• Title/Summary/Keyword: development rate

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An Analysis of the Imported Consumer Goods Distribution Sector of Korea: From a Vertical Structure Viewpoint (수입소비재(輸入消費財) 유통구조(流通構造)의 효율화(效率化) 방안(方案))

  • Nam, Il-chong
    • KDI Journal of Economic Policy
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    • v.13 no.1
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    • pp.3-33
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    • 1991
  • Since the early 1980's, the Korean government has gradually been widening the Korean market to foreign consumer goods. This, combined with the increased purchasing power of the Korean consumers resulting from the continued economic growth of the country, has sparked a spectacular influx of foreign consumer goods into Korea, ranging from BMW's to chopsticks. Import of foreign consumer goods amounted to more than 6 billion dollars in 1989 and is continuing to grow at a rapid rate. The increased import of foreign consumer goods doubtlessly improved the overall welfare of the Korean consumers by providing them with a wider range of options to choose from, by lowering the prices of some of the consumer goods domestically produced, and also by forcing the producers of some Korean goods to face competition with better foreign goods, thus giving them an incentive to raise the quality of their products. However, it is agreed by most economists that this increase in general welfare has been much smaller than what they had expected at the outset. Consumer prices of most imported consumer goods are easily double the import price, and in some cases, more than treble the import prices. Further, there has not been a noticeable drop in the prices of domestically produced consumer goods. Much of the blame has been attributed to the distribution sector of Korea. The objective of this paper is to analyze the imported consumer goods distribution sector of Korea, focusing on the possible sources of the poor performance of that sector, and to make policy suggestions that could potentially increase the welfare. This paper differs from all the previous research by others on this subject in that it analyzes the imported consumer goods distribution sector of Korea as a vertical structure. The distribution sector of an imported consumer good is a vertical structure since it consists of an international market, an import stage, and domestic wholesale and retail markets, in that order vertically. Our study naturally includes the analysis of the vertical restraints as well as the analysis of the industrial organization of each horizontal stage in the vertical structure. Each horizontal component of the imported consumer goods distribution sector is basically a monopolistically competitive market differentiated by characteristics of goods and by the locations and the services of firms. Further, restrictive dealership and resale price maintenance are found to be widely in use. Our main findings are the follwing; First, most consumer goods are imported monopolistically or oligopolistically through restrictive dealership contracts between foreign producers and domestic importers. Such restrictive dealership gives importers market power in the domestic market and explains many of the large discrepancies betwen the consumer prices and the import prices of many goods. Korean anti - trust law does not cover the issues arising from the market power of an importer resulting from a restrictive dealership contract. Second, some major producers of Korean goods are also importers of foreign goods that are substitutes of their products. The import of substitutes by major domestic producers is anti - competitive because it tends to raise the prices of both domestic goods and foreign goods, and also because it reduces the incentive of the domestic producers to raise the quality of their products. Third, wholesalers and retailers widely use resale price maintenance as a price fixing mechanism, and while this is against the anti- trust law, it seldom gets noticed. Fourth, the high level of rents of real estate for commercial use works as an entry barrier to the distribution sector and results in reduced competition by the firms in that sector. Finally, there are information problems. Consumers have inferior information to firms about the quality of a foreign consumer good that they have not tried before. Such information asymmetry often enables firms to raise prices. In addition, information asymmetry between importers frequently delays the import of cheaper substitutes. In order to alleviate the problems indentified above, we suggest the following policy changes. The government should strengthen the anti - trust law and its enforcement to regulate restrictive import contracts, import of competing goods by major domestic producers, and RPM by wholesalers and retailers that is aimed at price fixing. In addition, the government should loosen its tight real estate policy to encourage investment in the distribution sector. Finally, we suggest that the import price revelation policy that has been in use for some items since 1990 be expanded to most imported consumer goods that are introduced for the first time to give consumer better information and be used only for the period of time needed to inform sufficient number of consumers.

