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The Role of Primary Radiotherapy for Squamous Cell Carcinoma of the Suprag1ottic Larynx (성문상부 상피세포암에서의 근치적 방사선치료의 역할)

  • Kim, Won-Taek;Kim, Dong-Won;Kwon, Byung-Hyun;Nam, Ji-Ho;Hur, Won-Joo
    • 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.

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The Study of anti-cancer mechanism with Cobrotoxin on Human prostatic cancer cell line(PC-3) (전립선 암세포에 대한 Cobrotoxin의 항암(抗癌) 기전(機轉) 연구(硏究))

  • Chae, Sang-jin;Song, Ho-seup
    • Journal of Acupuncture Research
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    • v.22 no.3
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    • pp.169-183
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    • 2005
  • Objective : The purpose of this study was to investigate the anti-caner effect of cobrotoxin on the prostatic cancer cell line (PC-3).The goal of study is to ascertain whether cobrotoxin inhibits tile cell growth and cell cycle of PC-3, or the expression of relative genes and whether the regression of PC-3 cell growth is due to cell death or the expression of gene related to apoptosis. Methods : After the treatment of Pc-3 cells with cobrotoxin, we performed 형광현미경, MTT assay, Western blotting, Flow cytometry, PAGE electrophoresis and Surface plasmon resonance analysis to identify the cell viability, cell death, apoptosis, the changes of cell cycle and the related protein, Adk, MAP kinase. Results : 1. Compared with normal cell, the inhibition of cell growth reduced in proportion with the dose of cobrotoxin(0-16nM) in PC-3. 2. Cell viabilities of 0.1, 1, 4nM cobrotoxin treatment were decreased and those of 8, 16nM were decreased significantly. 3. S phase of cell cycle was decreased at the group of 1, 2, 4, 8, 16nM cobrotoxin, but M phase was increased at 0.1, 1, 2, 4, 8, 16nM cobrotoxin. 4. Cox-2 expression after cobrotoxin was peaked at 12hours and was decreased significantly after 6, 12, 24 hours. 5. The expression of Cdk4 was decreased dose-dependently at 1, 2, 4, 8nM cobrotoxin and was decreased siginificantly at 4, 8nM Cyclin D1 was decreased at 1, 2, 4, 8nM and Cycline E was not changed. Cycline B was decreased at 1, 2, 4, 8nM dose-dependently and was decreased siginificanlty at 2, 4, 8nM. 6. The expression of Akt was decreased at 1, 2, 4, 8nM dose-dependently and was decreased significantly at 2, 4, 8nM. 7. ERK was increased at 1, 2nM and decreased at 4, 8nM, p-ERK was increased at 1, 2, 4 nM, but decreased at 8nM. JNK and p-JNK were increased at 1, 4, 8 nM. p38 was increased at 2nM p-p38 was increased at lnM but decreased significantly at 2, 4, 8nM. 8. The nucli of normal cells were stained round and homogenous in DAPI staining, but those of PC-3 were stained condense and splitted. Apoptosis was increased dose-dependently at 2, 4, 8, 16nM and increased significantly at 2, 4, 8, 16nM. 9. Bax wasn`t changed at 1, 2, 4, 8nM and Bcl-2 was decreased significantly at 1, 2, 4, 8nM. Caspase 3 and 9 weren`t changed at 1, 2, 4nM but were decreased significantly at 8nM. Conclusions : These results indicate that cobrotoxin inhibits the growth of prostate Cancer cells, has anti-cancer effects by inducing apoptosis.

