indexes (RMI1-4) in a homogeneous population. Materials and Methods: We evaluated a total of 153 non-pregnant women with adnexal masses who did not have a history of malignancy and who were above 18 years of age. Results: A cut-off value of 250 for RMI-1 provided 95.9% inter-observer agreement, yielding 95.9% specificity, 93.5% negative predictive value, 75.0% sensitivity and 82.8% positive predictive value. A cut-off value of 250 for RMI-1 showed high performance in preoperative diagnosis of invasive malignant lesions than cut-off value of 200 in our population. A cut-off value of 350 for RMI-2 provided 94.5% inter-observed agreement, yielding 94.2% specificity, 93.4% negative predictive value, 75.0% sensitivity and 77.4% positive predictive value. RMI-2 showed the higher performance when the cut-off value was set at 350 in our population. A cut-off value of 250 provided 95.2% inter-observer agreement, yielding 95.0% specificity, 93.2% negative predictive value, 75.0% sensitivity, and 88.0% positive predictive value. RMI-3 showed the highest performance to diagnose malignant adnexal masses when the cut-off value was set at 250. In our study, RMI-4 showed similar statistical performance when the cut-off value was set at 400 [(Kappa: 0.684/p=0.000), yielding 93.8% inter-observer agreement, 93.4% specificity, 93.4% negative predictive value, 75.0% sensitivity, and 75.0% negative predictive value]. Conclusions: We showed successful utilization of RMIs in preoperative differentiation of benign from malignant masses. Many studies conducted in Asian and Pacific countries have reported different cut-off values as was the case in our study. We think that it is difficult to determine universally accepted cut-off values for RMIs for common use around the globe.

Research-history on Stanislawski in Korea -focused on problems of Reception, translation and research- (스타니슬랍스키 연구사 -국내 스타니슬랍스키 수용·번역·연구의 제 문제를 중심으로)

  • Kim, Daihyun
    • Journal of Korean Theatre Studies Association
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    • no.40
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    • pp.345-400
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    • 2010
  • Konstantin S. Stanislawski(1863-1938) is one of the great acting-teachers and directors. Especially his 'System' influences this day like his period so many actors and directors in the world. In Korea, Stanislawski was introduced at first in 1920's by Kim, Woojin, dramatist. After that time, his system was influenced fast everyone in the korean drama world. As a result, so many translations of his books and researches of his system are done until nowadays, but it is not perfect for the correct understanding of Stanislawski and his system. It seems to be several causes in this misunderstanding. And the purpose of this thesis is at first to observe historically the results of researches and translations on Stanislawski and his system in Korea and then to bring it in order according to characteristics. In this thesis are the process of reception observed dividing 4 periods. The first period is from the beginning to the liberation in 1945. The second is to 1980's and the next is to the year 2000. And the final period is from that time to the present time. As a result are several characteristics found as followings: 1) translations of Stanislawski's first book like other books, for example, Building a Character and Creating a Role, an Actor Prepares, are fast all secondhand translations, that means, man translated it not from russian direct but japanese or english. It caused man to misusing of terms and then misunderstanding on the system. 2) the researches on Stanislawski in are fast all concentrated on the book, an Actor Prepares, so this leads man to regard it as his whole acting system. On the other hand, thesisses which deal with his last and final acting technique, "the Method of the physical Action" are relatively not so much. As though man knows the last, man used to think that the system is developed systematically from the psychological technique to the physical action or the method of the physical action is only the way to understand of stanislawski's acting method. The psychological method and the physical are not the divided, different acting technique, but pairs which are applied to different objects, that is, the actor himself and the role in texts. 3) the political aspects are not considered especially under the situation of Stalin's social realism. This lack of the political context having relation with the system acts as a obstacle upon understanding the correct, whole his system. But so many thesises on this theme in other countries are so vivacious. For example, man can find subjects like "Stanislawski and Meyerhold", "means of Stanislawski's method for theatres in the social context". There are also many interesting Questions related to the physical action. That is, is the physical action the final acting technique or the materialistic dialectical device to survive under the Stalin's rule? Is there some interrelations between stanislawski's physical action and Meyerhold's biomechanics? In conclusion, the researches on Stanislwski and his system are not enough to understand correctly and overcome the system. We have to start the research again at least from the direct translation his books written russian in order to apply it in a new times.