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An Analytical Study on Stem Growth of Chamaecyparis obtusa (편백(扁栢)의 수간성장(樹幹成長)에 관(關)한 해석적(解析的) 연구(硏究))

  • An, Jong Man;Lee, Kwang Nam
    • Journal of Korean Society of Forest Science
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    • v.77 no.4
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    • pp.429-444
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    • 1988
  • Considering the recent trent toward the development of multiple-use of forest trees, investigations for comprehensive information on these young stands of Hinoki cypress are necessary for rational forest management. From this point of view, 83 sample trees were selected and cut down from 23-ear old stands of Hinoki cypress at Changsung-gun, Chonnam-do. Various stem growth factors of felled trees were measured and canonical correlaton analysis, principal component analysis and factor analysis were applied to investigate the stem growth characteristics, relationships among stem growth factors, and to get potential information and comprehensive information. The results are as follows ; Canonical correlation coefficient between stem volume and quality growth factor was 0.9877. Coefficient of canonical variates showed that DBH among diameter growth factors and height among height growth factors had important effects on stem volume. From the analysis of relationship between stem-volume and canonical variates, which were linearly combined DBH with height as one set, DBH had greater influence on volume growth than height. The 1st-2nd principal components here adopted to fit the effective value of 85% from the pincipal component analysis for 12 stem growth factors. The result showed that the 1st-2nd principal component had cumulative contribution rate of 88.10%. The 1st and the 2nd principal components were interpreted as "size factor" and "shape factor", respectively. From summed proportion of the efficient principal component fur each variate, information of variates except crown diameter, clear length and form height explained more than 87%. Two common factors were set by the eigen value obtained from SMC (squared multiple correlation) of diagonal elements of canonical matrix. There were 2 latent factors, $f_1$ and $f_2$. The former way interpreted as nature of diameter growth system. In inherent phenomenon of 12 growth factor, communalities except clear length and crown diameter had great explanatory poorer of 78.62-98.30%. Eighty three sample trees could he classified into 5 stem types as follows ; medium type within a radius of ${\pm}1$ standard deviation of factor scores, uniformity type in diameter and height growth in the 1st quadrant, slim type in the 2nd quadrant, dwarfish type in the 3rd quadrant, and fall-holed type in the 4 th quadrant.

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A Study to Decrease Exposure Dose for the Radiotechnologist in PET/CT (PET/CT 검사에서 방사선 종사자 피폭선량 저감에 대한 방안 연구)

  • Cho, Seok-Won;Park, Hoon-Hee;Kim, Jung-Yul;Ban, Yung-Kak;Lim, Han-Sang;Oh, Ki-Beak;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.159-165
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    • 2010
  • Purpose: Positron emission tomography scan has been growing diagnostic equipment in the development of medical imaging system. Compare to $^{99m}Tc$ emitting 140 keV, Positron emission radionuclide emits 511 keV gamma rays. Because of this high energy, it needs to reduce radioactive emitting from patients for radiotechnologist. We searched the external dose rates by changing distance from patients and measure the external dose rates when we used shielder investigate change external dose rates. In this study, the external dose distribution were analyzed in order to help managing radiation protection of radiotechnologists. Materials and Methods: Ten patients were searched (mean age: $47.7{\pm}6.6$, mean height: $165.5{\pm}3.8$ cm and mean weight: $65.9{\pm}1.4$ kg). Radiation were measured on the location of head, chest, abdomen, knees and toes at the distance of 10, 50, 100, 150 and 200 cm. Then, all the procedure was given with a portable radiation shielding on the location of head, chest and abdomen at the distance of 100, 150 and 200 cm and transmittance was calculated. Results: In 10 cm, head (105.40 ${\mu}Sv/h$) was the highest and foot (15.85 ${\mu}Sv/h$) was the lowest. In 200 cm, head, chest and abdomen showed similar. On head, the measured dose rates were 9.56 ${\mu}Sv/h$, 5.23 ${\mu}Sv/h$, and 3.40 ${\mu}Sv/h$ in 100, 150 and 200 cm respectively. When using shielder, it shows 2.24 ${\mu}Sv/h$, 1.67 ${\mu}Sv/h$, and 1.27 ${\mu}Sv/h$ in 100, 150 and 200 cm on head. On chest, the measured dose rates were 8.54 ${\mu}Sv/h$, 4.90 ${\mu}Sv/h$, 3.44 ${\mu}Sv/h$ in 100, 150 and 200 cm, respectively. When using shielder, it shows 2.27 ${\mu}Sv/h$, 1.34 ${\mu}Sv/h$, and 1.13 ${\mu}Sv/h$ in 100, 150 and 200 cm on chest. On abdomen, the measured dose rates were 9.83 ${\mu}Sv/h$, 5.15 ${\mu}Sv/h$ and 3.18 ${\mu}Sv/h$ in 100, 150 and 200cm respectively. When using shielder, it shows 2.60 ${\mu}Sv/h$, 1.75 ${\mu}Sv/h$ and 1.23 ${\mu}Sv/h$ in 100, 150 and 200 cm on abdomen. Transmittance was increased as the distance was expanded. Conclusion: As the distance was further, the radiation dose were reduced. When using shielder, the dose were reduced as one-forth of without shielder. The Radio technologists are exposed of radioactivity and there were limitations on reducing the distance with Therefore, the proper shielding will be able to decrease radiation dose to the radiotechnologists.

