• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4603-4608
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• 2015

Background: To determine the potential value of serum tumor markers in predicting pCR (pathological complete response) during neoadjuvant chemotherapy. Materials and Methods: We retrospectively monitored the pro-, mid-, and post-neoadjuvant treatment serum tumor marker concentrations in patients with locally advanced breast cancer (stage II-III) who accepted pre-surgical chemotherapy or chemotherapy in combination with targeted therapy at Fudan University Shanghai Cancer Center between September 2011 and January 2014 and investigated the association of serum tumor marker levels with therapeutic effect. Core needle biopsy samples were assessed using immunohistochemistry (IHC) prior to neoadjuvant treatment to determine hormone receptor, human epidermal growth factor receptor 2(HER2), and proliferation index Ki67 values. In our study, therapeutic response was evaluated by pCR, defined as the disappearance of all invasive cancer cells from excised tissue (including primary lesion and axillary lymph nodes) after completion of chemotherapy. Analysis of variance of repeated measures and receiver operating characteristic (ROC) curves were employed for statistical analysis of the data. Results: A total of 348 patients were recruited in our study after excluding patients with incomplete clinical information. Of these, 106 patients were observed to have acquired pCR status after treatment completion, accounting for approximately 30.5% of study individuals. In addition, 147patients were determined to be Her-2 positive, among whom the pCR rate was 45.6% (69 patients). General linear model analysis (repeated measures analysis of variance) showed that the concentration of cancer antigen (CA) 15-3 increased after neoadjuvant chemotherapy in both pCR and non-pCR groups, and that there were significant differences between the two groups (P=0.008). The areas under the ROC curves (AUCs) of pre-, mid-, and post-treatment CA15-3 concentrations demonstrated low-level predictive value (AUC=0.594, 0.644, 0.621, respectively). No significant differences in carcinoembryonic antigen (CEA) or CA12-5 serum levels were observed between the pCR and non-pCR groups (P=0.196 and 0.693, respectively). No efficient AUC of CEA or CA12-5 concentrations were observed to predict patient response toward neoadjuvant treatment (both less than 0.7), nor were differences between the two groups observed at different time points. We then analyzed the Her-2 positive subset of our cohort. Significant differences in CEA concentrations were identified between the pCR and non-pCR groups (P=0.039), but not in CA15-3 or CA12-5 levels (p=0.092 and 0.89, respectively). None of the ROC curves showed underlying prognostic value, as the AUCs of these three markers were less than 0.7. The ROC-AUCs for the CA12-5 concentrations of inter-and post-neoadjuvant chemotherapy in the estrogen receptor negative HER2 positive subgroup were 0.735 and 0.767, respectively. However, the specificity and sensitivity values were at odds with each other which meant that improving either the sensitivity or specificity would impair the efficiency of the other. Conclusions: Serum tumor markers CA15-3, CA12-5, and CEA might have little clinical significance in predicting neoadjuvant treatment response in locally advanced breast cancer.

• Korean Journal of Environment and Ecology
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• v.34 no.4
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• pp.294-303
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• 2020

This study aimed to examine was conducted to the ability of microclimate control in old pine forests by surveying pine forest in Buddhist temples, where the pine forest are stably growing through active protection in the Gyeongnam region, and comparing variation characteristics of microclimate characteristics (temperature and humidity) and distribution of vegetation type. The study sites were pine forests protected well by Buddhist temples (Haein-sa, Beomeo-sa, Tongdo-sa, and Bulguk-sa) in the southeast region of Korea and thus known for stably growing young pine trees. According to the vegetation distribution status analysis, these pine forests did not have a high ratio of pine trees. Except for Tongdo-sa, the ratio of deciduous forest and mixed (deciduous and pine trees) forest had a much larger presence than that of pine forest. Measured data of microclimate showed that the Tongdo-sa area had significantly different characteristics compared to the other three areas. Tongdo-sa area showed a significantly higher diurnal range of temperatures and humidity than the other three areas, in both spring and summer. It is due to the difference in vegetation management. The forests around Tongdo-sa are mostly pine forests, except for the developed areas, while those in the other three areas have a dominant ratio of deciduous brad-leaved forests. Intensive control of pine forest is not effective in mitigating microclimate, i.e., temperature and air humidity. Stress caused by rising temperatures and decreasing air humidity is blamed for the decline of pine forests. Thus, the current active management of pine forests, such as the Tongdo-sa case, has been found to have a greater negative impact on the temperature and humidity stress. Therefore, we believe that a new change in forest management is necessary to increase the effect of mitigating the microclimate of pine forests.

