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Five Most Common Prognostically Important Fusion Oncogenes are Detected in the Majority of Pakistani Pediatric Acute Lymphoblastic Leukemia Patients and are Strongly Associated with Disease Biology and Treatment Outcome

  • Awan, Tashfeen;Iqbal, Zafar;Aleem, Aamer;Sabir, Noreen;Absar, Muhammad;Rasool, Mahmood;Tahir, Ammara H.;Basit, Sulman;Khalid, Ahmad Mukhtar;Sabar, Muhammad Farooq;Asad, Sultan;Ali, Agha Shabbir;Mahmood, Amer;Akram, Muhammad;Saeed, Tariq;Saleem, Arsalan;Mohsin, Danish;Shah, Ijaz Hussain;Khalid, Muhammad;Asif, Muhammad;Haq, Riazul;Iqbal, Mudassar;Akhtar, Tanveer
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5469-5475
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    • 2012
  • Background and Objectives: Acute lymphoblastic leukemia (ALL) is a complex genetic disease involving many fusion oncogenes (FO) having prognostic significance. The frequency of various FO can vary in different ethnic groups, with important implications for prognosis, drug selection and treatment outcome. Method: We studied fusion oncogenes in 101 pediatric ALL patients using interphase FISH and RT-PCR, and their associations with clinical features and treatment outcome. Results: Five most common fusion genes i.e. BCR-ABL t (22; 9), TCF3-PBX1 (t 1; 19), ETV6-RUNX1 (t 12; 21), MLL-AF4 (t 4; 11) and SIL-TAL1 (del 1p32) were found in 89/101 (88.1%) patients. Frequency of BCR-ABL was 44.5% (45/101). BCR-ABL positive patients had a significantly lower survival ($43.7{\pm}4.24$ weeks) and higher white cell count as compared to others, except patients with MLL-AF4. The highest relapse-free survival was documented with ETV6-RUNX1 (14.2 months) followed closely by those cases in which no gene was detected (13.100). RFS with BCR-ABL, MLL-AF4, TCF3-PBX1 and SIL-TAL1 was less than 10 months (8.0, 3.6, 5.5 and 8.1 months, respectively). Conclusions: This is the first study from Pakistan correlating molecular markers with disease biology and treatment outcome in pediatric ALL. It revealed the highest reported frequency of BCR-ABL FO in pediatric ALL, associated with poor overall survival. Our data indicate an immediate need for incorporation of tyrosine kinase inhibitors in the treatment of BCR-ABL+ pediatric ALL in this population and the development of facilities for stem cell transplantation.

The Liability for Damage and Dispute Settlement Mechanism under the Space Law (우주법상 손해배상책임과 분쟁해결제도)