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Comparative analysis of dietary behavior and nutrient intake of elderly in urban and rural areas for development of "Village Lunch Table" program: Based on 2014 Korea National Health and Nutrition Examination Survey data (농촌 노인의 마을 밥상 개선 프로그램 개발을 위한 도시와 농촌 노인의 식생활 행태 및 영양소 섭취 상태 비교분석 : 2014년 국민건강영양조사 자료를 이용하여)

  • Lee, Youngmi;Choi, Yourim;Park, Hae Ryun;Song, Kyung Hee;Lee, Kyung Eun;Yoo, Chang;Lim, Young Suk
    • Journal of Nutrition and Health
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    • v.50 no.2
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    • pp.171-179
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    • 2017
  • Purpose: We conducted comparative analysis of dietary behavior and food and nutrient intakes of Korean elderly in urban and rural areas using the 2014 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: This study was conducted on 1,239 participants (urban elderly: 867, rural elderly: 372) aged 65 years and over who participated in the health examination and nutrition survey in the 6th 2014 KNHANES. Dietary behaviors, including skipping meals, eating out frequencies, and food and nutrient intakes were analyzed using 24-hour recall data. Analysis of complex sample design data through SPSS 19.0 was used for the analysis. Results: The rate of skipping dinner was higher in urban (6.5%) than in rural elderly (3.6%) (p < 0.05), and the frequency of eating out per week of urban elderly (1.73) was higher than that of rural elderly (1.35) (p < 0.001). The rural elderly consumed a greater amount of grain compared to urban elderly, whereas consumption of water, seaweed food, and dairy products was lower in rural than in urban areas (p < 0.05). The rural elderly consumed significantly less highly unsaturated fatty acids, n-6 fatty acids, phosphorus, iron, vitamin A, carotene, niacin, and vitamin C in comparison with elderly in urban areas. Comparison of the percentages of Dietary Reference Intakes for Koreans (KDRIs) between the two groups showed that intakes of vitamin A and vitamin C were significantly lower in the rural elderly than in urban elderly. Conclusion: The elderly in rural areas showed unbalanced food and nutrient intakes compared to the elderly in urban areas. Therefore, customized nutrition education according to residential areas should be developed and provided to rural elderly to improve their health and nutritional status.

STUDIES ON THE PROPAGATION OF ABALONE (전복의 증식에 관한 연구)

  • PYEN Choong-Kyu
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.3 no.3
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    • pp.177-186
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    • 1970
  • The spawning of the abalone, Haliotis discus hannai, was induced In October 1969 by air ex-position for about 30 minutes. At temperatures of from 14.0 to $18.8^{\circ}C$, the youngest trochophore stage was reached within 22 hours after the egg was laid. The trochophore was transformed into the veliger stage within 34 hours after fertilization. For $7\~9$ days after oviposition the veliger floated in sea water and then settled to the bottom. The peristomal shell was secreted along the outer lip of the aperture of the larval shell, and the first respiratory pore appears at about 110 days after fertilization. The shell attained a length of 0.40 mm in 15 days, 1.39 mm in 49 days, 2.14 mm in 110 days, 5.20 mm in 170 days and 10.00 mm in 228 days respectively. Monthly growth rate of the shell length is expressed by the following equation :$L=0.9981\;e^{0.18659M}$ where L is shell length and M is time in month. The density of floating larvae in the culture tank was about 10 larvae per 100 co. The number of larvae attached to a polyethylene collector ($30\times20\;cm$) ranged from 10 to 600. Mortality of the settled larvae on the polyethylene collector was about $87.0\%$ during 170 days following settlement. The culture of Nauicula sp. was made with rough polyethylene collectors hung at three different depths, namely 5 cm, 45 cm and 85 cm. At each depth the highest cell concentration appeared after $15\~17$ days, and the numbers of cells are shown as follows: $$5\;cm\;34.3\times10^4\;Cells/cm^2$$ $$45\;cm\;27.2\times10^4\;Cells/cm^2$$ $$85\;cm\;26.3\times10^4\;Cells/cm^2$$ At temperatures of from 13.0 to $14.3^{\circ}C$, the distance travelled by the larvae (3.0 mm In shell length) averaged 11.36 mm for a Period of 30 days. Their locomation was relatively active between 6 p.m. and 9 p.m., and $52.2\%$ of them moved during this period. When the larvae (2.0 mm in shell length) were kept in water at $0\;to\;\~1.8^{\circ}C$, they moved 1.15cm between 4 p.m. and 8 p.m. and 0.10 cm between midnight and 8 a.m. The relationships between shell length and body weight of the abalone sampled from three different localities are shown as follows: Dolsan-do $W=0.2479\;L^{2.5721}$ Huksan-do $W=0.1001\;L^{3.1021}$ Pohang $W=0.9632\;L^{2.0611}$

