• Childhood Kidney Diseases
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• v.4 no.1
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• pp.17-24
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• 2000

Purpose: MCNS is found in approximately $85\%$ of the idiopathic nephrotic syndrome in children and shows good prognosis with initial steroid therapy. However in FSGS, there is poor prognosis with initial therapy and shows higher rate of progression to chronic renal failure and relapse after kindney transplantation. We have experienced 8 patients who were diagnosed as MCNS on initial renal biopsy and then progressed to FSGS on follow-up biopsy. So we have investigated their clinical course and risk factors for transition of MCNS to FSGS. Methods: We conducted a retrospective study with a review of histopathologic findings and clinical manifestations of 296 cases of MCNS and FSGS that were diagnosed from January 1988 to May 1999. We classified them into 3 groups according to the histopathologic finding; MCNS, FSGS, MCNS progressed to FSGS in follow-up biopsy. Results: The number of children was 296 cases comprising 241 cases($81.4\%$) showing MCNS, 8 cases($2.7\%$) transition group, 47 cases($15.9\%$) FSGS. The mean onset age was $6.0{\pm}2.6$years in MCNS, transition group $8.3{\pm}2.3$years, FSGS $7.2{\pm4.3$years, and the gender (M:F) ratio was 3.7:1 in MCNS, 3:1 in transition group, 1.8:1 in FSGS. Comparing the presence of initial hematuria, hypertension,24 hour urine protein, serum albumin, serum creatinine, there were significant difference between the transition group and the FSGS group in the following points; 24hour urine protein $684:342mg/m^2/hr$(P<0.05), serum albumin 1.92: 2.47g/dL(P<0.05), serum cholesterol 494:343mg/dL(P<0.05). Refractoriness to steroid therapy was 13.3$\%$ in MCNS. $12.5\%$ in transition group, $29.6\%$ in FSGS; significantly higher in FSGS(P<0.05). Immunosuppressant therapy was performed in $58.5\%$ of MCNS, $100\%$ in transition group, $80.8\%$ in FSGS; transition group showed significantly higher .ate(P<0.05) comparing with MCNS. Mean number of relapse and duration from onset to first relapse showed no significance difference between these groups. Conclusion: 249 patients with MCNS have been followed and $3.2\%$ (8 patients) of them has shown change in pathologic diagnosis from MCNS to FSCS. The risk factor for transition could not be found. Our results point to the need for a follow-up biopsy to certify the possibility of transition to FSCS in some MCNS cases with refractory cases to steroid therepy, frequent relapsing cases, or in case of no remission in spite of vigorous immunosuppressant therapy.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.817-824
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• 2007

Background: There are two choices for heart valve replacement-the use of a tissue valve and the use of a mechanical valve. Using a tissue valve, additional surgery will be problematic due to valve degeneration. If the risk of additional surgery could be reduced, the tissue valve could be more widely used. Therefore, we analyzed the risk factors and mortality of patients undergoing repeated heart valve replacement and primary replacement. Material and Method: We analyzed 25 consecutive patients who underwent repeated heart valve replacement and 158 patients who underwent primary heart valve replacement among 239 patients that underwent heart vale replacement in out hospital from January 1995 to December 2004. Result: There were no differences in age, sex, and preoperative ejection fraction between the repeated valve replacement group of patients and the primary valve replacement group of patients. In the repeated valve replacement group, the previously used artificial valves were 3 mechanical valves and 23 tissue valves. One of these cases had simultaneous replacement of the tricuspid and aortic valve with tissue valves. The mean duration after a previous operation was 92 months for the use of a mechanical valve and 160 months for the use of a tissue valve. The mean cardiopulmonary bypass time and aortic cross clamp time were 152 minutes and 108 minutes, respectively, for the repeated valve replacement group of patients and 130 minutes and 89 minutes, respectively, for the primary valve replacement group of patients. These results were statistically significant. The use of an intra aortic balloon pump (IABP) was required for 2 cases (8%) in the repeated valve replacement group of patients and 6 cases (3.8%) in the primary valve replacement group of patients. An operative death occurred in one case (4%) in the repeated valve replacement group of patients and occurred in nine cases (5.1%) in the primary valve replacement group of patients. Among postoperative complications, the need for mechanical ventilation over 48 hours was different between the two groups. The mean follow up period after surgery was $6.5{\pm}3.2$ years. The 5-year survival of patients in the repeated valve replacement group was 74% and the 5-year survival of patients in the primary valve replacement group was 95%. Conclusion: The risk was slightly increased, but there was little difference in mortality between the repeated and primary heart valve replacement group of patients. Therefore, it is necessary to reconsider the issue of avoiding the use of a tissue valve due to the risk of additional surgery, and it is encouraged to use the tissue valve selectively, which has several advantages over the use of a mechanical valve. In the case of a repeated replacement, however, the mortality rate was high for a patient whose preoperative status was not poor. A proper as sessment of cardiac function and patient status is required after the primary valve replacement. Subsequently, a secondary replacement could then be considered.

