• Title/Summary/Keyword: Overall Survival

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A Survey on the Forest Cultural Assets in the Southern Coastal Areas for the Designation and Maintenance of Law-protected Trees (보호수 지정 및 관리를 위한 남해안 지역 산림문화자산 실태조사)

  • Kang, Kee-Rae
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.2
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    • pp.28-36
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    • 2012
  • Forests are one of the basic assets nearest our daily lives that provide the foundation of life necessities, culture and even survival. These assets pervade local residents' lives as culture and the necessities of life, and they will be handed down to posterity. Therefore, this study was conducted to carry out a field survey on old trees, plant communities and forests in the southern coastal areas in Korea, where not many surveys were not conducted on the forest cultural assets, further examining a possibility that some of the trees should be designated as law-protected. As for the survey of plants, this study investigated 80 different spots of old trees, plant communities and forests, located in 11 cities and counties in Gyengnam Province and Jeonnam Province adjacent to the southern coast of Korea. To measure the health and actual maintenance conditions of old trees and plant communities objectively, the standard of judgment was established through the brain storming of experts. As a result of the field survey, out of all the old trees and plant communities that are not law-protected, this study selected old trees and plant communities that are in good health and likely to pass the standard of designating law-protected trees according to the Established Rule 574 of the Korea Forest Service Regulation. As for the plant community and old trees likely to be law-protected, this study judged that the torreya forest in Naneum Li, Namhae and old trees in 13 spots, in cluding so-called 'Couple Pine Tree' in Pyeongsa Li, Hadong, have a high possibility of being designated as a law-protected plant community and old trees. As for the species of old trees, there were 3 zelkova serrata trees, 3 celtis sinensis persoon trees, 2 pinus densiflora trees, 1 castanopsis cuspidata tree, 1 salix chaenomeloides tree and 1 machilus thunbergii tree found in the survey areas. Overall, this study judged that those old trees and plant communities require a national systematic maintenance by being designated as law-protected ones, and their values should be handed down to posterity as our forest cultural assets.

An Empirical Study on the Effect of CRM System on the Performance of Pharmaceutical Companies (고객관계관리 시스템의 수준이 BSC 관점에서의 기업성과에 미치는 영향 : 제약회사를 중심으로)

  • Kim, Hyun-Jung;Park, Jong-Woo
    • Journal of Intelligence and Information Systems
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    • v.16 no.4
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    • pp.43-65
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    • 2010
  • Facing a complex environment driven by a decade, many companies are adopting new strategic frameworks such as Customer Relationship Management system to achieve sustainable profitability as well as overcome serious competition for survival. In many business areas, CRM system advanced a great deal in a matter of continuous compensating the defect and overall integration. However, pharmaceutical companies in Korea were slow to accept them for usesince they still have a tendency of holding fast to traditional way of sales and marketing based on individual networks of sales representatives. In the circumstance, this article tried to empirically address current status of CRM system as well as the effects of the system on the performance of pharmaceutical companies by applying BSC method's four perspectives, from financial, customer, learning and growth and internal process. Survey by e-mail and post to employers and employees who were working in pharma firms were undergone for the purpose. Total 113 cases among collected 140 ones were used for the statistical analysis by SPSS ver. 15 package. Reliability, Factor analysis, regression were done. This study revealed that CRM system had a significant effect on improving financial and non-financial performance of pharmaceutical companies as expected. Proposed regression model fits well and among them, CRM marketing information system shed the light on substantial impact on companies' outcome given profitability, growth and investment. Useful analytical information by CRM marketing information system appears to enable pharmaceutical firms to set up effective marketing and sales strategies, these result in favorable financial performance by enhancing values for stakeholderseventually, not to mention short-term profit and/or mid-term potential to growth. CRM system depicted its influence on not only financial performance, but also non-financial fruit of pharmaceutical companies. Further analysis for each component showed that CRM marketing information system were able to demonstrate statistically significant effect on the performance like the result of financial outcome. CRM system is believed to provide the companies with efficient way of customers managing by valuable standardized business process prompt coping with specific customers' needs. It consequently induces customer satisfaction and retentionto improve performance for long period. That is, there is a virtuous circle for creating value as the cornerstone for sustainable growth. However, the research failed to put forward to evidence to support hypothesis regarding favorable influence of CRM sales representative's records assessment system and CRM customer analysis system on the management performance. The analysis is regarded to reflect the lack of understanding of sales people and respondents between actual work duties and far-sighted goal in strategic analysis framework. Ordinary salesmen seem to dedicate short-term goal for the purpose of meeting sales target, receiving incentive bonus in a manner-of-fact style, as such, they tend to avail themselves of personal network and sales and promotional expense rather than CRM system. The study finding proposed a link between CRM information system and performance. It empirically indicated that pharmaceutical companies had been implementing CRM system as an effective strategic business framework in order for more balanced achievements based on the grounded understanding of both CRM system and integrated performance. It suggests a positive impact of supportive CRM system on firm performance, especially for pharmaceutical industry through the initial empirical evidence. Also, it brings out unmet needs for more practical system design, improvement of employees' awareness, increase of system utilization in the field. On the basis of the insight from this exploratory study, confirmatory research by more appropriate measurement tool and increased sample size should be further examined.