A Study on Monumental Expression of Korean War Memorials in Korea (6.25전쟁 기념공간에 나타난 기념적 표현)

  • Lee, Sang-Suk
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.2
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    • pp.98-108
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    • 2010
  • The purpose of this study was to analyze the monumental expression of Korean War Memorials(KWM) in Korea(KWMK). Through site survey and internet searching, the researcher selected 17 KWMK and analyzed four analysis categories: contents, spatial form, landscape elements, sculptures and architectural elements. The results are as follows: 1. The analysis revealed that main contents of KWMK were to cherish victims of the Korean War, honor military merit, and explain Korean War. 2. Most KWMK built battlefield had the form of symmetry and spatial axis arranged monuments and sculptures for solemnity and heroism. Though the sites were terraced by traditional spatial order, spatial sequence wasn't seen except Yang-gu KWMK and Chumomyeongbi in United Nations Memorial Cemetery in Korea. 3. Stone monument-like towers, tablets, podium, monoliths, cenotaphs, and exhibit halls to explain Korean War and combat history were used as main elements of KWMK and also, war weapons were often displayed the flags of countries taking part in Korean War were raised with Taegeukgi and the United Nations flag. 4. Most sculptures were used as important media to represent the Korean War and assumed realistically the form of heroic combat. But a few architectural memorial built in recent were designed in contemporary style to have spatial sequence and represent Korean War symbolically and narratively. 5. In memorial culture, KWMK were strongly influenced by ideology and patriotism, impacted by conventional value, and designed by some sculptors and designers in a certain circle. Further study will be required to analyze the characteristics of KWMK in the point of design style and diachronic.

Expressional Characteristics of Interior Design Presented in Exhibition Spaces of Jean-Michel Wilmotte (장 미쉘 빌모트의 전시공간에 나타난 실내디자인 표현특성)

  • Song, Ga-Hyun;Kim, Moon-Duck
    • Korean Institute of Interior Design Journal
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    • v.23 no.6
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    • pp.87-94
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    • 2014
  • Today, the growing number of international architects enters the open market of South Korean architecture and interior from exhibition spaces such as art galleries to buildings of major companies. Establishing new local landmarks, their works have a considerable influence on the development of architecture. Among many, French architect Jean-Michel Wilmotte has worked consistently in South Korea. The purpose of this study is to analyze and put together the expression characteristic of the interior design in his exhibition spaces including Gana Art Gallery. Jean-Michel Wilmotte has designed based on the history, culture, society, and arts in France and other European countries, and is influenced by architects like Charles Rennie Mackintosh, Josef Hoffmann, and Carlo Scarpa. Such an influence is shown in the form of contrast between verticality and horizontality as well as the fortification in his modern classical characteristic, which is one of his expression characters. In his work of improving the ancient architecture, Wilmotte is good at creating a modern space through contextual expression, and the textural contrast between materials of the past and the present. Thus I performed an analysis of the expression characteristic of the interior design in National Museum of Contemporary Art of Chiado in Lisbon, Cognac Hennessy Museum in France, Gana Art Gallery in Korea, Mus$\acute{e}$e du Pr$\acute{e}$sident Jacques Chirac in Sarran, France, Ullens Center for Contemporary Art (UCCA) in Beijing, and lastly Mus$\acute{e}$e d'Orsay in Paris. The results show that he maintains the spatial context by applying contemporary design to the preserved existing structure, continues the flow of exhibition through the lightings in the corridors and on the ceiling, and seeks for a balance by adding vertical or horizontal elements to the elevation. In the interior, the staircase and exhibition structure are turned into objects, and the contrasting texture of the wall vitalizes the space. Wilmotte redesigns the space of the past and the present by using indirect joint that allows an organic connection of the old and new structures, and by minimizing the conflict between the two elements through prefabrication. The expression character of his interior design will be potential resources for architects and interior designers to develop their own design languages.

