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Tertiary Cytoreduction for Recurrent Epithelial Ovarian Cancer: a Multicenter Study in Turkey

  • Arvas, Macit;Salihoglu, Yavuz;Sal, Veysel;Gungor, Tayfun;Sozen, Hamdullah;Kahramanoglu, Ilker;Topuz, Samet;Demirkiran, Fuat;Iyibozkurt, Cem;Bese, Tugan;Ozgu, Burcin Salman;Vatansever, Dogan;Tokgozoglu, Nedim;Berkman, Sinan;Turan, Hasan;Bengisu, Ergin;Sofiyeva, Nigar;Demiral, Irem;Meydanli, Mutlu
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1909-1915
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    • 2016
  • Background: The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. Materials and Methods: Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. Results: Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery. Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. Conclusions: Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.

An Analysis of the Quantitative Changes of Elements on Golf Courses - With Special Reference to the Membership Golf Courses in Capital Area, Korea - (한국 골프 코스 구성 요소의 정량적 변화 분석 - 수도권 회원제 골프장을 대상으로 -)

  • Rho, Joon-Taek;Cho, Se-Hwan
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.6
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    • pp.112-126
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    • 2012
  • The theme is to analyze the time-series changes of design elements on golf courses and golf country club and its factors influencing to the changes with regard to 81-membership country club located in the Capital Area of Seoul, created in the periods from 1964 until 2011. The research methods is to analyze the time-series changes of environmental factors influencing to the changes of the elements on the golf course by book review, and to compare and speculate the results of the analysis on the environmental factors with the time-series changes on the golf course elements of statistical analysis as like regression analysis. The research results were as follows. The first, the environmental factors influencing to the change of golf course elements were analyzed as the five elements of the golf-related policies and regulations, the economy, the numbers of golfers, PGA and KPGA golf tournaments, the golf instruments. The second, the type and scale of the location of the golf course were showing trends of transformation from flat ground to mountainous one and from small scale to large one. The third, it was analyzed that he golf course elements as like the sizes, length, numbers of golf course elements as like fairway, green, bunker, teeing ground and pond were influenced by the law and regulation, the increase of amateur golfers, the promotion of techniques of golfers, the increase of the chance of foreign course designer's involvement to domestic market through the opening of PGA and KPGA tournaments etc. The fourth, the promotion of golf instruments and the flying distance were the factors influencing to the numbers of bunker, the lengths of holes. The fifth, it was revealed that the trends of increase of sizes of ponds influenced by enacting environmenal friendly laws and regulations, considering of landscaping, reflecting of design trends followed by the opening of PGA tournaments. Finally, it was proposed that the further research would be introduced with regard to the qualitative analysis onto the changes and influential factors of golf course design.

Current Status and Future Prospect of Plant Disease Forecasting System in Korea (우리 나라 식물병 발생예찰의 현황과 전망)

  • Kim, Choong-Hoe
    • Research in Plant Disease
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    • v.8 no.2
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    • pp.84-91
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    • 2002
  • Disease forecasting in Korea was first studied in the Department of Fundamental Research, in the Central Agricultural Technology Institute in Suwon in 1947, where the dispersal of air-borne conidia of blast and brown spot pathogens in rice was examined. Disease forecasting system in Korea is operated based on information obtained from 200 main forecasting plots scattered around country (rice 150, economic crops 50) and 1,403 supplementary observational plots (rice 1,050, others 353) maintained by Korean government. Total number of target crops and diseases in both forecasting plots amount to 30 crops and 104 diseases. Disease development in the forecasting plots is examined by two extension agents specialized in disease forecasting, working in the national Agricul-tural Technology Service Center(ATSC) founded in each city and prefecture. The data obtained by the extension agents are transferred to a central organization, Rural Development Administration (RDA) through an internet-web system for analysis in a nation-wide forecasting program, and forwarded far the Central Forecasting Council consisted of 12 members from administration, university, research institution, meteorology station, and mass media to discuss present situation of disease development and subsequent progress. The council issues a forecasting information message, as a result of analysis, that is announced in public via mass media to 245 agencies including ATSC, who informs to local administration, the related agencies and farmers for implementation of disease control activity. However, in future successful performance of plant disease forecasting system is thought to be securing of excellent extension agents specialized in disease forecasting, elevation of their forecasting ability through continuous trainings, and furnishing of prominent forecasting equipments. Researches in plant disease forecasting in Korea have been concentrated on rice blast, where much information is available, but are substan-tially limited in other diseases. Most of the forecasting researches failed to achieve the continuity of researches on specialized topic, ignoring steady improvement towards practical use. Since disease forecasting loses its value without practicality, more efforts are needed to improve the practicality of the forecasting method in both spatial and temporal aspects. Since significance of disease forecasting is directly related to economic profit, further fore-casting researches should be planned and propelled in relation to fungicide spray scheduling or decision-making of control activities.