• Clinics in Shoulder and Elbow
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• v.15 no.2
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• pp.86-90
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• 2012

Purpose: We studied the need for distal clavicle resection by comparing rotator cuff tear patients who underwent non-surgical treatment with and without acromioclavicular joint pathology. Materials and Methods: 45 cases that had been under follow up care for at least 9 months after receiving rotator cuff repair in our hospital between Jan. 2005 and Jun. 2011 had been studied. Acromioclavicular joint pathology group and control group were classified by physical examination and MRI findings. The temporal changes in shoulder joint abduction, internal and external rotation strength, ASES and KSS score of the two groups were measured and analyzed. Results: The acromioclavicular joint pathology complicated rotator cuff injury group's strength measurements for abduction, internal rotation, external rotation were each 8.05 (${\pm}4.54$), 11.33 (${\pm}6.05$), 10.24 (${\pm}5.27$) preoperatively and improved to 13.26 (${\pm}5.50$), 17.51 (${\pm}6.80$), 15.60 (${\pm}5.37$) post operatively while the KSS score and ASES score were each 49.07 (${\pm}15.28$) and 48.65 (${\pm}13.27$) preoperatively, improving to 84.48 (${\pm}10.96$) and 84.65. (${\pm}9.86$). The measurements for the group without complicating acromioclavicular pathology are as follows. The strength for abduction, internal rotation, external rotation was each 6.42 (${\pm}3.11$), 7.59 (${\pm}4.81$) and 7.93 (${\pm}4.49$) preoperatively, improving to 15.85 (${\pm}7.35$), 19.18 (${\pm}9.14$), 16.95 (${\pm}5.70$) post operatively, while the KSS score and ASES score each went from 42.12 (${\pm}6.43$) and 41.37 (${\pm}7.42$) to 83.44 (${\pm}6.30$) and 83.17 (${\pm}7.01$) respectively. The measurements for the two groups, however, did not show a statistically significant difference (p>0.05). Conclusion: Analysis of the rotator cuff injury groups with and without AC joint pathology showed that both groups had improved strength, ASES and KSS scores with no statistical difference difference among the groups. As such, it thought that conservative treatment is an acceptable alternative to distal clavicle resection.

• Journal of Intelligence and Information Systems
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• v.24 no.1
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• pp.183-203
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• 2018