  • Lee, Kang-Bin
    • Journal of Arbitration Studies
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    • v.20 no.2
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    • pp.173-198
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    • 2010
  • The purpose of this paper is to research on the liability for the space damage and the settlement of the dispute with reference to the space activity under the international space treaty and national space law of Korea. The United Nations has adopted five treaties relating to the space activity as follows: The Outer Space Treaty of 1967, the Rescue and Return Agreement of 1968, the Liability Convention of 1972, the Registration Convention of 1974, and the Moon Treaty of 1979. All five treaties have come into force. Korea has ratified above four treaties except the Moon Treaty. Korea has enacted three national legislations relating to space development as follows: Aerospace Industry Development Promotion Act of 1987, Outer Space Development Promotion Act of 2005, Outer Space Damage Compensation Act of 2008. The Outer Space Treaty of 1967 regulates the international responsibility for national activities in outer space, the national tort liability for damage by space launching object, the national measures for dispute prevention and international consultation in the exploration and use of outer space, the joint resolution of practical questions by international inter-governmental organizations in the exploration and use of outer space. The Liability Convention of 1972 regulates the absolute liability by a launching state, the faulty liability by a launching state, the joint and several liability by a launching state, the person claiming for compensation, the claim method for compensation, the claim period of compensation, the claim for compensation and local remedy, the compensation amount for damage by a launching state, the establishment of the Claims Commission. The Outer Space Damage Compensation Act of 2008 in Korea regulates the definition of space damage, the relation of the Outer Space Damage Compensation Act and the international treaty, the non-faulty liability for damage by a launching person, the concentration of liability and recourse by a launching person, the exclusion of application of the Product Liability Act, the limit amount of the liability for damage by a launching person, the cover of the liability insurance by a launching person, the measures and assistance by the government in case of occurring the space damage, the exercise period of the claim right of compensation for damage. The Liability Convention of 1972 should be improved as follows: the problem in respect of the claimer of compensation for damage, the problem in respect of the efficiency of decision by the Claims Commission. The Outer Space Damage Compensation Act of 2008 in Korea should be improved as follows: the inclusion of indirect damage into the definition of space damage, the change of currency unit of the limit amount of liability for damage, the establishment of joint and several liability and recourse right for damage by space joint launching person, the establishment of the Space Damage Compensation Review Commission. The 1998 Final Draft Convention on the Settlement of Disputes Related to Space Activities of 1998 by ILA regulates the binding procedure and non-binding settlement procedure for the disputes in respect of space activity. The non-binding procedure regulates the negotiation or the peaceful means and compromise for dispute settlement. The binding procedure regulates the choice of a means among the following means: International Space Law Court if it will be established, International Court of Justice, and Arbitration Court. The above final Draft Convention by ILA will be a model for the innovative development in respect of the peaceful settlement of disputes with reference to space activity and will be useful for establishing the frame of practicable dispute settlement. Korea has built the space center at Oinarodo, Goheung Province in June 2009. Korea has launched the first small launch vehicle KSLV-1 at the Naro Space Center in August 2009 and June 2010. In Korea, it will be the possibility to be occurred the problems relating to the international responsibility and dispute settlement, and the liability for space damage in the course of space activity. Accordingly the Korean government and launching organization should make the legal and systematic policy to cope with such problems.

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A Study on Usefulness of Clinical Application of Metal Artifact Reduction Algorithm in Radiotherapy (방사선치료 시 Metal artifact reduction Algorithm의 임상적용 유용성평가)

  • Park, Ja Ram;Kim, Min Su;Kim, Jeong Mi;Chung, Hyeon Suk;Lee, Chung Hwan;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.2
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    • pp.9-17
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    • 2017
  • Purpose: The tissue description and electron density indicated by the Computed Tomography(CT) number (also known as Hounsfield Unit) in radiotherapy are important in ensuring the accuracy of CT-based computerized radiotherapy planning. The internal metal implants, however, not only reduce the accuracy of CT number but also introduce uncertainty into tissue description, leading to development of many clinical algorithms for reducing metal artifacts. The purpose of this study was, therefore, to investigate the accuracy and the clinical applicability by analyzing date from SMART MAR (GE) used in our institution. Methode: and material: For assessment of images, the original images were obtained after forming ROIs with identical volumes by using CIRS ED phantom and inserting rods of six tissues and then non-SMART MAR and SMART MAR images were obtained and compared in terms of CT number and SD value. For determination of the difference in dose by the changes in CT number due to metal artifacts, the original images were obtained by forming PTV at two sites of CIRS ED phantom CT images with Computerized Treatment Planning (CTP system), the identical treatment plans were established for non-SMART MAR and SMART MAR images by obtaining unilateral and bilateral titanium insertion images, and mean doses, Homogeneity Index(HI), and Conformity Index(CI) for both PTVs were compared. The absorbed doses at both sites were measured by calculating the dose conversion constant (cCy/nC) from ylinder acrylic phantom, 0.125cc ionchamber, and electrometer and obtaining non-SMART MAR and SMART MAR images from images resulting from insertions of unilateral and bilateral titanium rods, and compared with point doses from CTP. Result: The results of image assessment showed that the CT number of SMART MAR images compared to those of non-SMART MAR images were more close to those of original images, and the SD decreased more in SMART compared to non-SMART ones. The results of dose determinations showed that the mean doses, HI and CI of non-SMART MAR images compared to those of SMART MAR images were more close to those of original images, however the differences did not reach statistical significance. The results of absorbed dose measurement showed that the difference between actual absorbed dose and point dose on CTP in absorbed dose were 2.69 and 3.63 % in non-SMRT MAR images, however decreased to 0.56 and 0.68 %, respectively in SMART MAR images. Conclusion: The application of SMART MAR in CT images from patients with metal implants improved quality of images, being demonstrated by improvement in accuracy of CT number and decrease in SD, therefore it is considered that this method is useful in dose calculation and forming contour between tumor and normal tissues.

