• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.17-24
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• 2007

Background: The aim of this study is to assess the clinical results of various procedures in congenital aortic stenosis. Material and Method: From August 1987 to June 2004, 53 patients of congenital aortic stenosis underwent procedures such as percutaneous balloon valvuloplasty, aortic valvuloplasty, Ross procedure, and aortic valve replacement. The mean age of initial procedures was $8.2{\pm}6.0$ years. Percutaneous balloon valvuloplasty was peformed in sixteen patients, aortic valvulopiasty in thirty two patients, Ross procedure in nineteen patients, and aortic valve replacement in fourteen patients. The mean follow duration was $80.6{\pm}60\;(0{\sim}207)$ months. Result: There was 15.1% (8/53) of early mortality and no late mortality. The six patients with critical aortic stenosis were died of left ventricular dysfunction in early series (before 1 year; 4 cases) and two patients died after the Ross procedure and aortic valve replacement respectively. After percutaneous balloon valvuloplasty, most patients needed reoperations (14/16). Thirteen patients needed reoperation, after aortic valvuloplasty. After Ross procedure, two patients needed reoperation due to aortic regurgitation caused by progressive aortic root dilatation. The actuarial survival rate after Ross procedure at 7 years was 90.5%. Conclusion: In young children before the age of one, percutaneous balloon valvuloplasty was considered as :he safe initial palliative procedure. But children over one year-old, aortic valvuloplasty were the effective procedure. Ross procedure can be preformed safely with good results.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.26 no.4
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• pp.356-368
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• 2021

To understand the temporal variation of phytoplankton communities in a coastal area, the biomass and diversity were weekly investigated in the inner bay of Yeong-do, Busan. In the study area, chlorophyll a concentration ranged from 0.43~7.58 mg m^-3 during the study, indicating the study area was in mesotrophic or eutrophic status. The fractions of chlorophyll a occupied by large phytoplankton (> 3 ㎛ diameter) exhibited an average of 80% of total chlorophyll a in this study. Among the large phytoplankton, while Bacillariophyta was the most dominant in spring and summer, Cryptophyceae prevailed in the fall and winter. On the contrary, in the picophytoplankton community less than 3 ㎛ in diameter, Mamiellophyceae was the most dominant in most seasons, Cryptophyceae was relatively high with an average of 17.7 ± 17.6% throughout the year, but seasonal variations were large. Dinophyceae rarely occupied a higher fraction up to 60.4% of the picophytoplankton community. By weekly monitoring at a coastal station for 13 months, it is suggested that phytoplankton communities in coastal waters could be changed on a short time scale. If data are steadily accumulated at the time-series monitoring site for a long time, these will provide important data for understanding the long-term dynamics of phytoplankton as well as the impact of climate and environmental changes.

• Herbal Formula Science
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• v.31 no.1
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• pp.1-10
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• 2023

Objectives : The main aim of this study was to examine the LC-MS/MS used to identify phenolic compounds of CRE(Coptidis Rhizoma 70% EtOH Extract). Also, we investigated antioxidative activities and Anti-inflammatory activities. Methods : LC-MS/MS Analysis HPLC and LC-MS/MS were performed on a 1260 series HPLC system (Agilent Technologies, Inc., California, USA) and 3200 QTrap tandem mass system (Sciex LLC) operated in positive ion mode (spray voltage set at -4.5 kV). The solvent used was DW and Acetonitrile containing 0.1% formic acid, a gradient system was used at a flow rate of 0.5 mL/min for analysis, and a Prontosil C18 column (length, 250 mm; inner diameter, 4.6 mm; particle size, 5 ㎛; Phenomenex Co., Ltd., California, USA, Biochoff Chromatography) was used. The solvent conditions used in the mobile phases were 0-10 min at 10-15% B, 10-20 min at 20% B, 20-30 min at 25%, 30-40 min at 40%, 40-50 min at 70%, 50-60 min at 95%, and 60-70 min at 95%. The analysis was performed at a wavelength of 284 nm and a temperature of 35℃. The cell viability was measured using a 3-(4,5-dimethyethiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity. We examined the effects of CRE on the lipopolysaccharide (LPS)-induced production of nitric oxide (NO) in a RAW 264.7 cells Results : The chemical analysis CRE by Liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmed that Rosmarinic acid, Ferrulic acid, 3-O-feruloylquinic acid, and 5-O-feruloylquinic acid as phenolic components. DPPH radical scavenging activity was the inhibitory activity of CRE showed at 200 ㎍/mL a statistically significant level. MTT assay demonstrated that the CRE did not have a cytotoxic effect in RAW 264.7 and LPS-induced RAW264.7 cells. Also, CRE reduced NO production in RAW 264.7 cells stimulated with LPS. Conclusions : Based on these findings, The chemical analysis 4 major components CRE such as Rosmarinic acid, Ferrulic acid, 3-O-feruloylquinic acid, and 5-O-feruloylquinic acid. Moreover, we confirmed that CRE has effects antioxidant and anti-inflammatory. The results demonstrate that CRE can be used as an antioxidant and a powerful chemopreventive ingredient against inflammatory diseases.