News articles are the most suitable medium for examining the events occurring at home and abroad. Especially, as the development of information and communication technology has brought various kinds of online news media, the news about the events occurring in society has increased greatly. So automatically summarizing key events from massive amounts of news data will help users to look at many of the events at a glance. In addition, if we build and provide an event network based on the relevance of events, it will be able to greatly help the reader in understanding the current events. In this study, we propose a method for extracting event networks from large news text data. To this end, we first collected Korean political and social articles from March 2016 to March 2017, and integrated the synonyms by leaving only meaningful words through preprocessing using NPMI and Word2Vec. Latent Dirichlet allocation (LDA) topic modeling was used to calculate the subject distribution by date and to find the peak of the subject distribution and to detect the event. A total of 32 topics were extracted from the topic modeling, and the point of occurrence of the event was deduced by looking at the point at which each subject distribution surged. As a result, a total of 85 events were detected, but the final 16 events were filtered and presented using the Gaussian smoothing technique. We also calculated the relevance score between events detected to construct the event network. Using the cosine coefficient between the co-occurred events, we calculated the relevance between the events and connected the events to construct the event network. Finally, we set up the event network by setting each event to each vertex and the relevance score between events to the vertices connecting the vertices. The event network constructed in our methods helped us to sort out major events in the political and social fields in Korea that occurred in the last one year in chronological order and at the same time identify which events are related to certain events. Our approach differs from existing event detection methods in that LDA topic modeling makes it possible to easily analyze large amounts of data and to identify the relevance of events that were difficult to detect in existing event detection. We applied various text mining techniques and Word2vec technique in the text preprocessing to improve the accuracy of the extraction of proper nouns and synthetic nouns, which have been difficult in analyzing existing Korean texts, can be found. In this study, the detection and network configuration techniques of the event have the following advantages in practical application. First, LDA topic modeling, which is unsupervised learning, can easily analyze subject and topic words and distribution from huge amount of data. Also, by using the date information of the collected news articles, it is possible to express the distribution by topic in a time series. Second, we can find out the connection of events in the form of present and summarized form by calculating relevance score and constructing event network by using simultaneous occurrence of topics that are difficult to grasp in existing event detection. It can be seen from the fact that the inter-event relevance-based event network proposed in this study was actually constructed in order of occurrence time. It is also possible to identify what happened as a starting point for a series of events through the event network. The limitation of this study is that the characteristics of LDA topic modeling have different results according to the initial parameters and the number of subjects, and the subject and event name of the analysis result should be given by the subjective judgment of the researcher. Also, since each topic is assumed to be exclusive and independent, it does not take into account the relevance between themes. Subsequent studies need to calculate the relevance between events that are not covered in this study or those that belong to the same subject.

• Journal of Global Scholars of Marketing Science
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• v.20 no.2
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• pp.179-187
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• 2010

Understanding consumers' preferences and use of media types is imperative for marketing and advertising managers, especially in today's fragmented market. A clear understanding assists managers in making more effective selections of appropriate media outlets, yet individuals' choices of type and use of media are based on a variety of characteristics. This paper examines one personality trait, sensation seeking, which has not appeared in the literature examining "new" media preferences and use. Sensation seeking is a personality trait defined as "the need for varied, novel, and complex sensations and experiences and the willingness to take physical and social risks for the sake of such experiences" (Zuckerman 1979). Six hypotheses were developed from a review of the literature. Particular attention was given to the Uses and Gratification theory (Katz 1959), which explains various reasons why people choose media types and their motivations for using the different types of media. Current theory suggests that High Sensation Seekers (HSS), due to their needs for novelty, arousal and unconventional content and imagery, would exhibit higher frequency of use of new media. Specifically, we hypothesize that HSS will use the internet more than broadcast (H1a) or print media (H1b) and more than low (LSS) (H2a) or medium sensation seekers (MSS) (H2b). In addition, HSS have been found to be more social and have higher numbers of friends therefore are expected to use social networking websites such as Facebook/MySpace (H3) and chat rooms (H4) more than LSS (a) and MSS (b). Sensation seekers can manifest into a range of behaviors including disinhibition,. It is expected that alternative social networks such as Facebook/MySpace (H5) and chat rooms (H6) will be used more often for those who have higher levels of disinhibition than low (a) or medium (b) levels. Data were collected using an online survey of participants in extreme sports. In order to reach this group, an improved version of a snowball sampling technique, chain-referral method, was used to select respondents for this study. This method was chosen as it is regarded as being effective to reach otherwise hidden population groups (Heckathorn, 1997). A final usable sample of 1108 respondents, which was mainly young (56.36% under 34), male (86.1%) and middle class (58.7% with household incomes over USD 50,000) was consistent with previous studies on sensation seeking. Sensation seeking was captured using an existing measure, the Brief Sensation Seeking Scale (Hoyle et al., 2002). Media usage was captured by measuring the self reported usage of various media types. Results did not support H1a and b. HSS did not show higher levels of usage of alternative media such as the internet showing in fact lower mean levels of usage than all the other types of media. The highest media type used by HSS was print media, suggesting that there is a revolt against the mainstream. Results support H2a and b that HSS are more frequent users of the internet than LSS or MSS. Further analysis revealed that there are significant differences in the use of print media between HSS and LSS, suggesting that HSS may seek out more specialized print publications in their respective extreme sport activity. Hypothesis 3a and b showed that HSS use Facebook/MySpace more frequently than either LSS or MSS. There were no significant differences in the use of chat rooms between LSS and HSS, so as a consequence no support for H4a, although significant for MSS H4b. Respondents with varying levels of disinhibition were expected to have different levels of use of Facebook/MySpace and chat-rooms. There was support for the higher levels of use of Facebook/MySpace for those with high levels of disinhibition than low or medium levels, supporting H5a and b. Similarly there was support for H6b, Those with high levels of disinhibition use chat-rooms significantly more than those with medium levels but not for low levels (H6a). The findings are counterintuitive and give some interesting insights for managers. First, although HSS use online media more frequently than LSS or MSS, this groups use of online media is less than either print or broadcast media. The advertising executive should not place too much emphasis on online media for this important market segment. Second, social media, such as facebook/Myspace and chatrooms should be examined by managers as potential ways to reach this group. Finally, there is some implication for public policy by the higher levels of use of social media by those who are disinhibited. These individuals are more inclined to engage in more socially risky behavior which may have some dire implications, e.g. by internet predators or future employers. There is a limitation in the study in that only those who engage in extreme sports are included. This is by nature a HSS activity. A broader population is therefore needed to test if these results hold.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.94-102
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• 2001