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A Study on Market Size Estimation Method by Product Group Using Word2Vec Algorithm (Word2Vec을 활용한 제품군별 시장규모 추정 방법에 관한 연구)

  • Jung, Ye Lim;Kim, Ji Hui;Yoo, Hyoung Sun
    • Journal of Intelligence and Information Systems
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    • v.26 no.1
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    • pp.1-21
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    • 2020
  • With the rapid development of artificial intelligence technology, various techniques have been developed to extract meaningful information from unstructured text data which constitutes a large portion of big data. Over the past decades, text mining technologies have been utilized in various industries for practical applications. In the field of business intelligence, it has been employed to discover new market and/or technology opportunities and support rational decision making of business participants. The market information such as market size, market growth rate, and market share is essential for setting companies' business strategies. There has been a continuous demand in various fields for specific product level-market information. However, the information has been generally provided at industry level or broad categories based on classification standards, making it difficult to obtain specific and proper information. In this regard, we propose a new methodology that can estimate the market sizes of product groups at more detailed levels than that of previously offered. We applied Word2Vec algorithm, a neural network based semantic word embedding model, to enable automatic market size estimation from individual companies' product information in a bottom-up manner. The overall process is as follows: First, the data related to product information is collected, refined, and restructured into suitable form for applying Word2Vec model. Next, the preprocessed data is embedded into vector space by Word2Vec and then the product groups are derived by extracting similar products names based on cosine similarity calculation. Finally, the sales data on the extracted products is summated to estimate the market size of the product groups. As an experimental data, text data of product names from Statistics Korea's microdata (345,103 cases) were mapped in multidimensional vector space by Word2Vec training. We performed parameters optimization for training and then applied vector dimension of 300 and window size of 15 as optimized parameters for further experiments. We employed index words of Korean Standard Industry Classification (KSIC) as a product name dataset to more efficiently cluster product groups. The product names which are similar to KSIC indexes were extracted based on cosine similarity. The market size of extracted products as one product category was calculated from individual companies' sales data. The market sizes of 11,654 specific product lines were automatically estimated by the proposed model. For the performance verification, the results were compared with actual market size of some items. The Pearson's correlation coefficient was 0.513. Our approach has several advantages differing from the previous studies. First, text mining and machine learning techniques were applied for the first time on market size estimation, overcoming the limitations of traditional sampling based- or multiple assumption required-methods. In addition, the level of market category can be easily and efficiently adjusted according to the purpose of information use by changing cosine similarity threshold. Furthermore, it has a high potential of practical applications since it can resolve unmet needs for detailed market size information in public and private sectors. Specifically, it can be utilized in technology evaluation and technology commercialization support program conducted by governmental institutions, as well as business strategies consulting and market analysis report publishing by private firms. The limitation of our study is that the presented model needs to be improved in terms of accuracy and reliability. The semantic-based word embedding module can be advanced by giving a proper order in the preprocessed dataset or by combining another algorithm such as Jaccard similarity with Word2Vec. Also, the methods of product group clustering can be changed to other types of unsupervised machine learning algorithm. Our group is currently working on subsequent studies and we expect that it can further improve the performance of the conceptually proposed basic model in this study.