• Journal of the Korean Institute of Landscape Architecture
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• v.44 no.6
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• pp.84-97
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• 2016

This study was to investigate the user's thermal environments of the children's parks according to pavements and sunscreen types during periods of heat waves. The measurements were conducted at the sand pits, rubber chip pavement, shelters, and green shade ground of the two children's parks located in Jinju, Korea(Chilam: $N\;35^{\circ}11^{\prime}1.4{^{\prime}^{\prim}}$, $E\;128^{\circ}5^{\prime}31.7{^{\prime}^{\prime}}$, elevation 38m, Gaho: $N\;35^{\circ}09^{\prime}56.8{^{\prime}^{\prime}}$, $E\;128^{\circ}6^{\prime}41.1{^{\prime}^{\prime}}$, elevation 24m) over three days during 11-13, August, 2016. The highest ambient air temperatures at the Jinju Meteorological Office during the three measurement days were $35.9{\sim}36.8^{\circ}C$, which corresponded with the extremely hot weather. A series of experiments measured air temperature, relative humidity, wind velocity, black globe temperature, and long-wave and short-wave radiation of the six directions 0.6 m above ground level. The wet bulb globe temperature(WBGT) and the universal thermal climatic index(UTCI) were used to evaluate thermal stress. Surface temperature images of the play equipment were also taken using infrared thermography. Surface temperatures of the play equipment and grounds were used to evaluate burn risk through contact with playground materials. The results showed the following. The maximum air temperatures averaged over 1-hour period for three days were $36.6{\sim}39.4^{\circ}C$. The sun shades reduced those temperatures by up to $2.8^{\circ}C$(green shade) and $1.0^{\circ}C/2.3^{\circ}C$(shelters). The minimum relative humidity values averaged over 1-hour period for three days were 44~50%. The sun shades increased those humidity values by up to 6%(green shade) and 4%/6%(shelters). The risk of heat related illness at the measurement sites of the children's parks were extreme and high in the daytime hours. The maximum WBGT values averaged over a 30-minute period for three days were $31.2{\sim}33.6^{\circ}C$. The sun shades reduced those WBGT values by up to $2.4^{\circ}C$(green shade) and $0.5^{\circ}C/2.1^{\circ}C$(shelters) compared to sandpits, but would not block the risk of heat related illness in the daytime hours. The category of heat stress at the measurement sites of the children's parks were extreme and very strong in the daytime hours. The maximum UTCI values averaged over a 30-minute period for three days were $39.9{\sim}48.1^{\circ}C$. The sun shades reduced those UTCI values by up to $7.8^{\circ}C$(green shade) and $4.1^{\circ}C/8.2^{\circ}C$(shelters) compared to sandpits, but could not lower heat stress category from extreme and very strong to strong and moderate in the daytime hours. According to the burn threshold criteria when skin was in contact with playground materials, the maximum surface temperature of the stainless steels($70.8^{\circ}C$) surpassed three seconds $60^{\circ}C$ threshold for uncoated steel, that of the rubber chip($76.5^{\circ}C$) surpassed five seconds $74^{\circ}C$ threshold for the plastic, that of the plastic slide($68.5^{\circ}C$) and seats($71.0^{\circ}C$) surpassed the one min $60^{\circ}C$ threshold for plastic, respectively. The surface temperatures of shaded play equipment were lower approximately $20^{\circ}C$ than those of play equipment exposed to the sun. Therefore, sun shades can block the risk of burns in daytime hours. Because of the extreme and high risk of heat related illness and extreme and high heat stress at the children's parks during periods of heat waves, parents and administrators must protect children from the use of playgrounds. The risk of burn when contact with play equipments and grounds at the children's parks during periods of heat waves, was very high. The sun shades are essential to block the risk of burn from play equipments and grounds at the children's parks during heat waves.

