• Radiation Oncology Journal
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• v.18 no.1
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• pp.27-31
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• 2000

Purpose : The aim of this study was to investigate treatment results, toxicity and efficacy of hypefractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. Materials and Methods: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hypefractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 51 years. Initial FIGO stage was 1 stage IBI, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recurrent disease with superior margin at T12, and inferior margin was between L5 and S1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m$^{3}$ to 30 mg/m$^{3}$ (median, 25 mg/m$^{3}$), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. Results : Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75$\%$ and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30$\%$ and 7 months, respectively. At 1 month after treatment, 4 (40$\%$) achieved a complete response and 6 (60$\%$) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence In 2 patients after paraaortic node irradiation. There was 2 patients with grade 3 to 4 leukopenla and 8 patients with grade 1 to 2 nausea/ vomiting which was usually tolerable with antlemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. Conclusion : hypefractionated radiation therapy combined with paclitaxel chemotherapy diosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer Therefore, present results suggest that hypefractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.295-301
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• 1993

Since Jan. 1991 a prospective randomized study for Stage III unresectable non small cell lung cancer (NSCLC) has been conducted to evaluate the response rate and tolerance of induction chemotherapy with MVP followed by hyperfractionated radiotherapy and evaluate the efficacy of maintenance chemotherapy in Asan Medical Center. All patients in this study were treated with hyperfractionated radiotherapy (120 cGy/fx BID, 6480 cGy/54 fx) following 3 cycles of induction chemotherapy, MVP (Mitomycin C 6 $mg/m^2,$ Vinblastin 6 $mg/m^2,$ Cisplatin 60 $mg/m^2$) and then the partial and complete responders from induction chemotherapy were randomized to 3 cycles of adjuvant MVP chemotherapy group and observation group. 48 patients were registered to this study until December 1992; among 48 patients 3 refused further treatment after induction chemotherapy and 6 received incomplete radiation therapy because of patient's refusal, 39 completed planned therapy. Twenty-three $(58\%)$ patients including 2 complete responders showed response from induction chemotherapy. Among the 21 patients who achieved a partial response after induction chemotherapy,1 patient rendered complete clearance of disease and 10 patients showed further regression of tumor following hyperfractionated radiotherapy. Remaining 10 patients showed stable disease or progression after radiotherapy. Of the sixteen patients judged to have stable disease or progression after induction chemotherapy, seven showed more than partial remission after radiotherapy but nine showed no response in spite of radiotherapy. Of the 39 patients who completed induction chemotherapy and radiotherapy, 25 patients $(64\%)$ including 3 complete responders showed more than partial remission. Nineteen patients were randomized after radio-therapy. Nine Patients were allocated to adjuvant chemotherapy group and 4/9 showed further regression of tumor after adjuvant chemotherapy. For the time being, there is no suggestion of a difference between the adjuvant chemotherapy group and observation group in distant metastasis rate and survival. Median survival time was 13 months. Actuarial survival rates at 6,12 and 18 months of 39 patients who completed this study were $84.6\%,\;53.7\%\;and\;40.3\%,$ respectively. The partial and complete responders from induction chemotherapy showed significantly better survival than non-responders (p=0.028). Incidence of radiation pneumonitis in this study group was less than that in historical control group inspite of induction chemotherapy. All patients tolerated hypertractionated radiotherapy without definite increase of acute complications compared with conventional radiotherapy group. The longer follow up is needed to evaluate the efficacies of induction and maintenance chemotherapy and survival advantage by hyperfractionated radiotherapy but authors are encouraged with an excellent tolerance, higher response rate and improvement of one year survival rate in patients of this study.

