• Radiation Oncology Journal
• /
• v.26 no.4
• /
• pp.213-221
• /
• 2008

Purpose: The objective of this retrospective study was to identify predictive factors for the complete pathologic response and tumor downstaging after preoperative concurrent chemoradiotherapy for locally advanced rectal cancer. Materials and Methods: Between the years 2000 and 2008, 39 patients with newly diagnosed rectal cancer without prior evidence of distant metastasis received preoperative concurrent chemoradiotherapy followed by surgery. The median radiation dose was 50.4 Gy (range, $45{\sim}59.4\;Gy$)). Thirty-eight patients received concurrent infusional 5-fluorouracil and leucovorin, while one patient received oral capecitabine twice daily during radiotherapy. Results: A complete pathologic response (CR) was demonstrated in 12 of 39 patients (31%), while T-downstaging was observed in 24 of 39 patients (63%). N-downstaging was observed in 18 of 28 patients (64%), with a positive node in the CT scan or ultrasound. Two patients with clinical negative nodes were observed in surgical specimens. The results from a univariate analysis indicated that the tumor circumferential extent was less than 50% (p=0.031). Moreover, the length of the tumor was less than 5 cm (p=0.004), while the post-treatment carcinoembryonic antigen (CEA) levels were less than or equal to 3.0 ng/mL (p=0.015) and were significantly associated with high pathologic CR rates. The univariate analysis also indicated that the adenocarcinoma (p=0.045) and radiation dose greater than or equal to 50 Gy (p=0.021) were significantly associated with high T-downstaging, while a radiotherapy duration of less than or equal to 42 days (p=0.018) was significantly associated with N-downstaging. The results from the multivariate analysis indicated that the lesser circumferential extent of the tumor (hazard ratio [HR] 0.150; p=0.028) and shorter tumor length (HR, 0.084; p=0.005) independently predicted a higher pathologic CR. The multivariate analysis also indicated that a higher radiation dose was significantly associated with higher T-downstaging (HR, 0.115; p=0.025), while the shorter duration of radiotherapy was significantly associated with higher N-downstaging (HR, 0.028; p=0.010). Conclusion: The circumferential extent of the tumor and its length was a predictor for the pathologic CR, while radiation dose and duration of radiotherapy were predictors for tumor downstaging. Hence, these factors may be used to predict outcomes for patients and to develop further treatment guidelines for high-risk patients.

• Journal of Food Hygiene and Safety
• /
• v.13 no.4
• /
• pp.441-447
• /
• 1998

This study was performed to investigate the changes of amount of S. typhimurium during cooking processes using pork and japchae (a Korean food which is made from meat, vegetables and noodles), and to support a practical application to develop a hazard analysis critical control point (HACCP) model. The pork was purchased in a retail shop, cut ($0.5\;cm\;{\times}\;10\;cm\;{\times}\;10\;cm$, 25 g), tested for Salmonella contamination (results: negative), inoculated with S. typhimurium ($10^{7}\;CFU/g$), then treated in various conditions related to cooking. Mter thawing for 24 hours in various conditions, the number of S. typhimurium was increased to $10^{10}\;CFU/g$ at a refrigerated temperature ($4~10^{\circ}C$), and to $10^{21}\;CFU/g$ at room temperature ($22~29^{\circ}C$). Mter thawing in a microwave oven for 40 seconds, the number of S. typhimurium increased to $10^{8}\;CFU/g$. During the thawing period, the number of S. typhimurium increased over time. At the refrigerated temperature, the number of the bacteria was $10^{10}\;CFU/g$ after 24 hours, $10^{13}\;CFU/g$ after 48 hours, and $10^{20}\;CFU/g$ after 72 hours. At room temperature the number of bacteria reached $10^{11}\;CFU/g$ in 2 hours, $10^{15}\;CFU/g$ in 4 hours, $10^{16}\;CFU/g$ in 8 hours, $10^{18}\;CFU/g$ in 12 hours, and $10^{21}\;CFU/g$ in 24 hours. Mter cooking in a frying pan (150{\pm}7^{\circ}C$) for 3 minutes, the bacterial count was $10^{16}\;CFU/g$. After cooking in hot water for 20 minutes, the bacterial count was $10^{7}\;CFU/g\;at\;60^{\circ}C,\;10^{6}\;CFU/g\;at\;63^{\circ}C,\;and\;10^{4}\;CFU/g\;at\;65^{\circ}C$. The fried pork was mixed with cooked vegetables, noodles, sesame oil, sesame seeds, and seasonings to make Korean japchae. This process took $10{\pm}2$ minutes. The bacterial count in the japchae increased to $10^{7}\;CFU/g$ from the count of $10^{6}\;CFU/g$ of the fried pork before it was mixed with the other ingredients. These results indicate that the amount of S. typhimurium is effected by various different cooking processes. This study can suggest that pork should be cooked in water at over $65^{\circ}C$ for 20 minutes in order to prevent food poisoning, if the pork is contaminated with S. typhimurium. The presence of S. typhimurium in the raw pork is identified in an HA for japchae, and the primary CCP for japchae is inadequate cooking (cooking method and time/temperature). We need to standardize time-temperature-size and amount of pork in cooking japchae, because pork is usually cooked in ordinary frying pans when we make this food.