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Twitter Issue Tracking System by Topic Modeling Techniques (토픽 모델링을 이용한 트위터 이슈 트래킹 시스템)

  • Bae, Jung-Hwan;Han, Nam-Gi;Song, Min
    • Journal of Intelligence and Information Systems
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    • v.20 no.2
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    • pp.109-122
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    • 2014
  • People are nowadays creating a tremendous amount of data on Social Network Service (SNS). In particular, the incorporation of SNS into mobile devices has resulted in massive amounts of data generation, thereby greatly influencing society. This is an unmatched phenomenon in history, and now we live in the Age of Big Data. SNS Data is defined as a condition of Big Data where the amount of data (volume), data input and output speeds (velocity), and the variety of data types (variety) are satisfied. If someone intends to discover the trend of an issue in SNS Big Data, this information can be used as a new important source for the creation of new values because this information covers the whole of society. In this study, a Twitter Issue Tracking System (TITS) is designed and established to meet the needs of analyzing SNS Big Data. TITS extracts issues from Twitter texts and visualizes them on the web. The proposed system provides the following four functions: (1) Provide the topic keyword set that corresponds to daily ranking; (2) Visualize the daily time series graph of a topic for the duration of a month; (3) Provide the importance of a topic through a treemap based on the score system and frequency; (4) Visualize the daily time-series graph of keywords by searching the keyword; The present study analyzes the Big Data generated by SNS in real time. SNS Big Data analysis requires various natural language processing techniques, including the removal of stop words, and noun extraction for processing various unrefined forms of unstructured data. In addition, such analysis requires the latest big data technology to process rapidly a large amount of real-time data, such as the Hadoop distributed system or NoSQL, which is an alternative to relational database. We built TITS based on Hadoop to optimize the processing of big data because Hadoop is designed to scale up from single node computing to thousands of machines. Furthermore, we use MongoDB, which is classified as a NoSQL database. In addition, MongoDB is an open source platform, document-oriented database that provides high performance, high availability, and automatic scaling. Unlike existing relational database, there are no schema or tables with MongoDB, and its most important goal is that of data accessibility and data processing performance. In the Age of Big Data, the visualization of Big Data is more attractive to the Big Data community because it helps analysts to examine such data easily and clearly. Therefore, TITS uses the d3.js library as a visualization tool. This library is designed for the purpose of creating Data Driven Documents that bind document object model (DOM) and any data; the interaction between data is easy and useful for managing real-time data stream with smooth animation. In addition, TITS uses a bootstrap made of pre-configured plug-in style sheets and JavaScript libraries to build a web system. The TITS Graphical User Interface (GUI) is designed using these libraries, and it is capable of detecting issues on Twitter in an easy and intuitive manner. The proposed work demonstrates the superiority of our issue detection techniques by matching detected issues with corresponding online news articles. The contributions of the present study are threefold. First, we suggest an alternative approach to real-time big data analysis, which has become an extremely important issue. Second, we apply a topic modeling technique that is used in various research areas, including Library and Information Science (LIS). Based on this, we can confirm the utility of storytelling and time series analysis. Third, we develop a web-based system, and make the system available for the real-time discovery of topics. The present study conducted experiments with nearly 150 million tweets in Korea during March 2013.

Plasma Activity of Lysosomal Enzymes in Active Pulmonary Tuberculosis (활동성 폐결핵 환자에서 혈중 리소솜 효소의 활성도)