• Asia Marketing Journal
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• v.14 no.1
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• pp.25-51
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• 2012

Researches about the relationship between SST(Self Service Technology) and TRI(Technology Readiness Index) have been carried out after TRI was developed by Parasuraman and his colleagues(2000). We hypothesize Consumer Readiness can also influence consumer's motivation, attitude, and intent to use SST. Currently, there has been no research on this subject. In this study, we investigated the relationship between TR, Consumer Readiness and SST Core Attitudinal Model which Dabholkar & Bagozzi(1994) proposed. The researchers also investigated moderating effects of consumer traits and situational factors to verify the acceptance of such forms of service delivery by all kinds of consumers and under different situational contexts. Self consciousness, the need for interaction with an employee, and the technology anxiety were used as consumer trait variables. Perceived waiting time and perceived crowding were used as situational variables. 380 questionnaires were distributed to a sample group of people in their 20's and 30's, and the data were analyzed with structural equation model using AMOS 18.0 program. All of Cronbach's alpha values representing reliabilities were satisfactory. The values of Composite Reliability(CR) and Average Variance Extracted(AVE) also showed the above criteria, thus providing evidence of convergent validity. To confirm discriminant validity among the constructs, confirmatory factor analysis and correlations among all the variables were examined. The results were satisfactory. The results of this study are summarized as follows. 1. Optimism and innovativeness of TR partially influenced the motivation to use SST. People who tend to be optimistic use SST because of ease of use and fun. The innovative however, usually use SST due to its performance. However, consumer readiness of role clarity, ability and self-efficacy influence all the components of motivation to use SST, ease of use, performance and fun. The relative effect of consumer readiness on the motivation to use SST was much stronger and more significant than that of TR. No other previous studies have examined the effects of Consumer Readiness on SST usage motivation, attitude and intention. It is academically meaningful that the researchers verified that Consumer Readiness is the important precedent construct influencing the self service technology core Attitudinal Model. Our findings suggest that marketers should consider fun and ease of use attributes to promote the use of self service technology. In addition, the SST usage frequency will rise rapidly when role clarity, ability, and self-efficacy which anybody can easily handle SST is assured. If the SST usage rate is increased, waiting times for customers could be decreased. Shorter waiting time could lead to higher customer satisfaction. It may also result in making a long-term profit owing to the reduced number of employees. Thus, presentation of using SST by employees or videos showing how to use it will promote the usage attitude and intent. 2. In SST core attitudinal model, performance and fun factors among SST usage motivation affected attitudes of using SST. The attitude of using SST highly influenced intent to use SST. This result is consistent with previous researches that dealt with the relationship between motivation, attitude and intention. Expectation of using SST could result in good performance just like the effect of ordering menu to service employees and to have fun since fun during its use could promote more SST usage rate. 3. In the relationship among motivation, attitude and intent in SST core attitudinal model, the moderating effect of consumer traits(self-consciousness, need for interaction with service employees and technology anxiety) and situational factors(perceived crowding and perceived waiting time) were tested. The results also supported the hypothesized moderating effects except perceived crowding. The highly self-conscious tended to form attitudes to use SST because of its fun compared to those who were less self-conscious because of its performance. People who had a high need for interaction with service employees tended to use SST for its performance. This result indicates that if ordering results are assured, SST is easily accessible to even consumers who have a high need for interaction with a service employee. When SST is easy to use, attitudes strengthen intent among people who had a high level of anxiety of technology. People who had low technology anxiety formed attitudes to use SST because of its performance. Service firms must ensure their self service technology is designed to be easy to use for those who have a high level of technology anxiety. Shorter perceived waiting times strengthened the attitude to use self service technology because of its fun. If the fun aspect is assured, people willing to use self service technology even perceive waiting time to be shorter than it actually is. Greater perceived waiting times form higher level of intent to use self service technology than those of shorter perceived waiting times. This implies that people view self service technology as a faster alternative to ordering service employees. The fun aspect of self service technology will attract a higher rate of usage for self service technology. 4. It has been proven that ease of use, performance and fun aspects are very important factors in motivation to form attitudes and intent to use self service technology regardless of the amount of perceived waiting time, self-consciousness, need for interaction with service employees, and technology anxiety. Service firms must consider these motivation aspects(ease of use, performance and fun)strongly in their promotion to use self service technology. Ease of use, assuring absolute performance compared to interaction with service employees', and adding a fun aspect will positively strengthen consumers' attitudes and intent to use self service technology. Summarizing the moderating effects, fun is the most valuable factor triggering SST usage attitude and intention. Therefore, designing self service technology to be fun will be the key to its success. This study focused on the touch screen self service technology in fast food restaurant. Although it has its limits due to the fact that it is hard to generalize the results to any other self service technology, the conceptual framework of this study can be applied to future research of any other service site.