• Journal of Chest Surgery
• /
• v.41 no.1
• /
• pp.1-11
• /
• 2008

Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.

• Tuberculosis and Respiratory Diseases
• /
• v.49 no.5
• /
• pp.601-613
• /
• 2000

Background : Idiopathic pulmonary fibrosis (IPF) is a fatal progressive fibrous disease of the lung of unknown etiology. Recently it has been classified into several distinct entities on the basis of pathologic and clinical characteristics, ie : usual interstitial pneumonia (UIP), desquamative interstitial pneumonia (DIP), acute interstitial pneumonia (AIP), bronchiolitis obliterans with organizing pneumonia (BOOP), and nonspecific interstitial pneumonia (NSIP). IPF is now applied only for UIP, which has the worst prognosis. The previous reports of 3-5 year median survival appears to be overoptimistic because other types with better prognosis like NSIP or BOOP might have been included. Therefore, this study was performed to determine the clinical course and the prognostic factors of UIP as diagnosed by surgical lung biopsy. Methods : The subjects were 72 UIP patients (age $58.2{\pm}11.6$ years, M : F=45 : 27, median follow up period : 18.1 months (0.7-103.6) diagnosed by surgical lung biopsy at the Asan Medical Center (68 patients) and the Paik Hospital in Seoul (4 patients). Clinical scores (level of dyspnea : 1-20 points), radiologic score (honeycombing : HC score 0-5 points, ground glass : GG score 0-5 points), and physiologic scores (FVC : 1-12 points, $FEV_1$ : 0-3 points, TLC : 0-10 points, $D_{LCO)$ : 0-5 points, $AaDO_2$ : 0-10 points) were summed into a total CRP score. Results : 1) The one year survival rate was 78.3%, while the rate for three year survival was 58.1%, and the median survival period was 42.5months. 2) Short term (1 year) prognosis : The patients who died within one year of diagnosis (14 patients) had the higher initial total CRP score ($28.6{\pm}8.3$ vs. $16.6{\pm}9.7$) than those who lived longer than one year (46 patients). The difference in the total CRP score was attributed to the symptom score ($8.4{\pm}2.1$ vs. $5.7{\pm}3.9$) and the physiologic score ($15.7{\pm}7.1$ vs. $6.7{\pm}5.7$) including FVC, $D_{LCO)$ and $AaDO_2$. 3) Long-term (3year) prognosis : The total CRP score ($12.2{\pm}6.7$ vs. $28.7{\pm}7.9$ : including symptom score, FVC, $D_{LCO)$ and $AaDO_2$) at the time of diagnosis were also different for the long-term survivors and those who lived less than 3 years. 4) Cox regression analysis showed $D_{LCO)$ (${\geq}$60%) (Hazard ratio : 4.56, 95% CI : 2.30-16.04) was the independent prognostic factors of UIP (P<0.05). Conclusion : These results suggest that $D_{LCO)$ at the time of diagnosis seem to be a prognostic markers of biopsy-proven UIP.

• Asian Journal of Turfgrass Science
• /
• v.23 no.1
• /
• pp.1-8
• /
• 2009

This study was conducted to investigate the effect of rainfall, irrigation and fertilizer application on water qualities of pond in golf course from May in 2007 year to November in 2008 year. For survey of water quality, it was sampled at $10{\sim}12$ sites(irrigation site 2, drainage site 3, and hazard site $5{\sim}7$) of SKY72 G.C and evaluated with analysis items such as pH, electrical conductivity(EC), DO, SS, T-N, $PO_4$-P, K, Ca, Mg, Na, SAR, BOD and COD. Results obtained were summarized as follows: The value of pH, EC, DO, T-N, P04-P, K, Ca, Mg, Na and SAR was in dry season, but those of SS, BOD and COD in the rainy season. N and P concentration of pond water showed $1.2{\sim}28.8mg/L$ and $0.005{\sim}0.172mg/L$, respectively, and so it was higher than eutrophication level of lakes and marshes recommended by the Ministry of Environment in Korea. As a reault of correlation analysis, EC in the water was significantly(P<0.01) related items such as K, Ca, Mg, Na, SAR and salinity, and SS significantly(P<0.05) BOD and COD. In comparison with a corelation between respective analysis items and rainfall amount, SAR was significantly(P<0.01) positive but T-N negative(P<0.01). As compared with corelation between respective items and irrigation amount, pH was significantly(P<0.01) positive but T-N(P<0.05) and BOD(P<0.01) negative. When it was applied to N, $P_2O_5$ and $K_2O$ in golf course, N and $K_2O$ significantly affected water qualities of pond(P<0.01). These results suggested that a pond water in golf course was affected by the fertilizer application, rainfall and irrigation and EC was adequate monitoring indicator for the evaluating water quality of pond by chemicals influent.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.4
• /
• pp.1811-1815
• /
• 2014

Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.