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Retrieval of Sulfur Dioxide Column Density from TROPOMI Using the Principle Component Analysis Method (주성분분석방법을 이용한 TROPOMI로부터 이산화황 칼럼농도 산출 연구)

  • Yang, Jiwon;Choi, Wonei;Park, Junsung;Kim, Daewon;Kang, Hyeongwoo;Lee, Hanlim
    • Korean Journal of Remote Sensing
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    • v.35 no.6_3
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    • pp.1173-1185
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    • 2019
  • We, for the first time, retrieved sulfur dioxide (SO2) vertical column density (VCD) in industrial and volcanic areas from TROPOspheric Monitoring Instrument (TROPOMI) using the Principle component analysis(PCA) algorithm. Furthermore, SO2 VCDs retrieved by the PCA algorithm from TROPOMI raw data were compared with those retrieved by the Differential Optical Absorption Spectroscopy (DOAS) algorithm (TROPOMI Level 2 SO2 product). In East Asia, where large amounts of SO2 are released to the surface due to anthropogenic source such as fossil fuels, the mean value of SO2 VCD retrieved by the PCA (DOAS) algorithm was shown to be 0.05 DU (-0.02 DU). The correlation between SO2 VCD retrieved by the PCA algorithm and those retrieved by the DOAS algorithm were shown to be low (slope = 0.64; correlation coefficient (R) = 0.51) for cloudy condition. However, with cloud fraction of less than 0.5, the slope and correlation coefficient between the two outputs were increased to 0.68 and 0.61, respectively. It means that the SO2 retrieval sensitivity to surface is reduced when the cloud fraction is high in both algorithms. Furthermore, the correlation between volcanic SO2 VCD retrieved by the PCA algorithm and those retrieved by the DOAS algorithm is shown to be high (R = 0.90) for cloudy condition. This good agreement between both data sets for volcanic SO2 is thought to be due to the higher accuracy of the satellite-based SO2 VCD retrieval for SO2 which is mainly distributed in the upper troposphere or lower stratosphere in volcanic region.

A Biomechanical Study on the Various Factors of Vertebroplasty Using Image Analysis and Finite Element Analysis (의료영상 분석과 유한요소법을 통한 추체 성형술의 다양한 인자들에 대한 생체 역학적 효과 분석)

  • 전봉재;권순영;이창섭;탁계래;이권용;이성재
    • Journal of Biomedical Engineering Research
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    • v.25 no.3
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    • pp.171-182
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    • 2004
  • This study investigates the biomechanical efficacies of vertebroplasty which is used to treat vertebral body fracture with bone cement augmentation for osteoporotic patients using image and finite element analysis. Simulated models were divided into two groups: (a) a vertebral body, (b) a functional spinal unit(FSU). For a vertebral body model, the maximum axial displacement was investigated under axial compression to evaluate the effect of structural integrity. The stiffness of each FE model simulated was normalized by the stiffness of intact model. In the case of FSU model, 3 types of compression fractures were formulated to assess the influence on spinal curvature changes. The FSU models were loaded under compressive pressure to calculate the change of spinal curvature. The results according to the various factors suggest that vertebroplasty has the biomechanical efficacy of the increment of structural reinforcement in a patient who has relatively high level of BMD and a patient with the amount of 15%, PMMA injection of the cancellous bone volume. The spinal curvatures after compression fracture simulation vary from 9$^{\circ}$ to 17$^{\circ}$ of kyphosis compared to that the spinal curvature of normal model was -2.8$^{\circ}$ of lordosis. These spinal curvature changes cause the severe spinal deformity under the same loading. As the degree of compressive fracture increases the spinal deformity also increases. The results indicate that vertebroplasty has the increasing effect of the structural integrity regardless of the amount of PMMA or BMD and the restoration of decreased vertebral body height may be an important factor when the compressive fracture caused the significant height loss of vertebral body.