• Economic and Environmental Geology
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• v.40 no.6
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• pp.713-726
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• 2007

The Daebong deposit consists of gold-silver-bearing mesothermal massive quartz veins which fill fractures along fault zones($N10{\sim}20^{\circ}W,\;40{\sim}60^{\circ}SW$) within banded gneiss or granitic gneiss of Precambrian Gyeonggi massif. Ore mineralization of the deposit is composed of massive white quartz vein(stage I) which was formed in the same stage by multiple episodes of fracturing and healing and transparent quartz vein(stage II) which is separated by a major faulting event. The hydrothermal alteration of stage I is sericitization, chloritization, carbonitization, pyritization, silicification and argillization. Sericitic zone occurs near and at quartz vein and includes mainly sericite, quartz, and minor illite, carbonates and epidote. Chloritic zone occurs far from quartz vein and is composed of mainly chlorite, quartz and minor sericite, carbonates and epidote. Fe/(Fe+Mg) ratios of sericite and chlorite range 0.36 to 0.59($0.51{\pm}0.10$) and 0.66 to 0.73($0.70{\pm}0.02$), and belong to muscovite-petzite series and brunsvigite, respectively. Calculated $Al_{IV}-Fe/(Fe+Mg)$ diagrams of sericite and chlorite suggest that this can be a reliable indicator of alteration temperature in Au-Ag deposits. Calculated activities of chlorite end member are $a3(Fe_5Al_2Si_3O_{10}(OH){_6}=0.00964{\sim}0.0291,\;a2(Mg_5Al_2Si_3O_{10}(OH){_6}= 9.99E-07{\sim}1.87E-05,\;a1(Mg_6Si_4O_{10}(OH){_6}=5.61E-07{\sim}1.79E-05$. It suggest that chlorite from the Daebong deposit is iron-rich chlorite formed due to decreasing temperature from $T>450^{\circ}C$. Calculated $log\;{\alpha}K^+/{\alpha}H^+,\;log\;{\alpha}Na^+/{\alpha}H^+,\;log\;{\alpha}Ca^{2+}/{\alpha}^2H^+$ and pH values during wall-rock alteration are $4.6(400^{\circ}C),\;4.1(350^{\circ}C),\;4.0(400^{\circ}C),\;4.2(350^{\circ}C),\;1.8(400^{\circ}C),\;4.5(350^{\circ}C),\;5.4{\sim}6.5(400^{\circ}C)\;and\;5.1{\sim}5.5(350^{\circ}C)$, respectively. Gain elements (enrichment elements) during wallrock alteration are $K_2O,\;P_2O_5,\;Na2O$, Ba, Sr, Cr, Sc, V, Pb, Zn, Be, Ag, As, Ta and Sb. Elements(Sr, V, Pb, Zn, As, Sb) represent a potentially tools for exploration in mesothermal and epithermal gold-silver deposits.

• Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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• 2004.04a
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• pp.3-4
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• 2004

Results will be presented from two field studies that evaluated the in-situ treatment of chlorinated aliphatic hydrocarbons (CAHs) using aerobic cometabolism. In the first study, a cometabolic air sparging (CAS) demonstration was conducted at McClellan Air Force Base (AFB), California, to treat chlorinated aliphatic hydrocarbons (CAHs) in groundwater using propane as the cometabolic substrate. A propane-biostimulated zone was sparged with a propane/air mixture and a control zone was sparged with air alone. Propane-utilizers were effectively stimulated in the saturated zone with repeated intermediate sparging of propane and air. Propane delivery, however, was not uniform, with propane mainly observed in down-gradient observation wells. Trichloroethene (TCE), cis-1, 2-dichloroethene (c-DCE), and dissolved oxygen (DO) concentration levels decreased in proportion with propane usage, with c-DCE decreasing more rapidly than TCE. The more rapid removal of c-DCE indicated biotransformation and not just physical removal by stripping. Propane utilization rates and rates of CAH removal slowed after three to four months of repeated propane additions, which coincided with tile depletion of nitrogen (as nitrate). Ammonia was then added to the propane/air mixture as a nitrogen source. After a six-month period between propane additions, rapid propane-utilization was observed. Nitrate was present due to groundwater flow into the treatment zone and/or by the oxidation of tile previously injected ammonia. In the propane-stimulated zone, c-DCE concentrations decreased below tile detection limit (1 $\mu$g/L), and TCE concentrations ranged from less than 5 $\mu$g/L to 30 $\mu$g/L, representing removals of 90 to 97%. In the air sparged control zone, TCE was removed at only two monitoring locations nearest the sparge-well, to concentrations of 15 $\mu$g/L and 60 $\mu$g/L. The responses indicate that stripping as well as biological treatment were responsible for the removal of contaminants in the biostimulated zone, with biostimulation enhancing removals to lower contaminant levels. As part of that study bacterial population shifts that occurred in the groundwater during CAS and air sparging control were evaluated by length heterogeneity polymerase chain reaction (LH-PCR) fragment analysis. The results showed that an organism(5) that had a fragment size of 385 base pairs (385 bp) was positively correlated with propane removal rates. The 385 bp fragment consisted of up to 83% of the total fragments in the analysis when propane removal rates peaked. A 16S rRNA clone library made from the bacteria sampled in propane sparged groundwater included clones of a TM7 division bacterium that had a 385bp LH-PCR fragment; no other bacterial species with this fragment size were detected. Both propane removal rates and the 385bp LH-PCR fragment decreased as nitrate levels in the groundwater decreased. In the second study the potential for bioaugmentation of a butane culture was evaluated in a series of field tests conducted at the Moffett Field Air Station in California. A butane-utilizing mixed culture that was effective in transforming 1, 1-dichloroethene (1, 1-DCE), 1, 1, 1-trichloroethane (1, 1, 1-TCA), and 1, 1-dichloroethane (1, 1-DCA) was added to the saturated zone at the test site. This mixture of contaminants was evaluated since they are often present as together as the result of 1, 1, 1-TCA contamination and the abiotic and biotic transformation of 1, 1, 1-TCA to 1, 1-DCE and 1, 1-DCA. Model simulations were performed prior to the initiation of the field study. The simulations were performed with a transport code that included processes for in-situ cometabolism, including microbial growth and decay, substrate and oxygen utilization, and the cometabolism of dual contaminants (1, 1-DCE and 1, 1, 1-TCA). Based on the results of detailed kinetic studies with the culture, cometabolic transformation kinetics were incorporated that butane mixed-inhibition on 1, 1-DCE and 1, 1, 1-TCA transformation, and competitive inhibition of 1, 1-DCE and 1, 1, 1-TCA on butane utilization. A transformation capacity term was also included in the model formation that results in cell loss due to contaminant transformation. Parameters for the model simulations were determined independently in kinetic studies with the butane-utilizing culture and through batch microcosm tests with groundwater and aquifer solids from the field test zone with the butane-utilizing culture added. In microcosm tests, the model simulated well the repetitive utilization of butane and cometabolism of 1.1, 1-TCA and 1, 1-DCE, as well as the transformation of 1, 1-DCE as it was repeatedly transformed at increased aqueous concentrations. Model simulations were then performed under the transport conditions of the field test to explore the effects of the bioaugmentation dose and the response of the system to tile biostimulation with alternating pulses of dissolved butane and oxygen in the presence of 1, 1-DCE (50 $\mu$g/L) and 1, 1, 1-TCA (250 $\mu$g/L). A uniform aquifer bioaugmentation dose of 0.5 mg/L of cells resulted in complete utilization of the butane 2-meters downgradient of the injection well within 200-hrs of bioaugmentation and butane addition. 1, 1-DCE was much more rapidly transformed than 1, 1, 1-TCA, and efficient 1, 1, 1-TCA removal occurred only after 1, 1-DCE and butane were decreased in concentration. The simulations demonstrated the strong inhibition of both 1, 1-DCE and butane on 1, 1, 1-TCA transformation, and the more rapid 1, 1-DCE transformation kinetics. Results of tile field demonstration indicated that bioaugmentation was successfully implemented; however it was difficult to maintain effective treatment for long periods of time (50 days or more). The demonstration showed that the bioaugmented experimental leg effectively transformed 1, 1-DCE and 1, 1-DCA, and was somewhat effective in transforming 1, 1, 1-TCA. The indigenous experimental leg treated in the same way as the bioaugmented leg was much less effective in treating the contaminant mixture. The best operating performance was achieved in the bioaugmented leg with about over 90%, 80%, 60 % removal for 1, 1-DCE, 1, 1-DCA, and 1, 1, 1-TCA, respectively. Molecular methods were used to track and enumerate the bioaugmented culture in the test zone. Real Time PCR analysis was used to on enumerate the bioaugmented culture. The results show higher numbers of the bioaugmented microorganisms were present in the treatment zone groundwater when the contaminants were being effective transformed. A decrease in these numbers was associated with a reduction in treatment performance. The results of the field tests indicated that although bioaugmentation can be successfully implemented, competition for the growth substrate (butane) by the indigenous microorganisms likely lead to the decrease in long-term performance.