Bullying has recently become a serious social problem in Korean society. Bullying, which is defined as a phenomenon that one particular student is intensively and continuously harassed or ostracized by a group of students, is apt to produce harmful effects on bullies as well as victims. Bullying has many causes including those originated from the personality of victims and bullies. This study is designed to investigate the difference in personality trait between victims, bullies, victims/bullies, and neither. The subjects of this study were 215(115 male and 100 female) 6th-grade students in the primary school in Seoul. Questionnares were distributed to the students and their carers. The student carers were also asked to answer the questions for a survey called the Korean Personality Invertory for Children(KPI-C). SPSS was used for the statistical analysis of the collected test information；ANOVA, post hoc scheffe test, and T-test were used to analyze the differences between the tested groups. The result of the study is as follows. 1) The victims, bullies, victims/bullies and neither totaled respectively 11(5.1%), 56(26.0%), 11(5.1%) and 137(63.7%). 115 were male and 100 were female. 2) The frequency of victimized is as follows：1 time is 15(7.0%), 2 times is 4(1.9%) and more than 3 times is 3(1.4%). The frequency of bullying is as follows；1 time is 40(18.6%), 2 times is 17 (7.9%) and more than 3 times is 10(4.7%). 3) The differences between froups in KPI-C test is as follows. (1) The ESR(p=.00) scale was significantly lower in the victims group than in the neither group and the HPR(p=.00) scale and PSY(p<.01) scale were significantly higher in the former than in the latter. (2) The ESR(p=.00) scale was significantly lower in the victims/bullies group than in the neither group and the SOM(p=.00) scale and HPR(p=.00) scale were significantly higher in the formaer than in the latter. (3) The SOC(p=.00) scale, PSY(p<.01) scale and AUT(p=.00) scale were significantly higher in the victims group than in the bullies group. (4) There is statistically no difference between the bullies group and the neither group. To conclusion, Victims need to learn how to cope with harsh situations, or they will have to face difficulties in relationships. Even after they experience bullying, they may not realize why they have been bullied, or speak out for themselves.