Comparison and Analysis of Photon Beam Data for Hospitals in Korea and Data for Quality Assurance of Treatment Planning System (국내 의료기관들의 광자 빔 데이터의 비교 분석 및 치료계획 시스템 정도관리자료)

  • Lee, Re-Na;Cho, Byung-Chul;Kang, Sei-Kwon
    • Progress in Medical Physics
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    • v.17 no.3
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    • pp.179-186
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    • 2006
  • Purpose: Photon beam data of linear accelerators in Korea are collected, analyzed, and a simple method for checking and verifying the dose calculations in a TPS are suggested. Materials and Methods: Photon beam data such as output calibration condition, output factor, wedge factor, percent depth dose, beam profile, and beam quality were collected from 26 institutions in Korea. In order to verify the accuracy of dose calculation, ten sample planning tests were peformed. These Include square, elongated, and blocked fields, wedge fields, off-axis dose calculation, SSD variation. The planned data were compared to that of manual calculations. Results: The average and standard deviation of photon beam quality for 6, 10, and 15 MV were $0.576{\pm}0.005,\;0.632{\pm}0.004,\;and\;0.647{\pm}0.006$, respectively. The output factors of 6 MV photon beam measured at depth of dose maximum for $5{\times}5cm,\;15{\times}15cm,\;20{\times}20cm\;were\;0.944{\pm}0.006,\;1.031{\pm}0.006,\;and\;1.055{\pm}0.007$. For 10 MV photon beam, the values were $0.935{\pm}0.006,\;1.031{\pm}0.007,\;1.054{\pm}0.0005$. The collected data were not enough to calculate average, the output factors for 15MV photon beam with field size of $5{\times}5cm,\;15{\times}15cm,\;20{\times}20cm\;were\;0.941{\pm}0.008,\;1.032{\pm}0.004,\;1.049{\pm}0.014$. There was seven institutions $e{\times}ceeding$ tolerance when monitor unit values calculated from treatment planning system and manually were compared. The measured average MU values for the machines calibrated at SAD setup were 3 MU and 5 MU higher than the machines calibrated at SSD for 6 MV and 10 MV, respectively except the wedge case. When the wedges were inserted, the MU values to deliver 100 cGy to 5 cm depends on manufactures. When the same wedge angle was used, Siemens machine requires more MUs then Varian machine. Conclusion: In this study, photon beam data are collected and analyzed to provide a baseline value for chocking beam data and the accuracy of dose calculation for a treatment planning system.

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The Predcitors of the Development of Acute Respiratory Distress Syndrome in the Patients with Acute Pancreatitis (급성 췌장염으로 내과계 중환자실에 입원한 환자들의 급성호흡곤란 증후군 발생에 연관된 인자에 관한 연구)

  • Yoo, Mi-Ran;Koh, Youn-Suck;Lim, Chae-Man;Lee, Moon-Gyu;Lee, Hong-Jae;Lee, Moo-Song;An, Jong-Jun;Lee, Sung-Koo;Kim, Myung-Hwan;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.861-870
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    • 1997
  • Background : Though acute respiratory distress(ARDS) often occurs in the early stage of severe acute pancreatitis and significantly contributed to the mortality of the condition, the characteristics of the group who develops ARDS in the patients with acute pancreatitis have not been fully found. The objective of this investigation was to identify predictable factors which distinguish a group who would develop ARDS in the patients with acute pancreatitis. Method : A retrospective analysis of 94 cases in 86 patients who were admitted the Medical Intensive Care Unit with acute pancreatitis was done. ARDS were developed in 13 cases among them (13.8%). The possible clinical factors related to the development were analyzed using univariate analysis and $x^2$-test. Results : The risk of ARDS development was increased in the patients with abonormal findings of chest X-ray at admission compared to the patients with normal chest X-ray (p<0.05). The risk was also increased according to the sevecrity index score in abdominal computed tomography at the time of admission (p<0.05). The higher APACHE III score of the first day of admission, the more risk increment of ARDS development was observed (p<0.01). Patients with more than one points of Murray's lung injury score showed higher risk of ARDS compared to the patients with 0 points of that. The patients with sepsis and the patients with more than three organ dysfunction at admission had 3.5 times and 23.3 times higher risk of the development of ARDS compared to the patients without sepsis and without organ failure in each (p<0.05, p<0.01). Conclusion : The risk of ARDS development would be higher in the acute pancreatitis patients with abnormal chest X-ray, higher CT severity index, higher APACHE III or Murray's lung injury score, accompanying sepsis, and more than three organ failure at admission.