• Management & Information Systems Review
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• v.28 no.2
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• pp.41-67
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• 2009

Organizational interpersonal supervisory trust, organizational justice(distributive and procedural justice) and job satisfaction have been lately more spotlighted as generally concluded by many previous studies. The purpose of this study is to find out possible effects of these three factors upon organizational commitment. The results of this study can be outlined as follows: First, it was found that organizational trust, a preceding variable, had significant positive effects on distributive and procedural justice, as well as on organizational commitment as a dependent variable. Second, it was found that two independent variables, i.e. distributive and procedural justice had significant positive effects upon job satisfaction, and procedural justice had significant positive effects on organizational commitment as a dependent variable, but distributive fairness had no significant effects on organizational commitment. Third, it was found that job satisfaction, an independent variable, had significant positive effects on organizational commitment. Fourth, it was found that organizational trust had significant positive secondhand associations with organizational commitment by way of distributive and procedural justice and job satisfaction, and also had overall significant positive effects on organizational commitment. Thus, it is concluded that the higher organizational trust is an index of higher organizational commitment. Fifth, it was found that distributive justice had just significant secondhand effects on organizational commitment by way of job satisfaction, but it had no significant effects overall upon organizational commitment, since such secondhand effects were considerably set off due to negative firsthand effects of distributive justice upon organizational commitment. But procedural justice and job satisfaction had significant firsthand and overall effects on organizational commitment, so it is concluded that the higher procedural justice and the higher job satisfaction are good indices of the higher organizational commitment. Hence, it is concluded that organizational supervisory trust has positive effects on distributive and procedural justice and organizational commitment; distributive justice has positive effects on job satisfaction; procedural justice has positive effects on job satisfaction and organizational commitment; and job satisfaction has positive effects on organizational commitment, so these empirical findings hereof are consistent with general results of previous studies.

• Journal of dental hygiene science
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• v.3 no.1
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• pp.45-50
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• 2003

In order to develop the program of oral hygiene education for elementary school senior-students, a questionnaire survey of elementary fourth, fifth and sixth students who are under continual control program of oral hygiene. (1) For tooth brushing time, after dinner is more than before. 73.7% of respondents brushed the teeth twice or more a day. (2) 62.1% of respondents took the cariogenic food twice or more a day. (3) 90.1% of respondents had visited a dental clinic. (4) Concerning fear for dental treatment, only 14.4% had a feeling of fear. (5) Regarding the experience with a preventive treatment, 39.7% had an experience with pit and fissure sealing, and 24.2% had an experience with the application of fluorides. (6) 46.2% of respondents had a preference for the fluoride mouth rinsing program, and 38.4% wanted that program to keep going on. As to the reason to favor the fluoride mouth rinsing program, 38.2% preferred it because of prevention of dental caries, and 43.0%, the largest percentage, didn't favor it because they found it too much trouble to do. (7) Comparing with the research result in 2000, we proved positively the educational effect of brushing frequency, positive understanding and preference to water school fluoridation program, and got the negative data of experience of visiting to oral clinic and preventive treatment.

• Journal of dental hygiene science
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• v.14 no.4
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• pp.546-553
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• 2014

The purpose of this study was to investigate the actual condition of communication of dental hygienist in oral hygiene instruction during scaling. The research was intended for 67 dental hygienists who worked dental hospitals and clinics. Oral hygiene instruction during scaling was audiotaped. Pearson correlation analysis, t-test, one-way ANOVA, and chi-squared test were conducted. The results gained by the research were as follows. An analysis of 67 dental hygienists has found that 63 dental hygienists (94%) educated the patients with dentiform and 65 of them (97%) did rolling method. Thirty-three of them (49.3%) recommended oral care products to the patients. Only 14 of all educators (21%) said simple greetings and educated importance of care of subjects' teeth, side effect of scaling, when they finished all the scaling stage. The average time of oral hygiene education was 161.3 seconds. In detail, the dental hygienists told 155.0 seconds, the patients did 6.3 seconds on average. The percentage of education time without patients' comments and dialogue each other were 35.8% and 37.3% respectively. The conversation frequency according to the education level of dental hygienist showed significant difference (p<0.05). There was a negative correlation between total education time and patients coming for scaling per day and there was a positive correlation between total number of questions and patient talking time. The result of chi-squared test showed that there was significant difference on asking regards depending on setting a limitation of scaling time (p<0.05). The research showed that the dental hygienists seem to educate the patients mechanically, uniformly rather than educate them according to their oral hygiene condition.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.2
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• pp.185-194
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• 2018