The Developmental Effects of Radiation on ICR Mouse Embryos in Preimplantation Stage (착상전기(着床前期)에 있어서 ICR Mouse의 태아(胎兒)에 대한 방사선(放射線) 개체(個體) Level 영향(影響)의 연구(硏究))

  • Gu, Yeun-Hwa
    • Journal of Radiation Protection and Research
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    • v.21 no.4
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    • pp.273-284
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    • 1996
  • Embryos and fetuses are more sensitive to various environmental agents than are adults or children. The biological effects such as intrauterine death and malformation are closely connected with prenatal exposure very various agents. The sensitivity of these embryonic/fetal effects depends on the stage of pregnancy. From the viewpoint of fetal development, embryonic and fetal stages can be divided into three stages : Preimplantation, organogenetic and fetal. Each stage corresponds to 0 to 4.5days, 4.5 to 13.5days, and 13.5days of gestation in mice, respectively. Many studies on the biologcal effects of mice irradiated by ${\gamma}-rays$ at various stages during organogenesis and fetal period have been performed. Based on these results, the dose-effect and dose-response relationships in malformations, intrauterine death, or retardation of the physical growth have been practically modeled by the ICRP(International Commission on Radiological Protection) and other international bodies for radiation protection. Many experimental studies on mice have made it clear that mice embryos in the preimplantation period have a higher sensitivity to radiation for lethal effects than the embryos/fetuses on other prenatal periods. However, no eratogenic effects of radiation at preimplantation stages of mice have been described in many textbooks. It has been believed that 'all or none action results' for radiation of mice during the preimplantation period were applied. The teratogenic and lethal effects during the preimplantation stage are one of the most important problems from the viewpoint of radiological protection, since the preimplantation stage is the period when the pregnancy itself is not noticed by a pregnant woman. There are many physical or chemical agents which affect embryos/fetuses in the environment. It is assumed that each agents indirectly effects a human. Then, a safety criterion on each agent is determined independently. The pregnant ICR mice on 2, 48, 72 or 96 hours post-conception (hpc), at which are preimplantation stage of embryos, were irradiated whole body Cesium-gamma radiation at doses of 0.1, 0.25, 0.5, 1.5, and 2.5 Gy with dose rate of 0.2 Gy/min. In the embryos from the fetuses from the mice irradiated at various period in preimplantation, embryonic/fetal mortalities, incidence of external gross malformation, fetal body weight and sex ratio were observed at day 18 of gestation. The sensitivity of embryonic mortalities in the mice irradiated at the stage of preimplantation were higher than those in the mice irradiated at the stage of organogenesis. And the more sensitive periods of preimplantation stage for embryonic death were 2 and 48 hpc, at which embryos were one cell and 4 to 7 cell stage, respectively. Many types of the external gross malformations such as exencephaly, cleft palate and anophthalmia were observed in the fetuses from the mice irradiated at 2, 72 and 96 hpc. However, no malformations were observed in the mice irradiated at 48 hpc, at which stage the embryos were about 6 cell stage precompacted embryos. So far, it is believed that the embryos on preimplantation stage are not susceptible to teratogens such as radiation and chemical agents. In this study, the sensitivity for external malformations in the fetuses from the mice irradiated at preimplantation were higher than those in the fetuses on stage of organogenesis.

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Development and Assessment Individual Maximum Permissible Dose Method of I-131 Therapy in High Risk Patients with Differentiated Papillary Thyroid Cancer (물리학 선량법을 이용한 갑상선암의 개인별 최대안전용량 I-131 치료법 개발과 유용성 평가)

  • Kim, Jeong-Chul;Yoon, Jung-Han;Bom, Hee-Seung;JaeGal, Young-Jong;Song, Ho-Chun;Min, Jung-Joon;Jeong, Heong;Kim, Seong-Min;Heo, Young-Jun;Li, Ming-Hao;Park, Young-Kyu;Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.110-119
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    • 2003
  • Purpose: Radioiodine (I-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. Materials and Methods: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age $50{\pm}11$ years) of papillary thyroid cancer. Among them 43 patients were treated with ${\Leq}7.4GBq$, while 15 patients with ${\geq}9.25GBq$. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up I-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. Results: MPD measured by CF method using tracer and therapeutic doses were $13.3{\pm}1.9\;and\;13.8{\pm}2.1GBq$, respectively (p=0.20). They showed a significant correlation (r=0.8, p<0.0001). Exposed doses to blood measured by CF and biological methods were $1.54{\pm}0.03\;and\;1.78{\pm}0.03Gy$ (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-dose group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). Conclusion: Measurement of MPD using CF method is reliable, and the high-dose I-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.