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A comparative study of electroplating and electroless plating for diameter increase of orthodontic wire (교정용 선재의 직경 증가를 위한 전기도금법과 무전해도금법의 비교연구)

  • Kim, Jae-Nam;Cho, Jin-Hyoung;Sung, Young-Eun;Lee, Ki-Heon;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.36 no.2 s.115
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    • pp.145-152
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    • 2006
  • The purpose of this study was to evaluate electroless plating as a method of increasing the diameter of an orthodontic wire in comparison with eletroplating. After pretreatment plating of the 0.016 inch stainless steel orthodontic wire, electroless plating was performed at $90^{\circ}C$ until the diameter of the wire was increased to 0.018 inch. During the process of electroless plating, the diameter of the wire was measured every 5 minutes to examine the increasing ratio of the wire's diameter per time unit. And to examine the uniformity, the diameter at 3 points on the electroless-plated orthodontic wire was measured. An X-ray diffraction test for analyzing the nature of the plated metal and a 3-point bending test for analyzing the physical property were performed. The electroless-plated wire group showed a increased tendency for stiffness, yield strength, and ultimate strength than the electroplated wire group. And there was a statistically significant difference between the two groups for stiffness and ultimate strength. In the electroless-plated wire group, the increasing ratio of the diameter was $0.00461{\pm}0.00003mm/5min$ (0.00092 mm/min). In the electroplated wire group, it was $0.00821{\pm}0.00015mm/min$. The results of the uniformity test showed a tendency for uniformity in both the plating methods. The results of this study suggest that electroless plating of the wire is closer to the ready-made wire than electroplating wire in terms of the physical property. However, the length of plating time needs further consideration for the clinical application of electroless plating.

Needs of Patients and their Families in Hospice Care Unit (일 호스피스 병동 입원 환자와 가족의 요구도)

  • Kim, Hyung-Chul;Kim, Eun-Sook;Park, Kwang-He
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.137-144
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    • 2007
  • Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

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Studies on the Improvement of Mountainous Pasture III. Effect of seed coating on oversown pasture (산지초지 개량에 관한 연구 III. 종자 Coating에 의한 겉뿌림 초지육성)

  • 이인덕
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.4 no.3
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    • pp.194-200
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    • 1984
  • Effects of seed coating on establishment, early growth and herbage production were investigated in Pot, Soil box and Field experiments. Seed was coated with 60% Lime, 20% Phosphate and 20% Peatmoss(W/W), also finely sprayed 13% Arabic gum and 2% Methyl cellulose(W/V). Coating were generally 1:20, seed: coat(W/W). 1. In the general growth of the growing stages and different oversown species at 80 days, seed coated was promoted than none in early growth. (Table 2 and 3) 2. Stand counts at 60 days after oversown, seed coated was higher 15% than none, especially, there was advantage due to coating on the medium and large size seeds such as Orchardgrass, Perennial ryegrass and Kentucky bluegrass, but did not assist establishment of the large (Tall fescue) and small (Ladino clover) size seed. 3. Variation of sward composition was not quite different between two treatments, but seed coated was slightly increased the Percentage of sown grasses with advance of cutting time. 4. Total dry metter yield per unit area with seed coated was higher 17% than none in establishment year. 5. Variations in the chemical composition of the herbage and soil were influenced by coating materials in the coating regime (Table 8). 6. From these facts, seed coated also appeared that adequate seedling stands, early growth and herbage production could be obtained with higher than conventional overseeding method under a poor conditions.

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