The Impact of Perceived Risks Upon Consumer Trust and Purchase Intentions (인지된 위험의 유형이 소비자 신뢰 및 온라인 구매의도에 미치는 영향)

  • Hong, Il-Yoo B.;Kim, Woo-Sung;Lim, Byung-Ha
    • Asia pacific journal of information systems
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    • v.21 no.4
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    • pp.1-25
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    • 2011
  • Internet-based commerce has undergone an explosive growth over the past decade as consumers today find it more economical as well as more convenient to shop online. Nevertheless, the shift in the common mode of shopping from offline to online commerce has caused consumers to have worries over such issues as private information leakage, online fraud, discrepancy in product quality and grade, unsuccessful delivery, and so forth, Numerous studies have been undertaken to examine the role of perceived risk as a chief barrier to online purchases and to understand the theoretical relationships among perceived risk, trust and purchase intentions, However, most studies focus on empirically investigating the effects of trust on perceived risk, with little attention devoted to the effects of perceived risk on trust, While the influence trust has on perceived risk is worth studying, the influence in the opposite direction is equally important, enabling insights into the potential of perceived risk as a prohibitor of trust, According to Pavlou (2003), the primary source of the perceived risk is either the technological uncertainty of the Internet environment or the behavioral uncertainty of the transaction partner. Due to such types of uncertainty, an increase in the worries over the perceived risk may negatively affect trust, For example, if a consumer who sends sensitive transaction data over Internet is concerned that his or her private information may leak out because of the lack of security, trust may decrease (Olivero and Lunt, 2004), By the same token, if the consumer feels that the online merchant has the potential to profit by behaving in an opportunistic manner taking advantage of the remote, impersonal nature of online commerce, then it is unlikely that the merchant will be trusted, That is, the more the probable danger is likely to occur, the less trust and the greater need to control the transaction (Olivero and Lunt, 2004), In summary, a review of the related studies indicates that while some researchers looked at the influence of overall perceived risk on trust level, not much attention has been given to the effects of different types of perceived risk, In this context the present research aims at addressing the need to study how trust is affected by different types of perceived risk, We classified perceived risk into six different types based on the literature, and empirically analyzed the impact of each type of perceived risk upon consumer trust in an online merchant and further its impact upon purchase intentions. To meet our research objectives, we developed a conceptual model depicting the nomological structure of the relationships among our research variables, and also formulated a total of seven hypotheses. The model and hypotheses were tested using an empirical analysis based on a questionnaire survey of 206 college students. The reliability was evaluated via Cronbach's alphas, the minimum of which was found to be 0.73, and therefore the questionnaire items are all deemed reliable. In addition, the results of confirmatory factor analysis (CFA) designed to check the validity of the measurement model indicate that the convergent, discriminate, and nomological validities of the model are all acceptable. The structural equation modeling analysis to test the hypotheses yielded the following results. Of the first six hypotheses (H1-1 through H1-6) designed to examine the relationships between each risk type and trust, three hypotheses including H1-1 (performance risk ${\rightarrow}$ trust), H1-2 (psychological risk ${\rightarrow}$ trust) and H1-5 (online payment risk ${\rightarrow}$ trust) were supported with path coefficients of -0.30, -0.27 and -0.16 respectively. Finally, H2 (trust ${\rightarrow}$ purchase intentions) was supported with relatively high path coefficients of 0.73. Results of the empirical study offer the following findings and implications. First. it was found that it was performance risk, psychological risk and online payment risk that have a statistically significant influence upon consumer trust in an online merchant. It implies that a consumer may find an online merchant untrustworthy if either the product quality or the product grade does not match his or her expectations. For that reason, online merchants including digital storefronts and e-marketplaces are suggested to pursue a strategy focusing on identifying the target customers and offering products that they feel best meet performance and psychological needs of those customers. Thus, they should do their best to make it widely known that their products are of as good quality and grade as those purchased from offline department stores. In addition, it may be inferred that today's online consumers remain concerned about the security of the online commerce environment due to the repeated occurrences of hacking or private information leakage. Online merchants should take steps to remove potential vulnerabilities and provide online notices to emphasize that their website is secure. Second, consumer's overall trust was found to have a statistically significant influence on purchase intentions. This finding, which is consistent with the results of numerous prior studies, suggests that increased sales will become a reality only with enhanced consumer trust.