The objective of this study was to compare the shear bonding strength of zirconia after cleaning the crown contaminated by saliva or blood and determine the effect of thermocycling. 180 specimens were embedded in acrylic resin. 20 Specimens in the positive control group were bonded with resin cement without contamination. 20 Specimens in the negative control group were washed with water for 20 seconds and then dried for 10 seconds. 120 Specimens contaminated by saliva or blood were cleaned by using three cleaning methods: 37% phosphoric acid gel, commercial cleanse, and 2.5% NaOCl. All samples were bonded with resin cement and divided into two subgroups: One was not aged, and the other was tested with 30,000 thermocycling. In both groups contamination by saliva and blood, no statistically significant difference was not found in control, groups cleansed by commercial cleanser and 2.5% NaOCl. When the groups cleansed with water and 37% phosphate gel were compared with the control, significantly low shear bond strength was shown. Thermocycling group showed statistically significantly low shear bond stress compared to the groups without thermocycling. When zirconia was contaminated by saliva or blood, its original shear bond strength could be obtained if it was cleaned with commercial cleanser or 2.5% NaOCl.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.14-21
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• 1996

Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.167-172
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• 2006

Purpose: The laparoscopy assisted gastrectomy has been increasingly reported as the treatment of choice for early gastric cancer. However, expert surgeons, who have performed a conventional open gastrectomy for a long time, tend to have a negative attitude toward laparoscopic procedures. The aim of this study was to determine the learning curve of a laparoscopy assisted distal gastrectomy (LADG) for a surgeon expert in performing an open gastrectomy and to analyze the factors that have an effect on a LADG. Materials and Methods: Between April 2005 and March 2006, 62 patients underwent a LADG with D1+beta lymph-node dissection. The 62 patients were divided into 10 sequential groups with 6 cases in each group (the last group was 8 cases), and the time required to reach the plateau of the learning curve was determined by examining the average operative times of these 10 groups. Other factors, such as sex, BMI, complications, transfusion requirements, the number of retrieved lymph nodes, and change of postoperative hemoglobin level, were also analyzed. Results: With the $5^{th}$ group (after 30 cases), the operative time reached a plateau (average: 170 min/operation). The differences between before the $30^{th}$ case and after the $31^{st}$ case with respect to changes in the postoperative hemoglobin level, the number of retrieved lymph nodes, the transfusion requirements, and the complications rate were not significant. Conclusion: According to an analysis of the operative time, experience with 30 LADGs in patients with early gastric cancer is the point at which the plateau of the learning curve (7 months) is reached. Abundant experience with a conventional open gastrectomy and a well-organized laparoscopic surgery team are important factors in overcoming the learning curie earlier.

• KDI Journal of Economic Policy
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• v.30 no.1
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• pp.71-130
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• 2008