  • Koh, Youn-Suck;Choi, Jeong-Eun;Kim, Mi-Kyung;Lim, Chae-Man;Kim, Woo-Sung;Chi, Hyun-Sook;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.646-653
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    • 1995
  • Background: The confirmative diagnosis of pulmonary tuberculosis(Tb) can be made by the isolation of Mycobacterium Tuberculosis(MTb) in the culture of the sputum, respiratory secretions or tissues of the patients, but positive result could not always be obtained in pulmonary Tb cases. Although there are many indirect ways of the diagnosis of Tb, clinicians still experience the difficulty in the diagnosis of Tb because each method has its own limitation. Therefore development of a new diagnostic tool is clinically urgent. It was reported that silica cause some lysosomal enzymes to be released from macrophages in vitro and one of these enzymes is elevated in workers exposed to silica dust and in silicotic subjects. In pulmonary Tb, alveolar macrophages are known to be activated after ingestion of MTb. Activated macrophages can kill MTb through oxygen free radical species and digestive enzymes of lysosome. But if macrophages allow the bacilli to grow intracellularly, the macrophages will die finally and local lesion will enlarge. Then it is assumed that the lysosomal enzymes would be released from the dead macrophages. The goal of this investigation was to determine if there are differences in the plasma activities of lysosomal enzymes, ($\beta$-glucuronidase(GLU) and $\beta$-N-acetyl glucosaminidase(NAG), among the groups of active and inactive pulmonary Tb and healthy control, and to see if there is any possibility that the plasma activity of GLU and NAG can be used as diagnostic indicies of active pulmonary Tb. Methods: The plasma were obtained from 20 patients with bacteriologically proven active pulmonary Tb, 15 persons with inactive Tb and 20 normal controls. In 10 patients with active pulmonary Tb, serial samples after 2 months of anti-Tb medications were obtained. Plasma GLU and NAG activities were measured by the fluorometric methods using 4-methylumbelliferyl substrates. All data are expressed as the mean $\pm$ the standard error of the mean. Results: The activites of GLU and NAG in plasma of the patients with active Tb were $21.52{\pm}3.01$ and $325.4{\pm}23.37$(nmol product/h/ml of plasma), respectively. Those of inactive pulmonary Tb were $24.87{\pm}3.78$, $362.36{\pm}33.92$ and those of healthy control were $25.45{\pm}4.05$, $324.44{\pm}28.66$(nmol product/h/ml of plasma), respectively. There were no significant differences in the plasma activities of both enzymes among 3 groups. The plasma activities of GLU at 2 months after anti-Tb medications were increased($42.18{\pm}5.94$ nmol product/h/ml of plasma) in the patients with active pulmonary Tb compared with that at the diagnosis of Tb(P-value <0.05). Conclusion: The results of the present investigation suggest that the measurement of the plasma activities of GLU and NAG in the patients with active pulmonary Tb could not be a useful method for the diagnosis of active Tb. Further investigation is necessary to define the reasons why the plasma activities of the GLU was increased in the patients with active pulmonary Tb after Tb therapy.

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Summative Evaluation of 1993, 1994 Discussion Contest of Scientific Investigation (제 1, 2회 학생 과학 공동탐구 토론대회의 종합적 평가)