Characteristics and Clinical Correlations of Staphylococcus aureus Discovered in Stools from Children Hospitalized at a Secondary Hospital (일개 이차병원에 입원한 소아의 분변에서 발견된 황색포도알균의 특징과 임상적 연관성)

  • Shin, Eun Hye;Eun, Byung Wook;An, Young Min;Song, Mi Ok
    • Pediatric Infection and Vaccine
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    • v.25 no.2
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    • pp.61-71
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    • 2018
  • Purpose: Research on the clinical role of Staphylococcus aureus as a pathogen in acute gastroenteritis (AGE) in children has been scarce. This study aimed to clarify the prevalence and clinical correlation of S. aureus detection in children with AGE. Methods: Fecal samples were collected from children with symptoms of AGE who visited a secondary hospital between January 2012 and December 2015. The samples were sent to the Seoul Metropolitan Government Research Institute of Public Health and Environment to test for pathogenic organisms. Clinical patterns were analyzed through medical record review. Results: Among the 663 participants, the bacteria detection rate was 26.2% (n=174), the virus detection rate was 29.7% (n=197), and the non-detection rate was 43.1% (n=286). S. aureus was tested positive from 102 cases and was confirmed as a single pathogen in 53 cases. It was the third most common pathogen. The prevalence by age was highest (45.3%) in 0-2 year-olds. Most cases occurred in summer. Symptoms included diarrhea (71.7%), vomiting (67.9%), fever (49.1%), and abdominal pain (37.7%). Only vomiting showed a significant difference between the S. aureus group and the non-detection group (67.9% vs. 43.0%; P=0.001). Among enterotoxins, the higher incidence of vomiting was associated with classical staphylococcal enterotoxins (SEA, SEB, SEC, SED, and SEE) and SEH (P=0.027). Conclusions: S. aureus was the bacteria commonly isolated from children with AGE. Our study identified cases of staphylococcal AGE in children based on fecal samples and confirmed the characteristic symptoms, affected age groups, seasonal distribution, and correlation with enterotoxins.

Impact Evaluation of Water Footprint on Stages of Drainage Works (배수공 각 작업 단계별 물발자국 영향평가)

  • Chen, Di;Kim, Joon-Soo;Batagalle, Vinuri;Kim, Byung-Soo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.40 no.2
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    • pp.225-231
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    • 2020
  • Fresh water that can be used by a person of the total amount of water on the planet is increased because it is less than 0.01 % except underground water, ice and snow, etc. water management response need. In order to protect and efficiently utilize water resources, major countries are conducting water footprint studies that can quantitatively estimate the amount of water put into the operating phase of the resource harvesting phase, mainly agriculture. Korea has also recently developed a number of policies in order to cope with water shortages, and in the construction industry, as well as the need for basic research to support it has been emphasized. This study was constructed DB up to the raw material harvesting step, the transport step, the production stage in order to estimate the water consumption of resources to be put into the work process to target the drainage of the road. Water usage estimation method was utilized the method presented in the Water Footprint Manual and the environmental score card certification guide, unit water usage each drainage main method was calculated after estimating the water footprint considering the water character factor, indirect water and the direct water, the water consumption factor of material input to each process. Brown asphalt, rebar, remicon of the drainage material as a result of the water footprint calculation accounted for 97 % of the total. Drainage method is a culvert, a side channel, a culvert wing wall, reinforced concrete open channel accounted for 92.2 % of the total. Drainage total step-by-step calculated water consumption and water footprint was found in order of raw material harvesting step, transport stage, production stage. Water footprint each drainage method or total drainage material calculated in this study can be used as a base data in the agricultural and construction sectors. In order to increase the reliability of the analysis, it is believed that further overseas databases will be needed for continuous review and research.

The Effects of Learning Transfer on Perceived Usefulness and Perceived Ease of Use in Enterprise e-Learning - Focused on Mediating Effects of Self-Efficacy and Work Environment - (지각된 유용성과 사용용이성이 기업 이러닝 교육의 학습전이에 미치는 영향에 관한 연구 -자기효능감과 업무환경의 매개효과를 중심으로-)