Factors Influencing the Therapeutic Compliance of Patients with Lung Cancer (폐암환자의 치료순응도에 영향을 미치는 요인)

  • Chae, Sang-Chul;Park, Jae-Yong;Kim, Jeong-Suk;Bae, Moon-Seob;Shin, Moo-Chul;Kim, Keon-Yeob;Kim, Chang-Ho;Shon, Sang-Kyun;Kam, Sin;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.953-961
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    • 1998
  • Background : In recent years, lung cancer has been one of most common cause of death in Korea. Despite many physician's high degree of pessimism about the gains made in treatment, progressive improvement in the survival of lung cancer by treatment has occurred, particulary in the early stages of the disease. However, a lot of patients refuse treatment or give up in the fight against the disease. This study was done to evaluate factors influencing the compliance to therapy and to lead in the establishment of special programs to enhance compliance in patients with lung cancer. Methods: The medical records of 903 patients, whose ECOG(Eastern Cooperative Oncology Group) performance status was 3 or less and whose medical record was relatively satisfactory, among 1141 patients diagnosed with lung cancer between January 1989 and December 1996 were reviewed retrospectively. Compliance was classified into three groups based on the degree of compliance with physicians practice guideline: (a) compliants; (b) patients who initially complied but gave up of themselves midway during the course of treatment; (c) noncompliants who refused the treatment. Results: The overall compliance rate was 63.9%, which was progressively increased from 57.3-61.3% in 1989 and 1990 to 64.2-67.5% in 1995 and 1996. Age, education level and occupation of patients bore statistically significant relationship with the compliance but sex, marital status and smoking history did not. The compliance was significantly higher in patients without symptoms than with, and was also significantly higher in patients with good performance status. The compliance was significantly high in patients with NSCLC(non-small cell lung cancer) compared to SCLC(small cell lung cancer), but after exclusion of stage I and II, among NSCLC, which had higher compliance to surgery there was no significant difference of compliance by histology. The compliance was significantly lower in advanced stage. Conclusion: To enhance the compliance, special care including education programs about therapy including complication and prognosis are necessary, especially for educationally and economically disadvantaged patients.

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Coronary Artery Bypass Grafting in Elderly Patients Older Than 75 Years (75세 이상 고령환자의 관상동맥우회로술)