• Journal of the Korean Institute of Landscape Architecture
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• v.43 no.6
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• pp.73-85
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• 2015

This study investigated the extent and magnitude of the woodland edge effects on users' thermal environments according to distance from woodland border. A series of experiments to measure air temperature, relative humidity, wind velocity, MRT and UTCI were conducted over six days between July 31 and August 5, 2015, which corresponded with extremely hot weather, at the south-facing edge of Hadongsongrim(pure Pinus densiflora stands, tree age: $100{\pm}33yr$, tree height: $12.8{\pm}2.7m$, canopy closure: 75%, N $35^{\circ}03^{\prime}34.7^{{\prime}{\prime}}$, E $127^{\circ}44^{\prime}43.3^{{\prime}{\prime}}$, elevation 7~10m) and east-facing edge of Hamyangsangrim (Quercus serrata-Carpinus tschonoskii community, tree age: 102~125yr/58~123yr, tree height: tree layer $18.6{\pm}2.3m/subtree$ layer $5.9{\pm}3.2m/shrub$ layer $0.5{\pm}0.5m$, herbaceous layer coverage ratio 60%, canopy closure: 96%, N $35^{\circ}31^{\prime}28.1^{{\prime}{\prime}}$, E $127^{\circ}43^{\prime}09.8^{{\prime}{\prime}}$, elevation 170~180m) in rural villages of Hadong and Hamyang, Korea. The minus result value of depth means woodland's outside. The depth of edge influence(DEI) on the maximum air temperature, minimum relative humidity and wind speed at maximum air temperature time during the daytime(10:00~17:00) were detected to be $12.7{\pm}4.9$, $15.8{\pm}9.8$ and $23.8{\pm}26.2m$, respectively, in the mature evergreen conifer woodland of Hadongsongrim. These were detected to be $3.7{\pm}2.2$, $4.9{\pm}4.4$ and $2.6{\pm}7.8m$, respectively, in the deciduous broadleaf woodland of Hamyansangrim. The DEI on the maximum 10 minutes average MRT, UTCI from the three-dimensional environment absorbed by the human-biometeorological reference person during the daytime(10:00~17:00) were detected to be $7.1{\pm}1.7$ and $4.3{\pm}4.6m$, respectively, in the relatively sparse woodland of Hadongsongrim. These were detected to be $5.8{\pm}4.9$ and $3.5{\pm}4.1m$, respectively, in the dense and closed woodland of Hadongsongrim. Edge effects on the thermal environments of air temperature, relative humidity, wind speed, MRT and UTCI in the sparse woodland of Hadongsongrim were less pronounced than those recorded in densed and closed woodland of Hamyansangrim. The gradient variation was less steep for maximum 10 minutes average UTCI with at least $4.3{\pm}4.6m$(Hadongsongrim) and $3.5{\pm}4.1m$(Hamyansangrim) being required to stabilize the UTCI at mature woodlands. Therefore it is suggested that the woodlands buffer widths based on the UTCI values should be 3.5~7.6 m(Hamyansangrim) and 4.3~8.9(Hadongsongrim) m on each side of mature woodlands for users' thermal comfort environments. The woodland edge structure should be multi-layered canopies and closed edge for the buffer effect of woodland edge on woodland users' thermal comfort.