• Journal of Soil and Groundwater Environment
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• v.14 no.2
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• pp.33-44
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• 2009

The objective of the study was to develop a hybrid technology integrating biological and physicochemical technologies to efficiently remediate arsenic contaminated lands such as abandoned mine area. The tailing soil samples contaminated with As at a high level were obtained from Songchon abandoned mine, and the content of arsenic and heavy metals as well as physicochemical properties and mineral composition were investigated. In addition, two sets of sequential extraction methods were applied to analyze chemical speciations of arsenic and heavy metals to expect their leachability and mobility in geoenvironment. Based on these geochemical data of arsenic and heavy metal contaminants, column-type experiments on the bioleaching of arsenic were undertaken. Subsequently, experiments on the hybrid process incorporating bioleaching and electrokinetics were accomplished and its removal efficiency of arsenic was compared with that of the individual electrokinetic process. With the results, finally, the feasibilty of the hybrid technnology was evaluated. The arsenic removal efficiencies of the individual electrokinetic process (44 days) and the hybrid process incorporating bioleaching (28 days) and electrokinetics (16 dyas) were measured 57.8% and 64.5%, respectively, when both two processes were operated in an identical condition. On the contrary, the arsenic removal efficiency during the bioleaching process (28 days) appeared relatively lower (11.8%), and the result indicates that the bioleaching process enhanced the efficacy of the electrokinetic process as a result of mobilization of arsenic rather than removed arsenic by itself. In particular, the arsenic removal rate of the electrokinetics integrated with bioleaching was observed over than 2 times larger than that obtained by the electrokinetics alone. From the results of the study, if the bioleaching which is considered a relatively economic process is applied sufficiently prior to electrokinetics, the removal efficiency and rate of arsenic can be significantly improved. Consequently, the study proves the feasibility of the hybrid process integrating both technologies.

• Journal of Gastric Cancer
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• v.20 no.2
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• pp.152-164
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• 2020

Purpose: To compare long-term disease-free survival (DFS) between patients receiving tegafur/gimeracil/oteracil (S-1) or capecitabine plus oxaliplatin (CAPOX) adjuvant chemotherapy (AC) for gastric cancer (GC). Materials and Methods: This retrospective multicenter observational study enrolled 983 patients who underwent curative gastrectomy with consecutive AC with S-1 or CAPOX for stage II or III GC at 27 hospitals in Korea between February 2012 and December 2013. We conducted propensity score matching to reduce selection bias. Long-term oncologic outcomes, including DFS rate over 5 years (over-5yr DFS), were analyzed postoperatively. Results: The median and longest follow-up period were 59.0 and 87.6 months, respectively. DFS rate did not differ between patients who received S-1 and CAPOX for pathologic stage II (P=0.677) and stage III (P=0.899) GC. Moreover, hazard ratio (HR) for recurrence did not differ significantly between S-1 and CAPOX (reference) in stage II (HR, 1.846; 95% confidence interval [CI], 0.693-4.919; P=0.220) and stage III (HR, 0.942; 95% CI, 0.664-1.337; P=0.738) GC. After adjustment for significance in multivariate analysis, pT (4 vs. 1) (HR, 11.667; 95% CI, 1.595-85.351; P=0.016), pN stage (0 vs. 3) (HR, 2.788; 95% CI, 1.502-5.174; P=0.001), and completion of planned chemotherapy (HR, 2.213; 95% CI, 1.618-3.028; P<0.001) were determined as independent prognostic factors for DFS. Conclusions: S-1 and CAPOX AC regimens did not show significant difference in over-5yr DFS after curative gastrectomy in patients with stage II or III GC. The pT, pN stage, and completion of planned chemotherapy were prognostic factors for GC recurrence.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.776-784
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• 1997