Underwriting Method of Worksite Marketing Product (Worksite Marketing 상품과 언더라이팅 기법)

  • Kim, Cheong-Nyun;Chung, Sung-Wan
    • The Journal of the Korean life insurance medical association
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    • v.24
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    • pp.97-117
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    • 2005
  • Internally Korean insurance market is that whole life products' growth are becoming slowdown that's why new insurance products have appeared on the market in consideration of consumer's needs recently. Externally domestic insurance market competitions has drifted from insurance industry to whole financial industry since bankasurance started. Life insurance companies should open up a new market to survive from severe competitions. Worksite marketing can be an alternative. An insurer make arrangements with an employer about an insurance terms which an insurer offers in Worksite marketing. Then eligible individuals enroll in the plans at their own discretion and pay 100 percent of the premium for coverage through payroll deductions. An employer doesn't need to pay extra money for additional benefit but can raise employee's loyalty and satisfaction of company through worksite marketing. An employee can be covered at discounted premium rate and less strict underwriting guidelines to an insurer compared to individual insurance. In developed countries specially U.S insurance market, Worksite marketing is getting very popular and growing rapidly due to the advantages. Worksite marketing has both individual insurance characters and group insurance characters. Individual insurance characters are that employees enroll in the plans at their own discretion and pay 100 percent of the premium for coverage. Group insurance characters are that actively at work and participation etc. An insurer have to reflect these two characters on Worksite marketing when an insurance company work out a plan for developing products and underwriting guidelines. When an insurer devise worksite products, one should consider participation level which means percentage of eligible employees participating. Participation is related to anti-selection. As we know underwriting is essential for every kind of insurance, especially underwriting plays major role in worksite marketing. We can see that in the below. Firstly, it has a function in calculation of premium rate. When calculate premium rate for worksite products underwriters have to estimate expected participation level and risk factors. So underwriters and acturies keep in close contact with each other. Secondly, underwriting methods are important. When an insurer underwrite worksite products, there are three kinds of underwriting methods. These are Simplified issue underwriting, Full underwriting and Guaranteed issue underwriting. Simplified issue underwriting typically requires no medical examination, but usually requires supplying satisfactory answers to one or several health and/or lifestyle questions. Full underwriting requires a complete medical history questionnaire that may further require an exam. Guaranteed issue underwriting means that coverage is issued without the employee having to provide evidence of insurability. When insurer set the GI limit are usually based on the type of industry, number of eligible employees, the average amount of coverage and participation level. In addition to insurer should have a clear definition of eligible employee on the insurance provision and application form. It will minimize possibility of trouble claims and anti-selection. An insurer also establish preexisting condition exclusion and special guidelines for late entrants. When an insurer introduce Worksite marketing to Korean insurance market, an insurer has to examine market research to analyze potential market and strategy of sales most of all. Also an insurer should review real situation of the U.S, England and Japanese market etc. There are a lot of new technologies about worksite marketing process that an insurer should learn. When an insurer consider many things which we explained it can be a real alternative.

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Head and Neck Squamous Cell Carcinoma in Iranian Patients and Risk Factors in Young Adults: a Fifteen-Year Study

  • Mafi, Negar;Kadivar, Maryam;Hosseini, Niloufar;Ahmadi, Sara;Zare-Mirzaie, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3373-3378
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    • 2012
  • Background: Head and neck squamous cell carcinoma (HNSCC) is the 8th most common cancer worldwide. Although older age, male gender, smoking and alcohol consumption are known risk factors, an increasing number of HNSCC patients are without typical risk factors. Our aim was to define demographics of HNSCC in Iran and the potential risk factors related to Iranian ethnicity and lifestyle. Methods: We conducted a cross-sectional analytical study on 262 patients with primary SCC of the larynx, hypopharynx or tongue referred to our pathology department during 1995-2010. Patients' demographics, tumor characteristics and risk factors such as smoking, alcohol consumption and anemia were analyzed and compared in two groups of patients: over 40 years (older group) and 40 years or less (young group); Chi-square and Mann-Whitney analytical tests were employed. Results: 5.7% of patients were young adults. The male to female ratio was 1.5 in the younger group and 5.6 in the older group. In young adults, 40% of tumors were located in larynx and 40% in the tongue. Age >40 was significantly associated with laryngeal location (P<0.001). History of smoking and drinking was significantly associated with age >40 and SCC of larynx in both age groups. Cervical lymph node involvement was significantly correlated with SCC of tongue (P<0.001), however, considering young adults only, SCC of hypopharynx was most frequently accompanied by lymph node involvement (60%). The most prevalent tumor among men was SCC of larynx whereas SCC of hypopharynx was the most prevalent tumor among women (61%), of whom 18.2% were ${\leq}40$. Conclusions: The incidence of HNSCC among young adults seems to be higher in Iran compared to other countries. Reduction in exposure to known risk factors, especially tobacco smoking in forms of cigarettes and bubble pipes, and search for other causative agents of HNSCC in young population is recommended.