• Journal of Preventive Medicine and Public Health
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• v.24 no.3 s.35
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• pp.441-458
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• 1991

The objective of this study was to provide basic reference data for stabilization scheme of medical insurance benefits through forecasting of the medical care utilization rate, the medical expence per case, and the treatment days per case in medical insurance program for government employees & private school teachers and for industrial workers. For the achievement of above objective, this study was carried out by Box-Jenkins time series analysis (ARIMA Model), using monthly statistical data from Jan. 1979 to Dec. 1989, of medical insurance program for government employees & private school teachers and for industrial workers. The results are as follows ; ARIMA model of the medical care utilization rate in medical insurance program for government employees & private school teachers was ARIMA (1, 1, 1) and it for outpatient in medical insurance program for industrial workers was ARIMA (1, 1, 1), while it for inpatient in medical insurance program for industrial workers was ARIMA (1, 0, 1). ARIMA model of the medical expense per case in medical insurance program for government employees & private school teachers and for outpatient in medical insurance program for industrial workers were ARIMA (1, 1, 0), while it for inpatient in medical insurance program for industrial workers was ARIMA (1, 0, 1). ARIMA model of the treatment days per case of both medical insurance program for government employees & private school teachers and industrial workers were ARIMA (1, 1, 1). Forecasting value of the medical care utilzation rate for inpatient in medical insurance program for government employees & private school teachers was 0.0061 at dec. 1989, 0.0066 at dec. 1994 and it for outpatient was 0.280 at dec. 1989, 0.294 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 0.0052 at dec. 1989, 0.0056 at dec. 1994 and it for outpatient was 0.203 at dec. 1989, 0.215 at 1994. Forecasting value of the medical expense per case for inpatient in medical insurance program for government employees & private school teachers was 332,751 at dec. 1989, 354,511 at dec. 1994 and it for outpatient was 11,925 at dec. 1989, 12,904 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 281,835 at dec. 1989, 293,973 at dec. 1994 and it for outpatient was 11,599 at dec. 1989, 11,585 at 1994. Forecasting value of the treatment days per case for inpatient in medical insurance program for government employees & private school teachers was 13.79 at dec. 1989,13.85 at an. 1994 and in for outpatient was 5.03 at dec. 1989, 5.00 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 12.23 at dec. 1989, 12.85 at dec. 1994 and it for outpatient was 4.61 at dec. 1989, 4.60 at 1994.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.233-243
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• 2000

