• Title/Summary/Keyword: In-situ

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Development of Gated Myocardial SPECT Analysis Software and Evaluation of Left Ventricular Contraction Function (게이트 심근 SPECT 분석 소프트웨어의 개발과 좌심실 수축 기능 평가)

  • Lee, Byeong-Il;Lee, Dong-Soo;Lee, Jae-Sung;Chung, June-Key;Lee, Myung-Chul;Choi, Heung-Kook
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.73-82
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    • 2003
  • Objectives: A new software (Cardiac SPECT Analyzer: CSA) was developed for quantification of volumes and election fraction on gated myocardial SPECT. Volumes and ejection fraction by CSA were validated by comparing with those quantified by Quantitative Gated SPECT (QGS) software. Materials and Methods: Gated myocardial SPECT was peformed in 40 patients with ejection fraction from 15% to 85%. In 26 patients, gated myocardial SPECT was acquired again with the patients in situ. A cylinder model was used to eliminate noise semi-automatically and profile data was extracted using Gaussian fitting after smoothing. The boundary points of endo- and epicardium were found using an iterative learning algorithm. Enddiastolic (EDV) and endsystolic volumes (ESV) and election fraction (EF) were calculated. These values were compared with those calculated by QGS and the same gated SPECT data was repeatedly quantified by CSA and variation of the values on sequential measurements of the same patients on the repeated acquisition. Results: From the 40 patient data, EF, EDV and ESV by CSA were correlated with those by QGS with the correlation coefficients of 0.97, 0.92, 0.96. Two standard deviation (SD) of EF on Bland Altman plot was 10.1%. Repeated measurements of EF, EDV, and ESV by CSA were correlated with each other with the coefficients of 0.96, 0.99, and 0.99 for EF, EDV and ESV respectively. On repeated acquisition, reproducibility was also excellent with correlation coefficients of 0.89, 0.97, 0.98, and coefficient of variation of 8.2%, 5.4mL, 8.5mL and 2SD of 10.6%, 21.2mL, and 16.4mL on Bland Altman plot for EF, EDV and ESV. Conclusion: We developed the software of CSA for quantification of volumes and ejection fraction on gated myocardial SPECT. Volumes and ejection fraction quantified using this software was found valid for its correctness and precision.

Cervicography as a Screening Test for Cervical Cancer (자궁경부암 선별 검사에서 자궁경부 확대 촬영술의 이용)

  • Lee, Doo-Jin;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.169-180
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    • 1999
  • Background: Uterine cervical cancer is the most common malignant tumor of the women in Korea. This study was undertaken to evaluate the usefulness of the cervicography as a screening test of cervical cancer. Materials and Methods: Cervicography was taken from 482 women at department of obstetrics and gynecology, at Yeungnam University Hospital from March 1, 1998 to October 31, 1999. Of the 482 women, 172 women were exc1uded from the study for various reasons, and 310 women completed the study. Three-hundred and ten women had cervical cytology (Papanicolaou smear), cervicography and colposcopy, and punch biopsy was undertaken if any of the test result was abnormal. Results: The most common age group was 35-39, and 40-44, 45-49 in order and most common reason for having a screening test was regular check for cervical cancer. The mean duration from the last Pap smear was 17.1 months, and 64 women(20.4%) never had any prior screening tests. Of the 310 women, 254 women were categorized as normal or having benign disease such as cervicitis, erosion or metaplasia. Biopsy was taken from 56 patients and the results were 26 chronic cervicitis, 4 mild dysplasia, 6 moderate dysplasia, 2 severe dysplasia, 14 carcinoma in situ and 4 invasive carcinoma. The results of cytology and cervicography were well correlated(p<0.05). The sensitivity and specificity of cytology were 86.7% and 76.9%, respectively and the sensitivity and specificity of cervicography were 56.7% and 96.2%, respectively. False negative rate of cervicography(43.3%) was much higher than those of cytology(13. 3%) (p<0.05), but false positive rate of cervicography(3.8%) was much lower than that of cytology(23.1%) (p<0.05). Conclusion: It seems inappropriate to use cervicography as a single screening test for cervival cancer, but it may be an effective complementary test for cytology to lower the false negative rate of cytology.