  • Kim, Eun-Sook;Yoon, Hye-Gyoung
    • Journal of The Korean Association For Science Education
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    • v.16 no.4
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    • pp.376-388
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    • 1996
  • The first and the second "Discussion Contest of Scientific Investigation" was evaluated in this study. This contest was a part of 'Korean Youth Science Festival' held in 1993 and 1994. The evaluation was based on the data collected from the middle school students of final teams, their teachers, a large number of middle school students and college students who were audience of the final competition. Questionnaires, interviews, reports of final teams, and video tape of final competition were used to collect data. The study focussed on three research questions. The first was about the preparation and the research process of students of final teams. The second was about the format and the proceeding of the Contest. The third was whether participating the Contest was useful experience for the students and the teachers of the final teams. The first area, the preparation and the research process of students, were investigated in three aspects. One was the level of cooperation, participation, support and the role of teachers. The second was the information search and experiment, and the third was the report writing. The students of the final teams from both years, had positive opinion about the cooperation, students' active involvement, and support from family and school. Students considered their teachers to be a guide or a counsellor, showing their level of active participation. On the other hand, the interview of 1993 participants showed that there were times that teachers took strong leading role. Therefore one can conclude that students took active roles most of the time while the room for improvement still exists. To search the information they need during the period of the preparation, student visited various places such as libraries, bookstores, universities, and research institutes. Their search was not limited to reading the books, although the books were primary source of information. Students also learned how to organize the information they found and considered leaning of organizing skill useful and fun. Variety of experiments was an important part of preparation and students had positive opinion about it. Understanding related theory was considered most difficult and important, while designing and building proper equipments was considered difficult but not important. This reflects the students' school experience where the equipments were all set in advance and students were asked to confirm the theories presented in the previous class hours. About the reports recording the research process, students recognize the importance and the necessity of the report but had difficulty in writing it. Their reports showed tendency to list everything they did without clear connection to the problem to be solved. Most of the reports did not record the references and some of them confused report writing with story telling. Therefore most of them need training in writing the reports. It is also desirable to describe the process of student learning when theory or mathematics that are beyond the level of middle school curriculum were used because it is part of their investigation. The second area of evaluation was about the format and the proceeding of the Contest, the problems given to students, and the process of student discussion. The format of the Contests, which consisted of four parts, presentation, refutation, debate and review, received good evaluation from students because it made students think more and gave more difficult time but was meaningful and helped to remember longer time according to students. On the other hand, students said the time given to each part of the contest was too short. The problems given to students were short and open ended to stimulate students' imagination and to offer various possible routes to the solution. This type of problem was very unfamiliar and gave a lot of difficulty to students. Student had positive opinion about the research process they experienced but did not recognize the fact that such a process was possible because of the oneness of the task. The level of the problems was rated as too difficult by teachers and college students but as appropriate by the middle school students in audience and participating students. This suggests that it is possible for student to convert the problems to be challengeable and intellectually satisfactory appropriate for their level of understanding even when the problems were difficult for middle school students. During the process of student discussion, a few problems were observed. Some problems were related to the technics of the discussion, such as inappropriate behavior for the role he/she was taking, mismatching answers to the questions. Some problems were related to thinking. For example, students thinking was off balanced toward deductive reasoning, and reasoning based on experimental data was weak. The last area of evaluation was the effect of the Contest. It was measured through the change of the attitude toward science and science classes, and willingness to attend the next Contest. According to the result of the questionnaire, no meaningful change in attitude was observed. However, through the interview several students were observed to have significant positive change in attitude while no student with negative change was observed. Most of the students participated in Contest said they would participate again or recommend their friend to participate. Most of the teachers agreed that the Contest should continue and they would recommend their colleagues or students to participate. As described above, the "Discussion Contest of Scientific Investigation", which was developed and tried as a new science contest, had positive response from participating students and teachers, and the audience. Two among the list of results especially demonstrated that the goal of the Contest, "active and cooperative science learning experience", was reached. One is the fact that students recognized the experience of cooperation, discussion, information search, variety of experiments to be fun and valuable. The other is the fact that the students recognized the format of the contest consisting of presentation, refutation, discussion and review, required more thinking and was challenging, but was more meaningful. Despite a few problems such as, unfamiliarity with the technics of discussion, weakness in inductive and/or experiment based reasoning, and difficulty in report writing, The Contest demonstrated the possibility of new science learning environment and science contest by offering the chance to challenge open tasks by utilizing student science knowledge and ability to inquire and to discuss rationally and critically with other students.

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Chinese relationship between animation and best pole - Focused on the aesthetic principles of the Cultural Revolution period (중국 애니메이션과 모범극의 상관관계 연구 - 문화대혁명 시기의 미학 원칙을 중심으로)