• Journal of Food Hygiene and Safety
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• v.13 no.4
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• pp.441-447
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• 1998

This study was performed to investigate the changes of amount of S. typhimurium during cooking processes using pork and japchae (a Korean food which is made from meat, vegetables and noodles), and to support a practical application to develop a hazard analysis critical control point (HACCP) model. The pork was purchased in a retail shop, cut ($0.5\;cm\;{\times}\;10\;cm\;{\times}\;10\;cm$, 25 g), tested for Salmonella contamination (results: negative), inoculated with S. typhimurium ($10^{7}\;CFU/g$), then treated in various conditions related to cooking. Mter thawing for 24 hours in various conditions, the number of S. typhimurium was increased to $10^{10}\;CFU/g$ at a refrigerated temperature ($4~10^{\circ}C$), and to $10^{21}\;CFU/g$ at room temperature ($22~29^{\circ}C$). Mter thawing in a microwave oven for 40 seconds, the number of S. typhimurium increased to $10^{8}\;CFU/g$. During the thawing period, the number of S. typhimurium increased over time. At the refrigerated temperature, the number of the bacteria was $10^{10}\;CFU/g$ after 24 hours, $10^{13}\;CFU/g$ after 48 hours, and $10^{20}\;CFU/g$ after 72 hours. At room temperature the number of bacteria reached $10^{11}\;CFU/g$ in 2 hours, $10^{15}\;CFU/g$ in 4 hours, $10^{16}\;CFU/g$ in 8 hours, $10^{18}\;CFU/g$ in 12 hours, and $10^{21}\;CFU/g$ in 24 hours. Mter cooking in a frying pan (150{\pm}7^{\circ}C$) for 3 minutes, the bacterial count was $10^{16}\;CFU/g$. After cooking in hot water for 20 minutes, the bacterial count was $10^{7}\;CFU/g\;at\;60^{\circ}C,\;10^{6}\;CFU/g\;at\;63^{\circ}C,\;and\;10^{4}\;CFU/g\;at\;65^{\circ}C$. The fried pork was mixed with cooked vegetables, noodles, sesame oil, sesame seeds, and seasonings to make Korean japchae. This process took $10{\pm}2$ minutes. The bacterial count in the japchae increased to $10^{7}\;CFU/g$ from the count of $10^{6}\;CFU/g$ of the fried pork before it was mixed with the other ingredients. These results indicate that the amount of S. typhimurium is effected by various different cooking processes. This study can suggest that pork should be cooked in water at over $65^{\circ}C$ for 20 minutes in order to prevent food poisoning, if the pork is contaminated with S. typhimurium. The presence of S. typhimurium in the raw pork is identified in an HA for japchae, and the primary CCP for japchae is inadequate cooking (cooking method and time/temperature). We need to standardize time-temperature-size and amount of pork in cooking japchae, because pork is usually cooked in ordinary frying pans when we make this food.

• Journal of Distribution Research
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• v.16 no.1
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• pp.95-115
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• 2011