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Clinical Manifestation and Associated Cardiac Anomalies of Dextrocardia (우심증에 동반된 심기형과 임상양상)

  • Kim, Sung Hoon;Hong, Seung A;Cho, Yoon Jung;Lee, Sang Lak;Kwon, Tae Chan
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.622-628
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    • 2002
  • Purpose : The purpose of this study is to ascertain the clinical manifestations and associated cardiac anomalies of dextrocardia. Methods : Twenty-four pediatric patients, who were admitted to, or visited, Dongsan Medical Center Keimyung University and were diagnosed with dextrocardia between January 1996 and July 2001, were enrolled in this study. All patients received echocardiogram and abdominal ultrasonogram to identify structural cardiac anomalies and visceral position. Results : Among 24 patients, 7 cases were situs solitus(29.2%), 10 cases(41.6%) were situs inversus and 7 cases(29.2%) were situs ambiguous. Most were diagnosed within a week of life(87.5%). They were most commonly cyanotic(45.8%), but eleven cases(45.8%) had no specific symptoms or signs. Nineteen cases(79.2%) had accompanied cardiac anomalies, and pulmonary stenosis or atresia were the most common among them. All the cases of situs solitus and ambiguous had associated cardiac anomalies, but half of the situs inversus had that. Eleven cases were dead by cardiac or extracardiac anomalies during follow up and the mortality rate was higher in situs solitus or ambiguous group than situs inversus group. Conclusion : Dextrocardia accompanies different cardiac and extracardiac anomalies. It's very important to diagnose dextrocardia and associated cardiac or extracardiac anomalies in the early stages of life to improve prognosis.