Background : Various combinations of treatment modalities have been reported in stage III non-small cell lung cancer (NSCLC). however, the standard treatment modality has not established yet. Recently, the efficacy of concurrent chemotherapy and radiation therapy has been reported in locally advanced lung cancer. We evaluate the response rate, toxicity, and survival of concurrent chemotherapy with etoposide and cisplatin(EP) and radiation therapy for unresectable stage III NSCLC. Method : Between October 1995 and December 1996, 32 patients with histologically proven unresectable stage III NSCLC without malignant pleural effusion were entered into this study. Twenty-nine patients were eligible for the response, survival, and toxicity analysis. Induction was two cycles of chemotherapy with etoposide and cisplatin plus concurrent chest RT to 4500cGy. Resection was attempted if the clinical response offered surgical resectability. Boost radiation therapy upto 5940cGy and one cycle of EP were performed if the disease were stable or responsive but still unresectable. Results : Of 29 eligible patients, 22(75.9%) showed partial response(PR). The progression free interval was 6.3months(range 1.1 to 19.5months). Surgical resection was performed in one patient. The median survival was 12.1months and one-year survival rate was 50.6%. The major toxicity was leukopenia($\geq$ grade 3, 46%). Thrombocytopenia over grade 3 was found in 11%. Radiation pneumonitis occurred in 13 patients(46%). Conclusion : Concurrent chemotherapy(EP) plus radiotherapy was effective and tolerable in the treatment of unresectable stage III NSCLC.

• Journal of Animal Science and Technology
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• v.51 no.3
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• pp.207-216
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• 2009

This experiment was conducted to investigate the effects of dietary supplementation of organic acid mixture on growth performance, cecal microflora, blood characteristics and immune response in broiler chicks and to prove the possibility of organic acid mixture as an alternative to antibiotics growth promotor. A total of four hundred eighty, 1-day-old male broiler chicks (Ross$\times$Ross 308) were randomly divided into 4 groups with 4 replicates of 30 birds each. The treatments were NC (free antibiotics), PC (basal diet with virginiamycin 10 ppm and salinomycin 60 ppm), 0.3% organic acid, and 0.5% organic acid. The final body weight and body weight gain were significantly higher in organic acid 0.5% than NC (P<0.05). The feed conversion ratio in all treated groups were significantly improved as compared to that of NC (P<0.05). The carcass rate and relative organs weight were not significantly difference among the groups. The relative weight and length of small intestine in PC were significantly decreased than the other groups. The numbers of cecal coliform bacteria and Salmonella in all treated groups were significantly lower than NC (P<0.05). The number of cecal lactic acid bacteria was not different among the groups. No significant differences among the groups were observed in the contents of total cholesterol, triglyceride, blood urea nitrogen (BUN), albumin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in blood serum. The contents of total protein and globulin in blood serum of PC and organic acid treated groups were significantly increased as compared to those of NC (P<0.05). Therefore, albumin:globulin ratio of PC and organic acid treated groups was significantly lower than NC (P<0.05). The total white blood cell (WBC), heterophil, lymphocyte, and stress indicator (heterophil:lymphocyte ratio) were not significantly different among the groups. No significant difference was observed on the expression rate of splenic cytokines mRNA in organic acid treated groups compared to the control. Consequently, supplemental organic acid mixture improved the growth performance, and influenced positive effects on the intestinal microflora by inhibiting the growth of harmful bacteria without any adverse effects on relative weights of organs and blood biochemical parameters in broiler chicks.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.337-343
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• 2009

Background: Postoperative recurrence is a major problem after performing video-assisted thoracic surgery for the treatment of primary pneumothorax. This study was designed to evaluate the efficacy and safety of a bioabsorbable staple line reinforcement (GORE $SEAMGUARD^{(R)}$) for preventing recurrence after bullectomy. Material and Method: From January 2000 to December 2004, 300 patients underwent video assisted thoracoscopic surgery for the treatment of primary penumothorax. 143 patients were treated with bioabsorbable staple line reinforcement (Group A) and 142 patients were treated with stapling of the bullae (Group B). Mechanical pleural abrasion was performed in all the patients. The operating time, the duration of the indwelling chest tube, the length of the hospital stay and the number of recurrences after operation were compared between the groups. Result: No operative deaths occurred. The conversion rate to an open procedure was 5% (15/300). Comparison with these groups (Group A versus Group B) showed the following results: the operating time ($49.6{\pm}25.6$ vs $51.8{\pm}30.4$ minutes, respectively, p=0.514), the duration of an indwelling chest tube ($5.8{\pm}2.5$ vs $7.2{\pm}3.3$ days, respectively, p<0.005), the hospital stay ($10.9{\pm}4.3$ vs $12.5{\pm}4.3$ days, respectively, p<0.005) and the number of recurrences (14 (9.8%) vs 10 (7.0%), respectively, the over all rate: 8.4% p=0.523), and the mean follow up period. ($48.1{\pm}36.6$ vs $36.5{\pm}24.4$ months, respectively). Conclusion: There were advantages to use synthetic absorbable staple line reinforcement over the usual method for the treatment of primary pneumothorax in regard to the duration of an indwelling chest tube and the hospital stay, but here was no significant difference between the groups for postoperative recurrence.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1070-1075
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• 1998