Some Views for the Buddhist Culture of Southeast Asia at Middle Ages through the Chinese Description (I): Focused on the documents of Faxian and Ichong (중국문헌을 통해본 중세 동남아의 불교문화(I): 법현(法顯)과 의정(義淨)의 저술을 중심으로)

  • JOO, Soo Wan
    • SUVANNABHUMI
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    • v.2 no.1
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    • pp.55-94
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    • 2010
  • Even Faxian(法顯)'s Gaosengfaxianchuan (『高僧法顯傳』) and Iching(義淨)'s Nanhaijiguineifachuan (『南海寄歸內法傳』) are regarded as very important and useful documents to study the southeast asian buddhist culture, it is very difficult to grasp the contemporary state of those area because their descriptions are very brief and implicit. Therefore this essay aimed an in-depth reading their documents as original texts of modern understanding of those area, and tried to make a new views to approach the southeast asian buddhist culture by some more historically and concretely. At the early 5th century when Faxian(法顯) arrived, Buddhism was flourished in Sri Lanka. Because already a long time passed since the Saṇgha was schismatized into conservative and progressive at around the dominical year, he mentioned nothing about the conflict or disharmony of two orders. And the faith of Buddha tooth relic, which had been uprisen at 50 years ago from Faxian's visiting, was concretely established as a representative religion of Sri Lanka. According to his record, the carrying ritual of this Buddha tooth was performed very magnificently as similar with recent Korean Youngsan ceremony(靈山齋). In the mean time, it looks there were many sculptures of Buddha image made of precious stone of special product from Sri Lanka. The faith of Buddha-pāda(the Buddha's foot-prints) was also generalized at that time. The most famous monk of his contemporary Sir Lanka was Buddhaghosa, the author of Visuddhi-magga, but it is not sure that Faxian had met him. It can be suspected that the funeral in which Faxian participated could be belonged to him, or the Visuddhi-magga was writing at the peak during Faxian's staying. On the way to return to China, Faxian embarked an indigenous ship around Indonesia. It means there were no chinese trade ship which he can use. So the trade between china and southeast asia was advanced by south asian ships, and the chinese ships were not yet joined at that time so activity. And at least until that time, it looks there were no any remarkable buddhist movement in the southeast asian countries by where he stopped. In contrast, the southeast asian world which be seen by Iching had already experienced a lot of changes. He was impressed by the high quality buddhist culture of those area, and insisted to accept it to china. Further, he analyzed the sects of buddhism which were prevalent around the southeast asia in his contemporary time, and tried to make a good relationship with each native monks for learning from them. It looks the center of those exchanges may be Śrīvijaya of Indonesia. He also mentioned the situation of the late 7th century's Funan(扶南) in Cambodia. At that time, the buddhist Saṇgha was oppressed by newly rising Khmer(眞臘). On the other hand, he described the points of sameness and difference in detail between Indian and southeast asian buddhist culture in the field of ritual as like the practical use of garments, buddha images, and daily recited scriptures. There must be a lot of another aspects which this essay couldn't gather up or catch from these documents. Nevertheless, I hope this essay can help the researchers of this field and will wait for any advices and comments from them.

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Breast Cancer Screening in Morocco: Performance Indicators During Two Years of an Organized Programme

  • Fakir, Samira El;Najdi, Adil;Khazraji, Youssef Chami;Bennani, Maria;Belakhel, Latifa;Abousselham, Loubna;Lyoussi, Badiaa;Bekkali, Rachid;Nejjari, Chakib
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6285-6288
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    • 2015
  • Background: Breast cancer is commonly diagnosed at late stages in countries with limited resources. In Morocco, breast cancer is ranked the first female cancer (36.1%) and screening methods could reduce the proportion presenting with a late diagnosis. Morocco is currently adopting a breast cancer screening program based on clinical examination at primary health facilities, diagnosis at secondary level and treatment at tertiary level. So far, there is no systematic information on the performance of the screening program for breast cancer in Morocco. The aim of this study was to analyze early performance indicators. Materials and Methods: A retrospective evaluative study conducted in Temara city. The target population was the entire female population aged between 45-70 years. The study was based on process and performance indicators collected at the individual level from the various health structures in Tamara between 2009 and 2011. Results: A total of 2,350 women participated in the screening program; the participation rate was 35.7%. Of these, 76.8% (1,806) were married and 5.2% (106) of this group had a family history of breast cancer. Of the women who attended screening, 9.3% (190) were found to have an abnormal physical examination findings. A total of 260 (12.7%) were referred for a specialist consultation. The positive predictive value of clinical breast examination versus mammography was 23.0%. Forty four (35.5%) of the lesions found on the mammograms were classified as BI-RADs 3; 4 or 5 category. Cancer was found in 4 (1.95%) of the total number of screened women and benign cases represented 0.58%. Conclusions: These first results of the programme are very encouraging, but there is a need to closely monitor performance and to improve programme procedures with the aim of increasing both the participation rate and the proportion of women eligible to attend screening.