Control of Trophoblast Gene Expression and Cell Differentiation

  • Cheon, Jong-Yun
    • 대한생식의학회:학술대회논문집
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    • 2001.03a
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    • pp.195-205
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    • 2001
  • 태반 영양배엽 (trophoblast)은 포유동물의 발생과정 중 가장 먼저 분화되는 세포로서, 자궁환경내에서 배아가 착상, 발생, 및 분화하기 위해서 반드시 필요한 태반을 형성하는 색심적인 세포이다. 영양배엽 세포의 분화과정중의 결함은 배아의 사산이나 임신질환 등의 치명적 결과를 초래한다. 하지만, 영양배엽 세포의 분화를 조절하는 분자생물학적인 메카니즘은 아직 규명되지 않고 있다. 영양배엽 세포의 분화를 조절하는 경로를 규경하기 위한 선결과제는 분화된 영양배엽 세포에서만 발현하는 많은 유전자들이 밝혀져야만 한다. 본 연구팀은 최근에 분화된 영양배엽 세포에서만 발현하는 두 종류의 새로운 유전자들을 찾았다. 한 종류는 homeobox를 보유하고 있는 조절 유전자 Psx이고, 다른 한 종류는 임신호르몬인 태반 프로락틴 라이크 단백질 유전자 PLP-C${\beta}$이다. 본 연구과제의 목표는 이들 유전자의 기능과 조절 메카니즘을 규명함으로써, 영양배엽 세포의 분화를 조절하는 조절경로를 밝히는 것이다. 이를 위하여 다음과 같은 일련의 연구를 수행할 것이다. 1) Psx 유전자가 분화된 영양배엽 세포에서만 발현케 하는 조절 메카니즘을 규명하기 위해 functional assays, in vitro footprinting, gel mobility shift assays, 생쥐형질전화, UV crosslinking, Southwestern blot 등의 방법을 통해 Psx 유전자의 cis-acting 요인과 trans-acting factor를 밝혀 분석한다. 2) 영양배엽 세포의 분화조절 경로를 규명하기 위해 random oligonuclotide library screening, DD-PCR, subtractive screening 등의 방법을 이용하여 Psx 유전자에 의해 조절되는 하부유전자를 밝힌다. 3) Psx 유전자를 knock-out시켜 영양배엽 세포가 발달 및 분화하는데 미치는 역할을 밝힌다. 4) Yeast two-hybrid screening방법을 이용하여 태반 프로락틴 유전자의 수용체를 찾아 이들의 신호전달 기전을 밝힌다. 제1차년 연구결과로서, mouse와 rat으로부터 각각 Psx 유전자의 genomic DNA를 클로닝하여, 유전자 구조를 비교한 결과, mouse Psx (mPsx2)는 4개의 exons으로 이루어져 있는 반면에, rat Psx (Psx3)는 3개의 exons으로 구성되어 있었다. 즉, rPsx3는 mPsx2의 exon1이 없었다. Notrhern blot과 in situ hybridization 분석에 의해 mouse와 rat에서 Psx 유전자가 다르게 발현 조절되는 현상을 밝혔다. 실제로 mPsx2와 rPsx3의 5'-flanking지역을 클로닝하여 염기서열 분석 결과 전혀 homology를 찾을 수 없었다. 또한, 이들 각각 promoter의 activity를 luciferase reporter를 이용하여 조사한 결과 Rcho-1 trophoblast cells에서 각기 다른 activity를 보여 주는 것을 발견하였다. Psx 유전자의 transcription start sites는 Primer extension에 의해 밝혔다. 또한 Psx2 유전자를 knock-out 시키기 위해 targeting vector를 Osdupde1에 제작하였다. 본 과제를 시작할 때 새로운 프로락틴 유전자 하나를 클로닝하여 이 유전자를 PLP-I라고 이름을 붙였다. 이 후 이 유전자 (PLP-I)는 PLP-C${\beta}$라고 이름을 붙이게 되었다. Mouse PLP-C${\beta}$ 유전자의 counterpart를 rat에서 찾아 염기서열을 비교한 결과 mouse와 rat에서 PLP-C${\beta}$유전자의 homology는 약 79% (amino acid level)였다. 본 연구과정을 통해 또 하나의 새로운 PLP-C subfamily member를 mouse로부터 클로닝 하였고, 이 유전자를 PLP-C${\gamma}$라 하였다. PLP-C${\beta}$와 PLP-C${\gamma}$의 발현 유형은 Northern blot과 in 냐셔 hybridization 분석에 의해 태반의 제한된 spongitrophoblast와 trophoblast giant cells에서만 발현하는 것을 밝혔다. 놀랍게도 이들 두 새로운 유전자는 alternative splicing에 의해 두 종류의 isoform이 있음을 밝혔다. PLP family member 유전자로서 splicing에 의한 isoforms을 보여 주는 유전자로는 PLP-C${\beta}$와 PLP-C${\gamma}$가 최초이다. 이들 isoform mRNAs의 발현 유형은 RT-PCR 방법을 이용하여 규명하였다. 또 하나의 새로운 발견은 PLP-C${\beta}$와 PLP-C${\gamma}$가 독특한 유전자 구조를 갖고 있었다. 즉, PLP-C${\beta}$는 exon3의 alternative splicing에 의해 5개 혹은 6개의 exons을 갖는 two isoforms이 생긴다. 반면에 PLP-C${\gamma}$는 exon2가 alternative splcing이 되면서 7개의 exons을 갖거나 6개의 exons을 갖는 isoforms을 만든다. 그리고, PLP-C${\gamma}$의 promoter activity를 trophoblast Rcho-l${\gamma}$ 세포주를 이용하여 PLP-C${\gamma}$ 의 1.5 kb 5'-flanking 지역이 trophoblast-specific promoter activity를 갖고 있음을 밝혔다. PLP-C${\gamma}$ 유전자의 transcription start site는 Primer extension에 의해 밝혔다. 제 1차 년도의 연구결과를 토대로, 2차년에서는 다음단계의 연구를 수행하고자 한다. 즉, 1) mPsx2와 rPsx3의 promoter를 비교분석 함으로서 mouse와 rat에서 Psx 유전자가 다르게 조절되는 메카니즘 규명, 2) Psx와 PLP-C 유전자의 promoter에 있는 cis-acting elements 탐색, 3) Psx2와 Psx3의 단백질을 이용하여 이들이 binding하는 target sequence 규명, 4) 제작한 Psx2 targeting vector를 이용하여 ES cells에서 Psx2 유전자 knock-out, 5) Psx 유전자를 과발현시키는 세포주를 만들고 Psx에 의해 조절되는 유전자 탐색, 6) 새로 밝히 PLP-C members 유전자들의 조절기전을 Rcho-1 세포주를 이용하여 여러 거지 성장인자와 다른 호르몬에 대한 반응을 탐색, 7) Psx와 PLP-C${\gamma}$ 유전자의 chromosomal mapping 등을 밝힐 것이다.