  • Yoo Dong Gon;Kim Chong Wook;Park Chong Bin;Choo Suk Jung;Lee Jae Won;Song Meong Gun;Song Hyun
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.123-131
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    • 2005
  • Background: The number of elderly patients undergoing coronary artery bypass grafting (CABG) is increasing. Elderly patients are at increased risk for a variety of perioperative complications and mortality. We identified determinants of operative complications and mortality in elderly patients undergoing CABG. Material and Method: Between January 1995 and July 2003, 91 patients older than 75 years underwent isolated CABG at Asan Medical Center. There were 67 men and 24 women with mean age of $77.0\pm2.4$ years. Thirty clinical or hemodynamic variables hypothesized as predictors of operative mortality were evaluated. Result: CABG was performed under emergency conditions in 5 patients. The internal thoracic artery was used in 85 patients and 10 patients received both internal thoracic arteries. The mean number of distal anastomosis was 3.7 per patient. Operative mortality was $3.3\%$. Twenty-two patients had at least one major postoperative complication. Low cardiac output syndrome was the most common complication, followed by reoperation for bleeding, pulmonary dysfunction, perioperative myocardial infarction, stroke, acute renal failure, ventricular arrhythmia, upper gastrointestinal bleeding, infection, and delayed sternal closure. None were the predictors of mortality. Renal failure, peripheral vascular disease, emergency operation, recent myocardial infarction, congestive heart failure, New York Heart Association (HYHA) class III or IV, Canadian Cardiovascular Society (CCS) angina scale III or IV, and low left ventricle ejection fraction below $40\%$ were univariate predictors of overall complications. Actuarial probability of survival was $94.9\%,\;89.8\%,\;and\;83.5\%$ at postoperative 1, 3 and 5 years respectively. During the follow-up period $93.3\%$ of patients were in NYHA class I, or II and $91.1\%$ were free from angina. Conclusion: Although operative complication is increased, CABG can be performed with an acceptable operative mortality and excellent late results in patients older than 75 years.

A Clinical Study on the Surgical Treatment of the Rheumatic Cardiac Valve Disease (류마티스성 심장판막질환의 외과적 치료에 대한 임상적 연구)

  • 김종원;정황규;이성광;김병준;신영우
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.346-352
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    • 1998
  • Rheumatic valvulitis produces at least three distinct pathologic changes, the degree varying widely among the patients: fusion of the valve leaflets at the commissures; fusion and shortening of chordae tendinae: and fibrosis of the leaflets with subsequent stiffening, contraction and calcification. The most extensive changes usually are seen in patients with recurrent attacks of rheumatic fever. We studied on outcome of the surgical treatments of rheumatic valvular diseases that have been experienced for 12 years since 1982 at Pusan National University Hospital. The diagnoses were made by rheumatic fever history, echocardiographic findings, gross operative findings and microscopic findings. Total 502 patients were performed surgery for valvular heart diseases and 440 patients of rheumatic origin have bene analysed. There were more female than male patients as 1.3:1, and the mean age was 37.8 years old. 96.3% of them affected to the mitral valve, 19.8% to aortic valve, 16.3% affected to the tricuspid valve. Most of them underwent valve replacement, and valve repair was done in 3.9% of patients. There were 36 hospital deaths(8.2%) mainly from low cardiac output syndrome, and 15 late deaths equally due to embolism and hemorrhage. Follow up was 90.1% completed(2890 patient- year). Linealized rates of late complication events are follows : thromboembolism 1.3% per patient year; anticoagulant related hemorrhage 0.8% per patient year. Overall actuarial survival including hospital mortality was 92.7+/-2.9% in 1 year, 88.0+/-4.5% in 5 year, 82.3+/-7.7% in 10 year. We conclude that the rheumatic disease is still the most frequent and the most important cause of heart valve disease. So more intensive study is needed in spite of the abrupt decreasing rate of rheumatic fever in U.S.A. and other industrial country.

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Usefulness and Surgical Strategies of Pulmonary Artery Banding in Functional Univentricular Heart (단심실에서 폐동맥 교약술의 유용성 및 수술전략)