Health Status and Use of Health Care Services of the Elderly Utilizing Senior citizen Centers (경로당 노인의 건강상태와 건강관리서비스 이용 관련요인 분석)

  • Shin, Sun-Hye;Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.99-113
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    • 2002
  • For this study a sample of 205 people, 66 males and 139 females, over 65 years of age, residing in C-gu of S-si and utilizing senior centers, were selected, The objective of the study was to provide basic data for health promotion program development provided by health centers. A questionnaire was used to collect date on general characteristics, health status, social health status and utilization rate for health services. The instruments used in this study were the Lawton scale, to measure daily routine function, the MMSE-K developed by Folstein and modified to fit the Korea situation, for mental health status, and the CES-Dtool developed by Radloff, for emotional health status. the SPSS Window program was used to calculate percentages. Tests of significance were done using t-test and ANOVA. Multiple regression analysis was used to identify variables influencing the use of health services. The results are as follows : Of those utilizing senior citizen centers, 40.9% of males and 17.3% of the female thought they were healthy. The average score for IADL was 7.4. The daily routine of female respondents consisted of buying household articles and drugs, and other IADLs such as riding the bus or subway alone. These resulted in a higher score compared to males. For emotional health, 7.6% of the males reported depression compared to 21.6% of the females. For mental health, 48.5% of the males and 28.8% of the females were found to be in the group suspicious for dementia. On social health, 57.6% of the males and 62.6% of the females reported no intimate human relations. Of those older people who had close human relations, 52.5% of the males indicated a friend as the closest person and 53.8% of the females, their children. On use of health services, there was a significantly higher need for mobile medical care services treatment for those with lower education levels and status of window/widower. There was a significantly higher need for health exmination services for those with lower levels of exercise, greater satisfaction with sleep, higher levels of oral health care, and higher social contacts. In conclusion, there is a need to provide varied programs for the promotion of health, along with parallel resolution of social, psychological and economic issues. It is recommended that health services for elderly people provided by the health centers be implemented with full recognition of these characteristics and differences.

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Prophylactic cranial irradiation in limited small-cell lung cancer : incidence of brain metastasis and survival and clinical aspects (예방적 두강내 방사선 조사후 소세포 폐암 환자의 뇌전이 빈도와 생존율에 대한 연구)

  • Suh, Jae-Chul;Kim, Myung-Hoon;Park, Hee-Sun;Kang, Dong-Won;Lee, Kyu-Seung;Ko, Dong-Seok;Kim, Geun-Hwa;Jeong, Seong-Su;Cho, Moon-June;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.323-331
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    • 2000
  • Purpose: Brain metastases are present in approximately 10-16% of small cell lung cancer patients at diagnosis. Brain metastasis is an important clinical problem associated with increasing the survival rate, with a cumulative incidence of up to 80% in patients surviving 2 years. Prophylactic cranial irradiation(PCI) reduces the incidence of brain matastasis and may prolong survival in patients with limited small-cell lung cancer who achieved complete remission. This study was performed to analyze the incidence of brain metastasis, survival and clinical aspects after PCI in patients with limited small-cell lung cancer who achieved complete remission. Methods : Between 1989 and 1999, forty-two patients with limited small-cell lung cancer who achived achieved complete remission after therapy were enrolled into this study retrospectively. All patients received etoposide and cisplatin(VPP) alternating with cytoxan, adriamycin, and vincristine(CAV) every 3 weeks for at least 6 cycles initially. All patients received thoracic radiotherapy: concurrent(38.1%) and sequential(61.9%). All patients received late PCI. Results : Most patients(88.1%) were men, and the median age was 58 years. The median follow-up duration was 18.1 months. During the follow-up period, 57.1% of the patients developed relapse. The most frequent site of relapse was chest(35.7%), followed by brain(14.3%), liver(11.9%), adrenal gland(44%), and bone(2.2%). With the Kaplan-Meier method, the average disease-free interval was 1,090 days(median 305 days). The average time to development of brain relapse after PCI and other sites relapse(except brain) were 2,548 days and 1,395 days(median 460 days), respectively. The average overall survival was 1,233 days(median 634 days, 21.1 months), and 2-year survival rates was 41.7%. The average overall survival in the relapse group was 642 days(median 489 days) and in the no relapse group was 2,622 days(p<0.001). The average overall survival in the brain relapse group was 928 days(median 822 days) and in the no brain relapse group was 1,308 days(median 634 days)(p=0.772). In most patients(85.7%), relapse(except brain) or systemic disease was the usual cause of death. Brain matastasis was the cause of death in 14.3% of the cases. Conclusions : We may conclude that PCI reduces and delays brain metastasis in patients with limited small cell lung cancer who achieved complete remission. We found decreased survival in relapse group but, no significant survival difference was noted according to brain matastasis. And relapse(except brain) or systemic disease was the usual cause of death. In order to increase survival, new treatment strategies for control methods for relapse and systemic disease are required.

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