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Interpretation of Material Provenance and Production Techniques of Pottery and Kilns from Gundong and Majeon Sites in the 3rd Century at Yeonggwang, Korea (영광 군동.마전 원삼국시대 토기와 가마의 제작특성 및 태토의 산지해석)

  • Jang, Sung-Yoon;Lee, Gi-Gil;Moon, Hee-Soo;Lee, Chan-Hee
    • Journal of Conservation Science
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    • v.25 no.1
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    • pp.101-114
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    • 2009
  • Potsherds and kilns of the AD 3th century excavated from Gundong and Majeon sites, Korea were studied to investigate the production techniques and provenance of potsherds and kilns on the pastes. For potsherds, kilns blocks and in-situ paleo-soils, provenance of raw materials were estimated through mineralogy and geochemistry, while production technique and thermal feature of kilns were investigated through observation of textures and compositions as well as firing experiment on paleo-soils. As a result of study, potsherds and kilns were found to have similar mineralogical compositions as the neighboring paleo-soils and to have same evolution path with that of geochemistry. The potsherds were divided into 3 groups according to firing temperature and production technique. Group 1 consists of reddish stamped pattern pottery with loose textures, which has many pores and contains many iron oxides. Its temper is less than about 0.5mm, and was probably fired between 700 to $800^{\circ}C$. Group 2 contains ash to grayish blue stamped pattern pottery, which has vitrified texture and few pores. Its temper is less than about 0.5mm, and was probably fired from 900 to $1,000^{\circ}C$. However, some potsherd belongs to the group 2 in terms of features for temper and pastes, but it was probably fired over $1,100^{\circ}C$. Group 3 contains reddish and grayish stamped pattern pottery. It has vitrified matrix, few pores and temper consists of polycrystalline quartz and feldspar over 2mm, and it was probably fired around $1,000^{\circ}C$. The kiln had experienced temperature from 600 to $700^{\circ}C$ on the wall, from 900 to $1,000^{\circ}C$ on the bottom, suggesting the function of high temperature firing.

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An Experimental Study to Improve Permeability and Cleaning Efficiency of Oil Contaminated Soil by Plasma Blasting (플라즈마 블라스팅을 이용한 유류오염토양의 투수성과 정화효율 개선을 위한 실험적 연구)

  • Jang, Hyun-Shic;Kim, Ki-Joon;Song, Jae-Yong;An, Sang-Gon;Jang, Bo-An
    • The Journal of Engineering Geology
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    • v.30 no.4
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    • pp.557-575
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    • 2020
  • Plasma blasting which is generated by high voltage arc discharge of electricity is applied to soil mass to improve permeability of soil and cleaning efficiency of oil contamination. A new high voltage generator was manufactured and three types of soil including silty sand, silty sand mixed with lime and silty sand mixed with cement were prepared. Small and large soil columns were produced using these types of soil and plasma blasting was performed within soil columns to investigate the variation of soil volume penetrated by fluid and permeability. Soil volume penetrated by fluid increased by 11~71% when plasma blasting was applied in soil. Although plasma blasting with low electricity voltage induced horizontal fracture and fluid penetrated along this weak plane, plasma blasting with high voltage induced spherical penetration of fluid. Plasma blasting increased the permeability of soil. Permeabilty of soils mixed with lime and cement increased by 450~1,052% with plasma blasting. Permeability of soil increased as discharge voltage increased when plasma blasing was applied once. However, several blastings with the same discharge voltage increase or decrease permeability of soil. Oil contaminated soil was prepared by adding diesel into soil artificially and plasma blasting was performed in these oil contaminated soil. Cleaning efficiency increased by average of 393% for soil located nearby the blasting and by average of 239% for soil located far from the blasting. Cleaning efficiency did not show any correlation with discharge voltage. All these results indicated that plasma blasting might be used for in-situ cleaning of oil contaminated soil because plasma blasting increased permeability of soil and cleaning efficiency.