Background: With the advent of thoracoscopy, there has been increasing interest in less invasive surgical bullectomy and pleurodesis. The recurrence rate, however, has been reported higher in surgery with thoracoscopy than with open thoracotomy and it is thought to be caused by inappropriate mechanical pleurodesis during thoracoscopic surgery. Materials and methods: We compared the short-term recurrence rates according to the intensities of pleural abrasion in 62 patients who underwent VATS for treatment of spontaneous pneumothorax from April 1996 to August 1997. The patients were divided into 2 groups: group A(n=32) included patients who received relatively weak pleural abrasion using Endo-forcep instrument for grasping the gauze, and group B(n=30) received strong pleural abrasion using conventional instrument wrapped tightly with gauze. Each intensity of pleural abrasion allowed petechia on the parietal pleura in group A, and some tearing and bleeding in group B. Results: Indications for operation, sex distribution, and age were comparable in both groups. There were no differences in chest tube indwelling time(3.78±3.35 vs 3.80±2.49 days), hospital stay(4.72±1.87 vs 4.67±2.20 days), and the amount and duration of analgesics required postoperatively. Persistent air-leak more than 7 days after surgery occurred in 4/32(12.5%) and 2/30(6.7%) in group A and B, respectively. No bleeding-related complication occured. Pneumothorax recurred 12.5%(4/32) and 0%(0/30) of patients at a mean follow-up of 9.7 and 9.6 months in group A and B, respectively, and it was statistically significant(p<0.05). Conclusions: Proper intensity of pleural abrasion is very important factor to reduce recurrence after VATS for spontaneous pneumothorax. During short-term follow-upafter surgery, we could achieve excellent result in reducing recurrence rate with VATS and strong pleural abrasion which is comparable to thoracotomy.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.40-47
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• 2005

Purpose : S. pneumoniae is one of major pathogens of community-acquired respiratory infections. The rate of antibiotic resistance to this organism has increased, and resistance to multiple antimicrobial agents in a single strain of S. pneumoniae may compromise the efficacy of empiric antimicrobial treatment commonly used for respiratory infections. We did this study to find out the penicillin resistant distributions and oral antibiotics susceptibility patterns against S. pneumoniae, isolated from pediatric patients with community-acquired respiratory infections in Korea. Methods : One hundred fifty six pneumococcal isolates obtained from pediatric patients with community-acquired respiratory infections such as acute otitis media(AOM), sinusitis and pneumonia between May 2000 to June 2003. And MICs of penicillin and oral antibiotics(amoxicillin, amoxicillin-clavulanate, cefaclor) were performed by broth microdilution methods according to the NCCLS(2003a). Results : Seventy eight percent of the isolates were resistant to penicillin. The isolates, collected from AOM patients showed the highest penicillin resistance(92.7%). The resistant rates of amoxicillin (16.7%) and amoxicillin-clavulanate(9.6%), based on susceptibility breakpoints established by the NCCLS, were markedly lower than these of penicillin. But, the resistant rate of cefaclor was very high, above 95%. Conclusion : We concluded that pneumococci isolated from study cases may be one of the world's highest penicillin resistant rates. But, amoxicillin and amoxicillin-clavulanate can be used as a first-line antibiotics. Finally, we hope that a continuous surveillance study to monitor resistant patterns of pneumococcal respiratory infections will be needed for the standard guidelines of empiric antibiotic treatment.