  • Kong, De Wei
    • Cartoon and Animation Studies
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    • s.39
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    • pp.215-231
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    • 2015
  • The Cultural Revolution in the history of Chinese animation hinder the development of the initial animation, and after a negative assessment instrument provided the cause is to become sluggish growth of the Chinese animation. So this time animation are things that are the subject of academic research studies or analysis has been depreciating almost uniformly without evaluation. However, of all the cultural and artistic creation it is developing in its own specific historical conditions and has the aesthetic results. This paper puts the primary purpose is to hold in consideration the aesthetic principles that led to cultural and artistic creativity and objective perspective the achievements the Chinese animation of the time period of the Cultural Revolution. Cultural Revolution is avoided to the previous period in accordance with the socialist ideology of Mao Ze-dong(毛澤東) sikindaneun highlight the culture of the proletariat and placed our goal to create a new class culture. Therefore, cultural and artistic creation of this period is often inconsistent with this part of our aesthetic principles generally accepted character has a non- elitist and anti properties. Best drama is a creative one hand as a model to implement the principles of aesthetics, art and culture Cultural Revolution period kkophimyeo reference for understanding the aesthetic principles that animated the Chinese Cultural Revolution period of orientation. This paper has San Tu Chu(三突出), Hong Guang Liang(紅光亮), and Gao Da Quan(高大全) at the time of the Cultural Revolution aesthetic principles are reflected in how the concrete work, the Cultural Revolution when the animation is how to accommodate these aesthetic principles and placed emphasis on comparative studies on best pole and correlation of the Cultural Revolution when the Chinese animation to ensure that adaptation in own way. First, after analyzing whether the aesthetic principles of focusing on the similarities of the best pole time of the Cultural Revolution and China, and how to implement animation in the works, these aesthetic principles according to the analysis of positive and negative influence on the creation of Chinese animation It was described as neutral. The detailed analysis and comparative study courses were trying to access in two significant aspects of the characters and scenes directing. In terms of character animation of the Cultural Revolution in China when a young boy or girl, emphasis should emphasize the health tinged with red lips and cheek blush to highlight the desired Gong Nong Bing(工農兵) shape as the main character and smooth texture and sophisticated highlights the glittering feeling to the touch, it was confirmed focused hayeoteum to implement the principle of 'Hong Guang Liang', highlighting the brilliant colors with a clean, bright colors. Highlighting a number of protagoniste compared to the antagonist in the animated scene of the Cultural Revolution a few times in terms of production and, among a number of protagoniste also emphasizes the outstanding hero figure, "yet three outstanding heroes heroic figures also emphasize the leading figures among the the director of the extrusion step-by-step approach "('San Tu Chu')was used. In addition, the hero figure is generally high and low angle by directing a large and perfect aesthetic appearance was to faithfully implement the principle of 'high-charged'('Gao Da Quan').

Deep Learning-based Professional Image Interpretation Using Expertise Transplant (전문성 이식을 통한 딥러닝 기반 전문 이미지 해석 방법론)

  • Kim, Taejin;Kim, Namgyu
    • Journal of Intelligence and Information Systems
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    • v.26 no.2
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    • pp.79-104
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    • 2020
  • Recently, as deep learning has attracted attention, the use of deep learning is being considered as a method for solving problems in various fields. In particular, deep learning is known to have excellent performance when applied to applying unstructured data such as text, sound and images, and many studies have proven its effectiveness. Owing to the remarkable development of text and image deep learning technology, interests in image captioning technology and its application is rapidly increasing. Image captioning is a technique that automatically generates relevant captions for a given image by handling both image comprehension and text generation simultaneously. In spite of the high entry barrier of image captioning that analysts should be able to process both image and text data, image captioning has established itself as one of the key fields in the A.I. research owing to its various applicability. In addition, many researches have been conducted to improve the performance of image captioning in various aspects. Recent researches attempt to create advanced captions that can not only describe an image accurately, but also convey the information contained in the image more sophisticatedly. Despite many recent efforts to improve the performance of image captioning, it is difficult to find any researches to interpret images from the perspective of domain experts in each field not from the perspective of the general public. Even for the same image, the part of interests may differ according to the professional field of the person who has encountered the image. Moreover, the way of interpreting and expressing the image also differs according to the level of expertise. The public tends to recognize the image from a holistic and general perspective, that is, from the perspective of identifying the image's constituent objects and their relationships. On the contrary, the domain experts tend to recognize the image by focusing on some specific elements necessary to interpret the given image based on their expertise. It implies that meaningful parts of an image are mutually different depending on viewers' perspective even for the same image. So, image captioning needs to implement this phenomenon. Therefore, in this study, we propose a method to generate captions specialized in each domain for the image by utilizing the expertise of experts in the corresponding domain. Specifically, after performing pre-training on a large amount of general data, the expertise in the field is transplanted through transfer-learning with a small amount of expertise data. However, simple adaption of transfer learning using expertise data may invoke another type of problems. Simultaneous learning with captions of various characteristics may invoke so-called 'inter-observation interference' problem, which make it difficult to perform pure learning of each characteristic point of view. For learning with vast amount of data, most of this interference is self-purified and has little impact on learning results. On the contrary, in the case of fine-tuning where learning is performed on a small amount of data, the impact of such interference on learning can be relatively large. To solve this problem, therefore, we propose a novel 'Character-Independent Transfer-learning' that performs transfer learning independently for each character. In order to confirm the feasibility of the proposed methodology, we performed experiments utilizing the results of pre-training on MSCOCO dataset which is comprised of 120,000 images and about 600,000 general captions. Additionally, according to the advice of an art therapist, about 300 pairs of 'image / expertise captions' were created, and the data was used for the experiments of expertise transplantation. As a result of the experiment, it was confirmed that the caption generated according to the proposed methodology generates captions from the perspective of implanted expertise whereas the caption generated through learning on general data contains a number of contents irrelevant to expertise interpretation. In this paper, we propose a novel approach of specialized image interpretation. To achieve this goal, we present a method to use transfer learning and generate captions specialized in the specific domain. In the future, by applying the proposed methodology to expertise transplant in various fields, we expected that many researches will be actively conducted to solve the problem of lack of expertise data and to improve performance of image captioning.