Estimation of Soil Moisture Using Sentinel-1 SAR Images and Multiple Linear Regression Model Considering Antecedent Precipitations (선행 강우를 고려한 Sentinel-1 SAR 위성영상과 다중선형회귀모형을 활용한 토양수분 산정)

  • Chung, Jeehun;Son, Moobeen;Lee, Yonggwan;Kim, Seongjoon
    • Korean Journal of Remote Sensing
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    • v.37 no.3
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    • pp.515-530
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    • 2021
  • This study is to estimate soil moisture (SM) using Sentinel-1A/B C-band SAR (synthetic aperture radar) images and Multiple Linear Regression Model(MLRM) in the Yongdam-Dam watershed of South Korea. Both the Sentinel-1A and -1B images (6 days interval and 10 m resolution) were collected for 5 years from 2015 to 2019. The geometric, radiometric, and noise corrections were performed using the SNAP (SentiNel Application Platform) software and converted to backscattering coefficient of VV and VH polarization. The in-situ SM data measured at 6 locations using TDR were used to validate the estimated SM results. The 5 days antecedent precipitation data were also collected to overcome the estimation difficulty for the vegetated area not reaching the ground. The MLRM modeling was performed using yearly data and seasonal data set, and correlation analysis was performed according to the number of the independent variable. The estimated SM was verified with observed SM using the coefficient of determination (R2) and the root mean square error (RMSE). As a result of SM modeling using only BSC in the grass area, R2 was 0.13 and RMSE was 4.83%. When 5 days of antecedent precipitation data was used, R2 was 0.37 and RMSE was 4.11%. With the use of dry days and seasonal regression equation to reflect the decrease pattern and seasonal variability of SM, the correlation increased significantly with R2 of 0.69 and RMSE of 2.88%.

Preparation of Novel Natural Polymer-based Magnetic Hydrogels Reinforced with Hyperbranched Polyglycerol (HPG) Responsible for Enhanced Mechanical Properties (과분지 폴리글리세롤(HPG) 강화를 통해 기계적 물성이 향상된 새로운 천연 고분자 기반 자성 하이드로젤의 제조)

  • Eun-Hye Jang;Jisu Jang;Sehyun Kwon;Jeon-Hyun Park;Yujeong Jeong;Sungwook Chung
    • Clean Technology
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    • v.29 no.1
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    • pp.10-21
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    • 2023
  • Hydrogels that are made of natural polymer-based double networks have excellent biocompatibility, low cytotoxicity, and high water content, assuring that the material has the properties required for a variety of biomedical applications. However, hydrogels also have limitations due to their relatively weak mechanical properties. In this study, hydrogels based on an alginate di-aldehyde (ADA) and gelatin (Gel) double network that is reinforced with additional hydrogen bonds formed between the hydroxyl (-OH) groups of the hyperbranched polymer (HPG) and the functional groups present inside of the hydrogels were successfully synthesized. The enhanced mechanical properties of these synthesized hydrogels were evaluated by varying the amount of HPG added during the hydrogel synthesis from 0 to 25%. In addition, magnetite nanoparticles (Fe3O4 NPs) were synthesized within the hydrogels and the structures and the magnetic properties of the hydrogels were also characterized. The hydrogels that contained 15% HPG and Fe3O4 NPs exhibited superparamagnetic behaviors with a saturation magnetization value of 3.8 emu g-1. These particular hydrogels also had strengthened mechanical properties with a maximum compressive stress of 1.1 MPa at a strain of 67.4%. Magnetic hydrogels made with natural polymer-based double networks provide improved mechanical properties and have a significant potential for drug delivery and biomaterial application.

Estimation for Ground Air Temperature Using GEO-KOMPSAT-2A and Deep Neural Network (심층신경망과 천리안위성 2A호를 활용한 지상기온 추정에 관한 연구)