Using data from the Korean Labor & Income Panel Study (KLIPS), this study investigates private income transfers in Korea, where adult children have undertaken the most responsibility of supporting their elderly parents without well-established social safety net for the elderly. According to the KLIPS data, three out of five households provided some type of support for their aged parents and two out of five households of the elderly received financial support from their adult children on a regular base. However, the private income transfers in Korea are not enough to alleviate the impact of the fall in the earned income of those who retired and are approaching an age of needing financial assistance from external source. The monthly income of those at least the age of 75, even with the earning of their spouses, is below the staggering amount of 450,000 won, which indicates that the elderly in Korea are at high risk of poverty. In order to analyze microeconomic factors affecting the private income transfers to the elderly parents, the following three samples extracted from the KLIPS data are used: a sample of respondents of age 50 or older with detailed information on their financial status; a five-year household panel sample in which their unobserved family-specific and time-invariant characteristics can be controlled by the fixed-effects model; and a sample of the younger split-off household in which characteristics of both the elderly household and their adult children household can be controlled simultaneously. The results of estimating private income transfer models using these samples can be summarized as follows. First, the dominant motive lies on the children-to-parent altruistic relationship. Additionally, another is based on exchange motive, which is paid to the elderly parents who take care of their grandchildren. Second, the amount of private income transfers has negative correlation with the income of the elderly parents, while being positively correlated with the income of the adult children. However, its income elasticity is not that high. Third, the amount of private income transfers shows a pattern of reaching the highest level when the elderly parents are in the age of 75 years old, following a decreasing pattern thereafter. Fourth, public assistance, such as the National Basic Livelihood Security benefit, appears to crowd out private transfers. Private transfers have fared better than public transfers in alleviating elderly poverty, but the role of public transfers has been increasing rapidly since the welfare expansion after the financial crisis in the late 1990s, so that one of four elderly people depends on public transfers as their main income source in 2003. As of the same year, however, there existed and occupied 12% of the elderly households those who seemed eligible for the National Basic Livelihood benefit but did not receive any public assistance. To remove elderly poverty, government may need to improve welfare delivery system as well as to increase welfare budget for the poor. In the face of persistent elderly poverty and increasing demand for public support for the elderly, which will lead to increasing government debt, welfare policy needs targeting toward the neediest rather than expanding universal benefits that have less effect of income redistribution and heavier cost. Identifying every disadvantaged elderly in dire need for economic support and providing them with the basic livelihood security would be the most important and imminent responsibility that we all should assume to prepare for the growing aged population, and this also should accompany measures to utilize the elderly workforce with enough capability and strong will to work.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.506-525
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• 1992

Older people, because of the psychological and physiological changes related to the aging process are more vulnerable to experiencing powerlessness than any other age group. This self destructive cycle of depression in older people related to the experience of continued and long term powerlessness can lead even to death. The purpose of this study was to measure powerlessness and resources to increase power in older people, and to measure the effectiveness of a psychological rehabilitation program for reducing powerlessness. The research methodology used was a two step process. In the first step, a survey was done of perceived powerlessness and power resources comparing four groups of elderly people ; those living at home, those in hospital, those living in nursing homes and those attending educational programs for the elderly. The total sample size was 236. In the second step, a psychological rehabilitation program was carried out, pre and post measurements were taken related to this program. The sample consisted of 29 residents in a nursing home. The results of the study are as follows : 1. Powerlessness was classified as cognitive, emotional, activity and learning. The lowest score for powerlessness was in the area of activity, that is the people in the sample felt more power concerning their activities. The highest score was in the area of cognition where they felt they had less power. 2. When the different groups of elderly were compared, it was found that the residents of the nursing home had the highest score on perceived powerlessness and the group who were living at home had the lowest score. 3. Among the general characteristics, the factors influencing the powerlessness score were age, sex, level of education, financial resources and health status. In the interaction effects among these factors, it was found that level of education and health status were factors influencing perceived powerlessness. The elderly with lower education and poorer health status had the higher scores for perceived powerlessness. 4. The power resources could be classified into the following areas : physical strength, emotional strength, positive self-image, energy, knowledge, motivation and belief system. Belief system was given the highest score among the power resources and energy, knowledge and motivation were given low scores. 5. The group participating in an educational program for the elderly had the highest score for power resources while the group made up of residents of a nursing home had the lowest score as well as the highest score for perceived powerlessness. 6. The factors influencing the power resource scores were sex, level of education, financial resources and health status. In the analysis of the interaction effect among the factors, it was found that sex, level of education and financial resources were the factors that influenced the power resource score, that is, women, those with a low level of education and those with poor financial resources reported a lower level of power resources. 7. There was a negative correlation between perceived powerlessness and power resources in the elderly in this study. Since power resources explainded 49% of the variance for powerlessness, it can be concluded that the power resources can be used to reduce powerlessness. 8. The psychological rehabilitation program was carried out with the nursing home residents over a period of five weeks. No statistically significant difference was found in the scores on powerlessness between the pre and post tests, but there was a slight decrease in the raw scores on the post test for emotional, activity and learning powerlessness. There was a statistically significant increase in the power resource scores for emotional strength, positive self-image, energy, knowledge and motivation in the post test as compared to the pre test. In conclusion, the study indicates that a psychological rehabilitation program for the elderly could be effective in increasing power resources and this in turn could lead to a decrease in perceived powerlessness.