Postoperative Radiation Therapy in the Soft-tissue Sarcoma (연부 조직 육종의 수술 후 방사선 치료 결과)

  • Kim Yeon Shil;Jang Hong Seok;Yoon Sei Chul;Ryu Mi Ryeong;Kay Chul Seung;Chung Su Mi;Kim Hoon Kyo;Kang Yong Koo
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.485-495
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    • 1998
  • Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 50 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patients with median follow up duration 50 months (range 6-162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58$\%$) was the most frequent site of occurrence followed by trunk (20$\%$) and head and neck (12$\%$). Histologically malignant fibrous histiocytoma (23$\%$), liposarcoma (17$\%$), malignant schwannoma (12$\%$) constitute 52$\%$ of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42$\%$) received chemotherapy with various regimen in the postoperative period. Results : Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48$\%$) of local recurrence. Four patients (7$\%$) developed simultaneous local recurrence and distant metastasis and 8 patients (13$\%$) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck Primary This feature is likely explanation for the decreased local control rate. Five of 29 Patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 $\%$, 30.6$\%$ respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

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The Results and Prognostic Factors of Chemo-radiation Therapy in the Management of Small Cell Lung Cancer (항암화학요법과 방사선 치료를 시행한 소세포폐암 환자의 치료 성적 -생존율과 예후인자, 실패양상-)

  • Kim Eun-Seog;Choi Doo-Ho;Won Jong-Ho;Uh Soo-Taek;Hong Dae-Sik;Park Choon-Sik;Park Hee-Sook;Youm Wook
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.433-440
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    • 1998
  • Purpose : Although small ceil lung cancer (SCLC) has high response rate to chemotherapy and radiotherapy (RT), the prognosis is dismal. The authors evaluated survival and failure patterns according to the prognostic factors in SCLC patients who had thoracic radiation therapy with chemotherapy. Materials and Methods : One hundred and twenty nine patients with SCLC had received thoracic radiation therapy from August 1985 to December 1990. Seventy-seven accessible patients were evaluated retrospectively among 87 patients who completed RT. Median follow-up period was 14 months (2-87months). Results : The two years survival rate was 13$\%$ with a median survival time of 14 months. The two year survival rates of limited disease and extensive disease were 20$\%$ and 8$\%$, respectively, with median survival time of 14 months and 9 months, respectively. Twenty two patients (88$\%$) of limited disease showed complete response (CR) and 3 patients (12$\%$) did partial response (PR). The two year survival rates on CR and PR groups were 24$\%$ and 0$\%$, with median survival times of 14 months and 5 months. respectively (p=0.005). No patients with serum sodium were lower than 135 mmol/L survived 2years and their median survival time was 7 months (p=0.002). Patients whose alkaline phophatase lower than 130 IU/L showed 26$\%$ of 2 year survival rate and showed median survival time of 14 months and those with alkaline phosphatase higher than 130 IU/L showed no 2 year survival and median survival time of 5 the months, respectively (p=0.019). No statistical differences were found according to the age, sex, and performance status. Among the patients with extensive disease, two rear survivals according to the metastatic sites were 14$\%$, 0$\%$, and 7$\%$ in brain, liver, and other metastatic sites, respectively, with median survival time of 9 months, 9 months, and 8 months, respectively (p>0.05). Two year survivals on CR group and PR group were 15$\%$ and 4$\%$, respectively, with a median survival time of 11 months and 7 months, respectively (p=0.01). Conclusion : For SCLC, complete response after chemoradiotherapy was the most significant prognostic tactor. To achieve this goal. there should be further investigation about hyperfractionation, dose escalation, and compatible chemo-radiation schedule such as concurrent chemo-radiation and early radiation therapy with chemotherapy.