  • Park, Dae-Bum;Gu, Ja-Won
    • Management & Information Systems Review
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    • v.37 no.3
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    • pp.1-25
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    • 2018
  • This research performed the empirical test for the effects of learning transfer on perceived usefulness, perceived ease of use, self-efficacy and work environment using 390 employees who have experienced e-learning in domestic and foreign companies. Analyzed the mediating effects of self-efficacy and work environment in addition to direct effect of each factor on learning transfer. The results showed that perceived usefulness and perceived ease-of-use of e-learning learner had a positive(+) effect on self-efficacy and a positive influence on supervisor and peer support and organizational climate. Self-efficacy showed a positive effect on learning transfer, and supervisor support, peer support and organizational climate had a positive influence on learning transfer as well. Perceived usefulness also had a positive effect on learning transfer. However, perceived ease-of-use had no significant effect on learning transfer. As a result of the mediating effect analysis, self-efficacy and work environment were analyzed to have mediating effects between perceived usefulness, perceived ease of use, and learning transfer. The implications of this study are as follows. First, this study designed a new research model that reflects factors influencing the effect of learning transfer on acceptance of e-learning that is common in corporate education. It has derived a research model of perceived usefulness and perceived ease-of-use, which were used as mediating variables for external characteristics factors, as independent variables, using self-efficacy and work environment as mediating variables, which were studied as external factors. Second, most of the studies on technology acceptance model and learning transfer are conducted in a single country. The reliability was enhanced by testing the study models using different samples from 26 countries. Third, perceived usefulness and ease-of-use in existing studies have been considered as key determinants of acceptance intention and learning transfer. This study explored the mediating effects of learner and environmental factors on the accepted information technology and strengthened and supplemented the path of learning transfer of perceived usefulness and ease-of-use. In addition, based on the sample analysis of various countries used in this study, it is expected that future international comparative studies will be possible.

A Study on Prioritization of HNS Management in Korean Waters (해상 위험·유해물질(HNS) 관리 우선순위 선정에 관한 연구)

  • Kim, Young Ryun;Kim, Tae Won;Son, Min Ho;Oh, Sangwoo;Lee, Moonjin
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.21 no.6
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    • pp.672-678
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    • 2015
  • The types of hazardous and noxious substances (HNS) being transported by sea in Korea are at about 6,000, HNS transport volume accounts for 19% of total tonnage shipped in Korea, and the increase rate of seaborne HNS trade in Korea is 2.5 times higher than the average increase rate of the world seaborne HNS trade. Reflecting this trend, HNS spill incidents have been frequently reported in Korean waters, and there are increasing social demands to develop HNS management technology for the preparedness, response, post-treatment and restoration in relation to HNS spill incidents at sea. In this study, a risk-based HNS prioritization system was developed and an HNS risk database was built with evaluation indices such as sea transport volume, physicochemical properties, toxicities, persistency, and bioaccumulation. Risk scores for human health and marine environments were calculated by multiplying scores for toxicity and exposure. The top-20 substances in the list of HNS were tabulated, and Aniline was ranked first place, but it needs to be managed not by individuals but by HNS groups with similar score levels. Limitations were identified in obtaining data of chronic toxicity and marine ecotoxicity due to lack of testing data. It is necessary to study on marine ecotoxicological test in the near future. Moreover, the priority list of HNS is expected to be utilized in the development of HNS management technology and the relevant technologies, after the expert's review process and making up for the lack of test data in the current research results.

Review on the Triassic Post-collisional Magmatism in the Qinling Collision Belt (친링 충돌대의 트라이아스기 충돌 후 화성작용에 대한 리뷰)

  • Oh, Chang Whan;Lee, Byung Choon;Yi, Sang-Bong;Zhang, Cheng Li
    • The Journal of the Petrological Society of Korea
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    • v.23 no.4
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    • pp.293-309
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    • 2014
  • The Qinling-Dabie-Sulu-Hongseong-Odesan collision belt was formed by the collision between the North China and South China Cratons during late Permian to Triassic. During the collision, Triassic post-collision igneous rocks regionally intruded in the Qinling and the Hongseong-Odesan collision belts which represent the western and eastern ends of the collision belt, respectively. However, no and minor Triassic post-collision igneous activities occur in the Dabie and Sulu belts respectively. The peak metamorphic pressure conditions along the Qinling-Dabie-Sulu-Hongseong-Odesan belt indicate that the slab break-off occurred at the depth of ultra-high pressure (UHP) metamorphic condition in the Dabie and Sulu belts and at the depths of high pressure (HP) or high pressure granulite (HPG) metamorphic condition in the Qinling and Hongseong-Odesan belts. In the Dabie and Sulu belts the heat supply from the asthenospheric mantle through the gab formed by slab break-off could not cause an extensive melting in the lower continental crust and lithospheric mantle directly below it due to the very deep depth of slab break-off. On the other hand, in the Qinling and Hongseong-Odesan belts, shallower slab break-off caused the emplacement of regional post collision igneous rocks. The post-collision igneous rocks occur in the area to the north of the Mianlu Suture zone in the western Qinling belt and crop out continuously eastwards into the areas to the north of the Shangdan Suture zone in the eastern Qinling belt through the areas within the South Qinling block. This distribution pattern of post collision igneous rocks suggests that the Triassic collision belt in the Mianleu Suture zone may be extended into the Shangdan Suture zone after passing through the South Qinling block instead into the boundary between the South Qinling block and the South China Craton.