  • 김웅한
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.439-448
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    • 2002
  • Pulmonary artery banding (PAB) in the functional univentricular heart (UVH) is a palliative procedure for staging toward the Fontan procedure; however, it is known to be a risk factor. Material and method: The records of all 37 patients with functional UVHs who underwent surgical palliation using PAB between September 1989 and August 1999 were reviewed retrospectively. We investigated the aortic arch obstruction, the development and progression of subaortic stenosis after PAB, and risk factor of mortality according to surgical method. Result: In 37 neonates and infants with single ventricular physiology, aortic arch obstruction was combined in 7. There were 6 early deaths (16.2%) after PAB and 3 late deaths (8.1%) after Fontan operation. The actuarial overall survival including early mortality at 3 and 5 years were 80.7$\pm$6.6%, 72.2$\pm$8.2% respectively. Among 31 patients who survived PAB, 27 patients (87.1 %) could become candidates for Fontan operation; 22 patients (71.0%) completed Fontan operation with 3 deaths and 5 were waiting bidirectional cavopulmonary shunt(BCPS) or Fontan operation (follow-up mean 4.5 year, minimal 2 year). Subaortic stenosis developed in 8 patients after PAB (8/29, 27.6%); 3 cases in the patients without arch anomaly (3/22, 13.6%) and 5 in those with arch anomaly (5/7, 71.4%). The subaortic stenosis was managed with Damus-Kaye-Stansel procedure (DKS) in 6 patients without operative mortality and conal septum resection in 2 without long-term survivor. Analysis of risk factors established that aortic arch obstruction was strongly associated with subaortic stenosis (p<0.001). The only risk factor of late mortality was Fontan procedure without staged palliation by BCPS (p=0.001). Conclusion: PAB is effective as an initial palliative step in functional UVH. And the high risk group of patients with aortic obstruction can undergo effective short-term PAB as an initial palliative step, with subsequent DKS for subaortic stenosis. This strategy, initial PAB and careful surveillance, and early relief of subaortic stenosis can maintain acceptable anatomy and hemodynamics for later Fontan procedures.

Immunohistochemical Study to Evaluate the Prognostic Significance of Four Biomolecular Markers in Radiotherapy of Nasopharyngeal Carcinoma (방사선 치료를 받은 코인두암의 생체분자적 예후 인자를 찾기 위한 면역조직화학염색 연구)

  • Kim, Yeon-Joo;Lee, Seung-Hee;Wu, Hong-Gyun;Go, Heoun-Jeong;Jeon, Yoon-Kyung
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.57-63
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    • 2010
  • Purpose: We performed an immunohistochemical study with pre-treatment biopsy specimens to evaluate the prognostic significance of four biomolecular markers which can be used as a predictive assay for radiotherapy (RT) treatment of nasopharyngeal carcinoma (NPC). Materials and Methods: From January 1998 through December 2006, 68 patients were histologically diagnosed as non-metastatic NPC and treated by RT. Only 38 patients had the paraffin block for the immunohistochemical study. Thirty-one patients had undifferentiated carcinoma and 7 patients had squamous cell carcinoma. Thirtytwo patients (84%) had advanced stage NPC (2002 AJCC Stage III~IV). Immunohistochemical staining was performed for Met, COX-2, nm23-H1, and epidermal growth factor receptor (EGFR) expression using routine methods. Results: The median follow-up time was 30 months (range, 11 to 83 months) for all patients, and 39 months (range, 19 to 83 months) for surviving patients. The 5-year overall survival (OS) rate of the patients with high Met extent (${\geq}50%$) was significantly lower than that of the patients with low Met extent (48% vs. 84%, p=0.02). In addition, Met extent was also a significant prognostic factor in multivariate analysis (p=0.01). No correlation was observed between Met extent and T stage, N stage, stage group, gender, age, and the response to chemotherapy or RT. Met extent showed moderate correlation with COX-2 expression (Pearson coefficient 0.496, p<0.01), but COX-2 expression did not affect OS. Neither nm23-H1 or EGFR expression was a prognostic factor for OS in this study. Conclusion: High Met extent (${\geq}50%$) might be an independent prognostic factor that predicts poor OS in NPC treated with RT.

Changes in chemical composition and physiological activity of Jeju-Tatary buckwheat tea according to leaching temperature (제주 타타리메밀의 침출 조건에 따른 제주 타타리메밀침출차의 이화학적 특성 및 생리활성)