Purpose : First of all, this study was performed to assess the result of curative radiotherapy and to evaluate different possible prognostic factors for squamous cell carcinoma of the supraglottic larynx treated at the Pusan National University Hospital. The second goal of this study was by comparing our data with those of other study groups, to determine the better treatment policy of supraglottic cancer in future. Methods and Material : Thirty-two patients with squamous cell carcinoma of the supraglottic larynx were treated with radiotherapy at Pusan National University Hospital, from August 1985 to December 1996. Minimum follow-up period was 29 months, Twenty-seven patients (84.4$\%$) were followed up over 5 years. Radiotherapy was delivered with 6 MV photons to the primary laryngeal tumor and regional iymphatics with shrinking field technique. Ail patients received radiotherapy under conventional fractionated schedule (once a day). Median total tumor dose was 70.2 Gy (range, 55.8 to 75.6 Gy) on primary or gross tumor lesion. Thirteen patients had Induction chemotherapy with cisplatln and 5-fluorouracil (1-3 cycles). Patient distribution, according to the different stages, were as follows: stage I, 5/32 (15.6$\%$): stage II, 10/32 (31.3$\%$); stage III, 8/32 (25$\%$): stage IV, 9/32 (28.1$\%$). Results :The 5-year overall survival rate of the whole series (32 patients) was 51.7$\%$. The overall survival rate at 5-years was 80$\%$ in stage I, 66.7$\%$ in stage II, 42.9$\%$ in stage III, 25$\%$ in stage IV (p=0.0958). The S-year local control rates after radiotherapy were as fellows: stage I, 100$\%$; stage II, 60$\%$ stage III, 62.5$\%$; stage IV, 44.4$\%$ (p=0.233). Overall vocal preservation rates was 65.6$\%$, 100% In stage I, 70% in stage II, 62.5$\%$ In stage III, 44.4$\%$ in stage IV (p=0.210). There was no statistical significance in survival and local control rate between neoadjuvant chemotherapy followed by radiotherapy group and radiotherapy alone group. Severe laryngeal edema was found in 2 cases after radiotllerapy, emergent tracheostomy was done. Four patients were died from distant metastsis, . three in lung, one in brain. Double primary tumor was found in 2 cases, one in lung (metachronous), another in thyroid (synchronous). Ulcerative lesions were revealed as unfavorable prognostic factor ( p=0.0215), and radiation dose (more or less than 70.2 Gy) was an important factor on survival (p=0.002). Conclusion : The role of radiotherapy treatment of supraglottic carcinoma is to important factor on survival and to preserve the laryngeal function. Based on our data and other studies, early and moderately advanced supragiottic carcinomas could be successfully treated with either consewative surgery or radiotherapy alone. Both modalities showed similar results in survival and vocal preservation. For the advanced cases, radiotherapy alone is Inadequate for curative aim and surgery combined with radiotherapy should be done in operable patients. When patients refuse operation or want to preserve vocal function, or for the patients with inoperable medical conditions, combined chemoradiotherapy (concurrent) or altered fractionated radiotherapy with or without radiosensitizer should be taken into consideration in future.

• Journal of Preventive Medicine and Public Health
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• v.30 no.2 s.57
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• pp.437-461
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• 1997

Because of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 30 years, the life expectancy of the Korean people has lengthened considerably and as a result, the number of the elderly has markedly increased. Such an increase of the number of aged population brought about many social, economic, and medical problems which were never seriously considered before. This study was conducted to assess the trend of medical care utilization and medical expenditure of the elderly. The data of each patient in the study were taken from computer database maintained for administrative purpose by the Korea Medical Insurance Corporation. The study population was 132,670 who were 60 years old or more and registered in Korean Medical Insurance Corporation from 1989 to 1993. The study subjects were predominantly female(56.3%) and 10,000-20,000 Won premium group(50.6%). The following are summaries of findings : The total increase of the number of inpatient cases was 40.5% from 1989 through 1993. The average annual increase was 3.7% in inpatient medical expenditures per case, 4.4% in inpatient medical expenditures per day and 0.08% in length of stay per case from 1989 through 1993. Cataract was the most prevalent disease of 10 leading frequent diseases in all ages from 1989 through 1993. The case mix in 1993 compared to 1989 revealed that cataract and ischemic cerebral disease were increased whereas essential hypertension and pulmonary tuberculosis were decreased . The average annual increase of medical expenditures was 3.8% in general hospitals, 6.3% in hospitals and 2.4% in clinics. From 1989 through 1993, medical expenditures used by high-cost patients accounted for about 14% to 20% of all expenditures for inpatient care, while they represented less than 2.5% of the elderly population. Time series analysis revealed that total medical expenditures and doctor's fee for inpatient will be progressively increased whereas drug expenditures for inpatient will be decreased. And there will be no change in length of stay. Based on the above results, the factors increasing medical cost and utilization should be identified and the method of cost containment for the elderly health care should be developed systematically.