The Analysis and Strengthening Method of Export Competitive Power of Medical Device Industry - With Respect to Medical Device Industry in Gangwon Area (의료기기산업의 수출경쟁력 분석 및 강화방안 -강원지역 의료기기산업을 중심으로-)

  • Lee, Kang-Bin
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.45
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    • pp.191-238
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    • 2010
  • The purpose of this paper is to make research on the trend of the worldwide medical device market, the trend of the medical device market in the major foreign countries, the present status of the medical device industry in Korea and Gangwon area, the present status of export competitive power and the SWOT analysis of competitive power of the medical device industry in Gangwon area, and the strengthening methods of export competitive power of the medical device industry in Gangwon area. As the research method, the questionaire for the strengthening of export competitive power of the medical device industry in Gangwon area was carried out from August 13 to Otober 22, 2009. The worldwide medical device market in 2008 is estimated at USD 210.2 billion, with the United States being the largest market, followed closely by Japan and Western Europe. In 2006, the worldwide export amount of medical devices recorded USD 121.1 billion and the worldwide import amount of medical devices recorded USD 126.3 billion. As of the end of 2008, the number of Korea's medical device manufacturers expanded to 1,726. The production amount of Korea's medical device industry in 2008 recorded 2,525 billion won, and the domestic market volume of medical devices in 2008 recorded 3,618 billion won. Korea's export amount of medical devices in 2008 recorded USD 1,132 million and recorded a 9.67% growth compared to the previous year, and the import amount of medical devices recorded USD 2,123 million and recorded a 1.43% reduction compared to the previous year. As of the end of 2008, the number of Gangwon area's medical device manufacturers expanded to 81. The production amount of Gangwon area's medical industry in 2008 recorded 380 billion won, and Gangwon area's export amount of medical devices recorded USD 269 million and recorded a 0.25% reduction compared to the previous year, and the import amount of medical devices recorded USD 3 million and recorded a 39.63% reduction compared to the previous year. According to the result analysis of the questionaire for the strengthening of export competitive power of medical device industry in Gangwon area(August 13~October 22, 2009), the competing country of the export medical device is the United States being the highest ranking. Comparing to the collective competitive power level 100 of the competing country, the collective competitive level of the export medical device is 60 below and 70-80 below being the highest ranking. Comparing to the quality level 100 of the United States, EU and Japan, the quality level of the export medical device is 80-90 below being the highest ranking. Comparing to the design level 100 of the United States, EU and Japan, the design level of the export medical device is 90-100 below being the highest ranking. Comparing to the technology level 100 of the United States, EU and Japan, the technology level of the export medical device is 80-90 below being the highest ranking. According to the SWOT analysis of competitive power of medical device industry in Gangwon area, the strength is the abundant expert manpower of the medical device in Wonju area. The weakness is the fragility of the brand recognition of the medical device industry. The opportunity is the demand increase of the new medical device owing to the advanced age of population. The threat is the difficulty of entry into overseas market owing to the request of the new specification certification of the medical device. In order to strengthen the export competitive power of the medical device industry in Gangwon area, the following measures should be taken by the government, local self-government body, related organization and medical device industry : the development of new technology and design, the enhancement of brand recognition. the acquisition of the foreign specification certification, the building of overseas distribution channel and after sales service channel, the positive participation in overseas medical device exhibition and opening of medical device exhibition, the training of expert manpower, the strengthening of overseas marketing, and the application of FTA and the establishment of counter measures against FTA. In conclusion, the medical device industry in Gangwon area has the difficulty in the entry into the overseas market owing to the shortage of overseas marketing capability. Therefore, the government and local self-government body should make the intensive and systematical support for overseas marketing of the medical device industry. For the support of overseas marketing, the government and local self-government body should provide positively the support of expenses for the acquisition of foreign specification certification, the support of participation in the overseas medical device exhibition, the despatch of market development mission, the increase of the support amount for R&D investment fund, and the training of expert manpower of medical devices.

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