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Compensation for Personal Injury and the Insurer's Claim for Indemnity - Focused on the NHIC's Claim for Indemnity - (인신사고로 인한 손해배상과 보험자의 구상권 - 국민건강보험공단의 구상권을 중심으로 -)

  • Noh, Tae Heon
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.87-130
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    • 2015
  • In a case in which National Health Insurance Corporation (NHIC) pays medical care expenses to a victim of a traffic accident resulting in injury or death and asks the assailant for compensation of its share in the medical care expenses, as the precedent treats the subrogation of a claim set by National Health Insurance Act the same as that set by Industrial Accident Compensation Insurance Act, it draws the range of its compensation from the range of deduction, according to the principle of deduction after offsetting and acknowledges the compensation of all medical care expenses borne by the NHIC, within the amount of compensation claimed by the victim. However, both the National Health Insurance Act and the Industrial Accident Compensation Insurance Act are laws that regulate social insurance, but medical care expenses in the National Health Insurance Act have a character of 'an underinsurance that fixes the ratio of indemnification,' while insurance benefit on the Industrial Accident Compensation Insurance Act has a character of full insurance, or focuses on helping the insured that suffered an industrial accident lead a life, approximate to that in the past, regardless of the amount of damages according to its character of social insurance. Therefore, there is no reason to treat the subrogation of a claim on the National Health Insurance Act the same as that on the Industrial Accident Compensation Insurance Act. Since the insured loses the right of claim acquired by the insurer by subrogation in return for receiving a receipt, there is no benefit from receiving insurance in the range. Thus, in a suit in which the insured seeks compensation for damages from the assailant, there is no room for the application of the legal principle of offset of profits and losses, and the range of subrogation of a claim or the amount of deduction from compensation should be decided by the contract between the persons directly involved or a related law. Therefore, it is not reasonable that the precedent draws the range of the NHIC's compensation from the principle of deduction after offsetting. To interpret Clause 1, Article 58 of the National Health Insurance Act that sets the range of the NHIC's compensation uniformly and systematically in combination with Clause 2 of the same article that sets the range of exemption, if the compensation is made first, it is reasonable to fix the range of the NHIC's compensation by multiplying the medical care expenses paid by the ratio of the assailant's liability. This is contrasted with the range of the Korea Labor Welfare Corporation's compensation which covers the total amount of the claim of the insured within the insurance benefit paid in the interpretation of Clauses 1 and 2, Article 87 of the Industrial Accident Compensation Insurance Act. In the meantime, there are doubts about why the profit should be deducted from the amount of compensation claimed, though it is enough for the principle of deduction after offsetting that the precedent took as the premise in judging the range of the NHIC's compensation to deduct the profit made by the victim from the amount of damages, so as to achieve the goal of not attributing profit more than the amount of damage to a victim; whether it is reasonable to attribute all the profit made by the victim to the assailant, while the damages suffered by the victim are distributed fairly; and whether there is concrete validity in actual cases. Therefore, the legal principle of the precedent concerning the range of the NHIC's compensation and the legal principle of the precedent following the principle of deduction after offsetting should be reconsidered.

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