Food service is the major part of franchise business in Korea, accounting for 69.9% of the brands in the market. As the food service industry becomes mature, many franchisees have struggled to survive in the market. In general, consumers have higher levels of expectation toward service quality of franchised outlets compared that of (non-franchised) independent ones. They also tend to believe that franchisees deliver standardized service at the uniform food price, regardless of their locations. Such beliefs seem to be important reasons that consumers prefer franchised outlets to independent ones. Nevertheless, few studies examined the impact of qualify features of franchisees on customer satisfaction so far. To this end, this study examined the characteristics of various quality features of franchisees in the food service industry, regarding their relationship with customer satisfaction and dissatisfaction. The quality perception of heavy-users was also compared with that of light-users in order to find insights for developing differentiated marketing strategy for the two segments. Customer satisfaction has been understood as a one-dimensional construct while there are recent studies that insist two-dimensional nature of the construct. In this regard, Kano et al. (1984) suggested to categorize quality features of a product or service into five types, based on their relation to customer satisfaction and dissatisfaction: Must-be quality, Attractive quality, One-dimensional quality, Indifferent quality, and Reverse quality. According to the Kano model, customers are more dissatisfied when Must-be quality(M) are not fulfilled, but their satisfaction does not arise above neutral no matter how fully the quality fulfilled. In comparison, customers are more satisfied with a full provision of Attactive quality(A) but manage to accept its dysfunction. One-dimensional quality(O) results in satisfaction when fulfilled and dissatisfaction when not fulfilled. For Indifferent quality(I), its presence or absence influences neither customer satisfaction nor dissatisfaction. Lastly, Reverse quality(R) refers to the features whose high degree of achievement results in customer dissatisfaction rather than satisfaction. Meanwhile, the basic guidelines of the Kano model have a limitation in that the quality type of each feature is simply determined by calculating the mode statistics. In order to overcome such limitation, the relative importance of each feature on customer satisfaction (Better value; b) and dissatisfaction (Worse value; w) were calculated following the formulas below (Timko, 1993). The Better value indicates how much customer satisfaction is increased by providing the quality feature in question. In contrast, the Worse value indicates how much customer dissatisfaction is decreased by providing the quality feature. Better = (A + O)/(A+O+M+I) Worse = (O+M)/(A+O+M+I)(-1) An on-line survey was performed in order to understand the nature of quality features of franchisees in the food service industry by applying the Kano Model. A total of twenty quality features (refer to the Table 2) were identified as the result of literature review in franchise business and a pre-test with fifty college students in Seoul. The potential respondents of our main survey was limited to the customers who have visited more than two restaurants/stores of the same franchise brand. Survey invitation e-mails were sent out to the panels of a market research company and a total of 257 responses were used for analysis. Following the guidelines of Kano model, each of the twenty quality features was classified into one of the five types based on customers' responses to a set of questions: "(1) how do you feel if the following quality feature is fulfilled in the franchise restaurant that you visit," and "(2) how do you feel if the following quality feature is not fulfilled in the franchise restaurant that you visit." The analyses revealed that customers' dissatisfaction with franchisees is commonly associated with the poor level of cleanliness of the store (w=-0.872), kindness of the staffs(w=-0.890), conveniences such as parking lot and restroom(w=-0.669), and expertise of the staffs(w=-0.492). Such quality features were categorized as Must-be quality in this study. While standardization or uniformity across franchisees has been emphasized in franchise business, this study found that consumers are interested only in uniformity of price across franchisees(w=-0.608), but not interested in standardizations of menu items, interior designs, customer service procedures, and food tastes. Customers appeared to be more satisfied when the franchise brand has promotional events such as giveaways(b=0.767), good accessibility(b=0.699), customer loyalty programs(b=0.659), award winning history(b=0.641), and outlets in the overseas market(b=0.506). The results are summarized in a matrix form in Table 1. Better(b) and Worse(w) index indicate relative importance of each quality feature on customer satisfaction and dissatisfaction, respectively. Meanwhile, there were differences in perceiving the quality features between light users and heavy users of any specific franchise brand in the food service industry. Expertise of the staffs was labeled as Must-be quality for heavy users but Indifferent quality for light users. Light users seemed indifferent to overseas expansion of the brand and offering new menu items on a regular basis, while heavy users appeared to perceive them as Attractive quality. Such difference may come from their different levels of involvement when they eat out. The results are shown in Table 2. The findings of this study help practitioners understand the quality features they need to focus on to strengthen the competitive power in the food service market. Above all, removing the factors that cause customer dissatisfaction seems to be the most critical for franchisees. To retain loyal customers of the franchise brand, it is also recommended for franchisor to invest resources in the development of new menu items as well as training programs for the staffs. Lastly, if resources allow, promotional events, loyalty programs, overseas expansion, award-winning history can be considered as tools for attracting more customers to the business.

• Radiation Oncology Journal
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• v.15 no.2
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• pp.121-128
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• 1997