Present Status of Fermented Milk Products in Japan

  • Hosono, Akiyoshi
    • 한국유가공학회:학술대회논문집
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    • 2004.06a
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    • pp.21-39
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    • 2004
  • Fermented milks have been recognized as healthy foods since ancient times, but those using intestinal bacteria such as Bifidobacterium and lactic acid bacteria (LAB) are even more valuable from the standpoint of view of maintaining health. They have also now come to be recognized as important in the field of preventive medicine. Although advances in the medical sciences in the last 50 years have significantly increased the human lift span, an unfortunate fact is that many of us are now living long enough to experience chronic disorders such as coronary heart disease, hypertension, osteoporosis, diabetes and cancer. In recent years there has been renewed interest in health promotion and disease prevention by incorporating probiotic bacteria into foods to counteract harmful bacteria in the intestinal tract. Therefore, there are now a wide variety of commercial products containing prospective probiotics that claim health-promoting effects, such reductions in large botvel carcinogens and mutagens, antitumor properties, cholesterol-lowering effects, increased lactose digestion, relief from con-stipation, stimulation of immunocomponent cells and enhancement of phagocytosis. Two well-known representative probiotic is LAB and Bifidobaclerium. Traditional probiotic dairy strains of LAB which have been designated as GRAS (Generally Recognized As Safe) bacteria have a long history of safe use and most strains are considered comestible microorganisms with no pathogenic potential. Accordingly, there is considerable interest in extending the range of foods containing probiotic organisms from dairy foods to infant formulas, baby foods, and pharmaceuticals. In addition, the ingestion of probiotics, prebiotics, and symbiotic as wll as combinations of pro- and prebiotics has recently aroused renewed interest as enhancing the beneficial relationship between the host and intestinal microflora in both healthy and diseased indivisuals. Non-communicable chronic diseases such as cancer, cerebral hemorrhage, is chemic heart disease, and diabetes mellitus has recently been recognized as adult diseases in Japan as well as other countries. and are considered to be inevitably associated with aging. These diseases occur as a result of individual life styles. The Japanes Government. Ministry of Health, Labor and Welfare has proposed substituting the term 'adult diseases' with 'lifestyle-related diseases'. It has emphasized the importance of prevention rather than treatment. since the well-known increase in the elderly population in Japan is predicted to result in a variety of socioeconomic problems. n this lecture on the Present status of fermented milk products in Japan, I will report a strategy for the development of fermented milk products in Japan from the standpoint of view of research in Japan on LAB and Bifidobacteria. They could play an important role in preserving human health by controlling intestinal microflora capable of producing toxic effects on the host.

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Using Dark Tourism Study on Culture and Tourism of industrialization - Focusing on Honam righteous army - (다크 투어리즘을 활용한 문화관광 산업화 방안에 관한 연구 - 한말 호남 의병사(義兵史)를 중심으로 -)

  • Kim, Hyun-Cheol;Yoo, Jun-Ho;Ha, Kyu-Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.6 no.1
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    • pp.59-81
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    • 2011
  • The 21st century, the creation and utilization of knowledge and information are the core of all economic activity, knowledge-based economy is plunging into. Culture can not live without knowing the age of culture and national spirit of a nation's cultural assets. Closed for other cultures, countries can develop a culture that is neither marked by imitation and import of cultural industries can never be developed. Creative and diverse culture of its own cultural code, evenly balanced mix of social culture is really the cultural and creative culture. Central government and local government-led growth in the local economy in terms of competitive cultural industry development policy has been carried out. In general, a country or society, culture, industry, the creation of a unique cultural and Planning on the basis of information deliquescent recreated a typical high-risk high returns to pay the venture industry and the nature of the creative industries and the venture industry a unique mix of industrial Characteristic is that it has. These times and the industry can contribute to the flow of valuable cultural assets and a history of our righteous living and exercise will be a source of resources.

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