  • Taeyoon Eom;Kwangnyun Kim;Yonghan Jo;Keunyong Song;Yunjeong Lee;Yun Gon Lee
    • Korean Journal of Remote Sensing
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    • v.39 no.2
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    • pp.207-221
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    • 2023
  • This study suggests deep neural network models for estimating air temperature with Level 1B (L1B) datasets of GEO-KOMPSAT-2A (GK-2A). The temperature at 1.5 m above the ground impact not only daily life but also weather warnings such as cold and heat waves. There are many studies to assume the air temperature from the land surface temperature (LST) retrieved from satellites because the air temperature has a strong relationship with the LST. However, an algorithm of the LST, Level 2 output of GK-2A, works only clear sky pixels. To overcome the cloud effects, we apply a deep neural network (DNN) model to assume the air temperature with L1B calibrated for radiometric and geometrics from raw satellite data and compare the model with a linear regression model between LST and air temperature. The root mean square errors (RMSE) of the air temperature for model outputs are used to evaluate the model. The number of 95 in-situ air temperature data was 2,496,634 and the ratio of datasets paired with LST and L1B show 42.1% and 98.4%. The training years are 2020 and 2021 and 2022 is used to validate. The DNN model is designed with an input layer taking 16 channels and four hidden fully connected layers to assume an air temperature. As a result of the model using 16 bands of L1B, the DNN with RMSE 2.22℃ showed great performance than the baseline model with RMSE 3.55℃ on clear sky conditions and the total RMSE including overcast samples was 3.33℃. It is suggested that the DNN is able to overcome cloud effects. However, it showed different characteristics in seasonal and hourly analysis and needed to append solar information as inputs to make a general DNN model because the summer and winter seasons showed a low coefficient of determinations with high standard deviations.

Treatment Results of Radical Radiotherapy in Uterine Cervix Cancer (자궁경부암 환자의 근치적 방사선치료성적)

  • Huh Seung Jae;Kim Bo Kyong;Lim Do Hoon;Shin Seong Soo;Lee Jeong Eun;Kang Min Kyu;Ahn Yong Chan
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.237-245
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    • 2002
  • Purpose : This study was conducted to evaluate the treatment results, prognostic factors, and complication rates after high dose rate (HDR) brachytherapy in patients with uterine cervix cancer who were treated with curative aim. Materials and Methods : Of 269 cervix cancer patients treated at the department of radiation oncology, Samsung Medical Center from September 1994 to July 1998, the 106 who were treated with radical radio-therapy were analyzed. The median age was 61 years (range 22 to 89). All patients except 4 with carcinoma in situ (CIS) were given external beam radiotherapy (range $30.6\~50.4\;Gy$ to whole pelvis) and HDR brachytherapy. The common regimens of HDR brachytherapy were a total dose of $24\~28\;Gy$ with $6\~7$ fractions to point A at two fractions per week. The median overall treatment time was 55 days (range 44 to 104) in patients given both external beam radiotherapy and HDR brachytherapy. Results : Early responses of radiotherapy were evaluated by gynecologic examination and follow-up MRI 1 month after radiotherapy. Treatment responses were complete remission in 72 patients, partial response in 33 and no response in 1. The overall survival (OS) rate of all patients was $82\%,\;and\;73\%$, and the disease free survival (DFS) rate was $72\%,\;and\;69\%$, at 3, and 5 years, respectively. The pelvic control rate (PCR) was $79\%$ at both 3 and 5 years. According to the FIGO stage,3 and 5 year OS were $100\%\;and\;50\%$ in CIS/IA, $100\%\;and\;100%$ in IB, $83\%\;and\;69\%$ in IIA, $87\%\;and\;80\%$ in IIB, and $62\%\;and\;62\%$ in III, respectively. The 3 year OS in 4 patients with stage IVA was $100\%$. Three-year DFS were $80\%$ in CIS/IA, $88\%$ in IB, $100\%$ in IIA, $64\%$ in IIB, $58\%$ in III, and $75\%$ in IVA. Three-year PCR were $100\%$ in CIS/IA, $94\%$ in IB, $100\%$ in IIA, $84\%$ in IIB, $69\%$ in III, and $50\%$ in IVA. By univariate analysis, FIGO stage and treatment response were significant factors for OS. The significant factors for DFS were age, FIGO stage, treatment response and overall treatment time (OTT). For pelvic control rate, treatment response and OTT were significant factors. By multivariate analysis, FIGO stage had a borderline significance for OS (p=0.0825) and treatment response had a borderline significance for DFS (0=0.0872). A total of 14 patients $(13\%)$ experienced rectal bleeding, which occurred from 3 to 44 months (median, 13 months) after the completion of radiotherapy. Conclusion : HDR brachytherapy protocol of Samsung Medical Center combined with properly optimal external beam pelvic irradiation is a safe and effective treatment for patients with uterine cervix cancer. The authors found that OTT of less than 55 days had a positive impact on pelvic control and survival rate.