Purpose : To evaluate the effect of postoperative adjuvant radiation therapy and chemotherapy on the survival, pattern of failure and complication for locally advanced rectal carcinoma Materials and Methods : From October 1992 to September 1995, twenty eight patients with rectal carcinoma were treated by postoperative adjuvant radiation therapy and chemotherapy Radiation therapy was delivered with 6MV and 15MV linear accelerator, 180c0y fractions 5 day per week. Total radiation doses were 5040cGy in $B_{2+3}$ and 5580cGy in $C_{2+3}$. Within 4 weeks after radical surgery. 5-FU$(400mg/m^2/day)\;and\;Leucovorin(20mg/m^2/day)$ were administered by intravenous injection for 4 days during the first and fifth week of radiation therapy. The median follow up was 19 months with a range 2 to 47 months. Results : The 2 year overall survival and disease free survival rates were $78.6\%\;and\;70.8\%$, respectively. The 2 year overall survival was $93.0\%\;in\;B_{2+3}$ and $76.2\%\;in\;C_{2+3}$(p=0.11) The 2 year disease free survival was $79.4\%\;in\;B_{2+3}\;and\;69.2\%\;in\;C_{2+3}(p=0.13)$. The overall failure rate was $21.42\%$(6/28) including $10.72\%$(3/28) locoregional recurrence, $3.62\%$(1/28) distant metastasis and $7.12\%$(2/28) locoregional recurrence with distant metastasis. The overall locoregional recurrence rate was $17.92\%$(5/28). The 2 year locoregional recurrence rates were $13.32\%(2/15)\;and\;23.12\%$(3/13) for respectively for $B_{2+3}\;and\;C_{2+3}$ The difference between the locoregional recurrence of $B_{2+3}\;and\;C_{2+3}$ patients was not significant(p=0.07). Complications developed in 13 patients$(46.42\%)$, including 8 dermatitis, 7 loose stool, 6 leukopenia, 4 tenesmus, 2 diarrhea. In Univariate analysis, there was no statistically significant factor except for tumor grade in locoregional recurrence, disease free survival and overall survival rate(p=0.04, 0.05, 0.04). Conclusion : This study sugges1s that postoperative adjuvant radiation therapy and chemotherapy is effective in patients with locally advanced rectal cancer. Therefore these results need to be confirmed with a long term follow-up and larger number of patients with the further clinical trials including prospective controlled studies.

• Radiation Oncology Journal
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• v.22 no.3
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• pp.165-176
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• 2004

Purpose: Firstly, to analyze facto in terms of radiation treatment that might potentially cause subfrontal relapse in two patients who had been treated by craniospinal irradiation (CSI) for medulloblastoma, Secondly, to explore an effective salvage treatment for these relapses. Materials and Methods: Two patients who had high-risk disease (T3bMl, T3bM3) were treated with combined chemoradiotherapy CT-simulation based radiation-treatment planning (RTP) was peformed. One patient who experienced relapse at 16 months after CSI was treated with salvage surgery followed by a 30.6 Gy IMRT (intensity modulated radiotherapy). The other patient whose tumor relapsed at 12 months after CSI was treated by surgery alone for the recurrence. To investigate factors that might potentially cause subfrontal relapse, we evaluated thoroughly the charts and treatment planning process including portal films, and tried to find out a method to give help for placing blocks appropriately between subfrotal-cribrifrom plate region and both eyes. To salvage subfrontal relapse in a patient, re-irradiation was planned after subtotal tumor removal. We have decided to treat this patient with IMRT because of the proximity of critical normal tissues and large burden of re-irradiation. With seven beam directions, the prescribed mean dose to PTV was 30.6 Gy (1.8 Gy fraction) and the doses to the optic nerves and eyes were limited to 25 Gy and 10 Gy, respectively. Results: Review of radiotherapy Portals clearly indicated that the subfrontal-cribriform plate region was excluded from the therapy beam by eye blocks in both cases, resulting in cold spot within the target volume, When the whole brain was rendered in 3-D after organ drawing in each slice, it was easier to judge appropriateness of the blocks in port film. IMRT planning showed excellent dose distributions (Mean doses to PTV, right and left optic nerves, right and left eyes: 31.1 Gy, 14.7 Gy, 13.9 Gy, 6.9 Gy, and 5.5 Gy, respectively. Maximum dose to PTV: 36 Gy). The patient who received IMRT is still alive with no evidence of recurrence and any neurologic complications for 1 year. Conclusion: To prevent recurrence of medulloblastoma in subfrontal-cribriform plate region, we need to pay close attention to the placement of eye blocks during the treatment. Once subfrontal recurrence has happened, IMRT may be a good choice for re-irradiation as a salvage treatment to maximize the differences of dose distributions between the normal tissues and target volume.