  • Hyun-A Ko;Hyun Ju Park;Inhae Kang
    • Journal of Applied Biological Chemistry
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    • v.65 no.4
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    • pp.421-427
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    • 2022
  • In this study, Jeju Tatary buckwheat tea's chemical composition and physiological activities were compared according to the leaching temperature (60, 80, 100 ℃). As the leaching temperature is increased, the degree of browning is induced. However, there was no significant change in pH. The total polyphenol content was higher at 80 ℃ than at 60 ℃ leaching temperature, but significantly decreased at 100 ℃ leaching temperature (60 ℃: 17.06 mg GA/g, 80 ℃: 20.09 mg GA/g, 100 ℃ :18.45 mg GA/g). There were high content of flavonoid and rutin as the leaching temperature increased. Consistently, 2,2-diphenyl1-picrylhydrazyl (DPPH) radical scavenging activity and tyrosinase inhibitory activity were significantly higher with increasing temperature (DPPH % inhibition: 60 ℃: 41.88%, 80 ℃: 46.01%, 100 ℃: 46.80%/tyrosinase inhibitory activity: 60 ℃: 9.38%, 80 ℃: 22.94%, 100 ℃: 28.17%). However, there was no significant difference in DPPH radical scavenging activity between 80 and 100 ℃. A cytotoxicity test was performed by treating with Jeju Tatary buckwheat extract into mouse macrophage cells (Raw264.7). 100 and 200 ㎍/mL treatment (100 ℃ extract) were significantly upregulated the survival rate, but there was no significant difference in other concentrations. Collectively, most of the bioactive components, antioxidant activity, and tyrosinase inhibitory activity were induced as the leaching temperature increased. However, the content of polyphenols which are known to have antioxidant activity, was significantly reduced at 100 ℃ leaching temperature. Several reports have demonstrated that leaching at too high temperature lowered the overall acceptability, so the optimal leaching condition of Tatary Buckwheat is 80 ℃, 5 min in this study.

The Clinical Outcome of Dedifferentiated Chondrosarcoma (역분화 연골육종의 임상 결과)

  • Kong, Chang-Bae;Lee, Seung Yong;Song, Won-Seok;Cho, Wan-Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.164-171
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    • 2019
  • Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.

A Study on the Support System for Reinforcement of Competitiveness of Small Business persons - Mainly Focused on Support System for Small Business Persons - (소상공인 경쟁력 강화의 지원제도에 관한 연구 - 소상공인 지원제도를 중심으로 -)

  • Woo, Dae-IL;Lee, Sang-Youn
    • The Korean Journal of Franchise Management
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    • v.2 no.2
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    • pp.95-110
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    • 2011
  • As global economic conditions are getting uneasy and polarization of our economy is intensified, the economic sentiment of small businesses is still low and unstable. The collapse of worldwide banking systems due to sub prime crisis in 2007 became the catalyst that shakes financial industries in each country in the world; the most sentiment people, small businesspersons, also have hard time facing survival way out, facing a great crisis. All organizing powers including manufactures, wholesales and retails are being gradually greater in mutual relations and dependence, and unstable factors about risks are also increasing. For exterior environmental and physical risk factors which cannot make small businesses survive themselves by developing ways out are eventually increasing, those who cannot cope with these factors face a great crisis. Although the government tries hard to overcome this situation conducting many ways, the effect does not continue. It is the real state that independent business markets including overall employment and establishing business have vicious cycle that they cannot be improved, due to increase of employment centered on short-term labors which lack durability in creation of employment and decline of household income. Recently, growth shows indication of slowdown because of multinational risk factors including financial crisis in each country in Europe, the death of Kim Jung-il, relationship with North Korea, and unstability of war situation in the Middle East Asia. Experts expect that growth rate will be about 4%, and independent business that ordinary people feel is still gloomy. It's reality that there is no adequate alternative for lack of jobs, unstable employment and a means of living after retirement. Also, the fact that large companies enter the market which is narrow and in the excessive competition should be an environmental factor that makes the situation worse. The business concept, a franchise, is the part we should think about whether it is the institutional solution that can guarantee independent businessmen stable life. Major companies are frightfully entering the market today, breaking the barrier to entry and shouting of a win-win with independent businesses. It's the small businesspersons who go through painful domestic recession, cannot predict the future and manage confusing and unstable independent business. It's very important to restore the domestic economy through wisely boosting consumption as soon as possible. It's also important to lead the situation by gathering powers of the government and related organizations, agonizing, suggesting solutions, and establishing accurate directions. The purpose of this study, therefore, is to suggest ways to strengthen competitiveness of small businesspersons by examining small business support policies which are currently implemented.