• Journal of Food Hygiene and Safety
• /
• v.35 no.1
• /
• pp.51-59
• /
• 2020

This study evalutated the risk of foodborne illness from Vibrio spp. (Vibrio vulnificus and Vibrio cholerae) through sea squirt consumption. The prevalence of V. vulnificus and V. cholerae in sea squirt was evaluated, and the predictive models to describe the kinetic behavior of the Vibrio in sea squirt were developed. Distribution temperatures and times were collected, and they were fitted to probabilistic distributions to determine the appropriate distributions. The raw data from the Korea National Health and Nutrition Examination Survey 2016 were used to estimate the consumption rates and amount of sea squirt. In the hazard characterization, the Beta-Poisson model for V. vulnificus and V. cholerae infection was used. With the collected data, a simulation model was prepared and it was run with @RISK to estimate probabilities of foodborne illness by pathogenic Vibrio spp. through sea squirt consumption. Among 101 sea squirt samples, there were no V. vulnificus positive samples, but V. cholerae was detected in one sample. The developed predictive models described the fates of Vibrio spp. in sea squirt during distribution and storage, appropriately shown as 0.815-0.907 of R² and 0.28 of RMSE. The consumption rate of sea squirt was 0.26%, and the daily consumption amount was 68.84 g per person. The Beta-Poisson model [P=1-(1+Dose/β)^-α] was selected as a dose-response model. With these data, a simulation model was developed, and the risks of V. vulnificus and V. cholerae foodborne illness from sea squirt consumption were 2.66×10^-15, and 1.02×10^-12, respectively. These results suggest that the risk of pathogenic Vibrio spp. in sea squirt could be considered low in Korea.

• Radiation Oncology Journal
• /
• v.18 no.4
• /
• pp.300-308
• /
• 2000

Purpose :The aim of this study is to analysis of suwival and recurrence rates of the uterine cervical carcinoma patients whom received the radiation therapy respectively. The prognostic factors, such as Papanicolaou (Pap) smear, carcinoembriogenic antigen (CEA) and squamous cell carcinoma (SCC) antigen has been studied. Methods and Materials : From January 1981 to December 1998, eight-hundred twenty-seven uterine carvical cancer patients were treat with radiation therapy. All of the patients were divided into two groups : the radiation therapy only (S2l patients) group and the postoperative radiation therapy (326 patients) group. The age, treatment modality, clinical stage, histopathology, recurrence, follow-up Pap smears, CEA and SCC antigen were used as parameters for the evaluation. The prognostic factors such as survival and recurrence rates were peformed with the Kaplan-Meier method and the Cox hazard model, respectively. Median rollow-up was 38.6 months. Results :On the radiation therapy only group, 314 patients (60$\%$) achieved complete response (CR), 47 patients (9$\%$) showed local recurrence (LR), 78 patients (15$\%$) developed distant metastasis (DM). On the Postoperative radiation therapy group, showed 276 Patients (85$\%$) CR, 8 Patients (2$\%$) LR, 37 Patients (11$\%$) DM. The 5-year survival and recurrence rates was evaluated for all parameters. The statistically significant factors for the survival rate in univariate analysis were clinical stage (p=0.0001), treatment modality (p=0.0010), recurrence (p=0.0001), Pap smear (p=0.0329), CEA (p=0.0001) and SCC antigen (p=0.0001). Conclusion: This study indicated that after treatment, the follow-up studies of Pap smear, CEA and SCC antigen were significant parameter and prediction factors for the survival and recurrence of the uterine cervical carcinoma.

• Radiation Oncology Journal
• /
• v.18 no.4
• /
• pp.226-232
• /
• 2000

Purpose :This study was performed to find out the prognostic factors affecting local control in early glottic cancer treated with radiation therapy alone. Materials and Methods :We analysed 37 patients of histologically confirmed early glottic cancer treated at Chonnam National University Hospital between July Im and December 1995, retrospectively. Age of patients ranged from 30 to 73 years (median; 59 years). Thirty-five (95$\%$) patients were male. Histological type was all squamous cell carcinoma. According to the staging system of 1997 American Joint Committee on Cancer, 37 patients were restaged as follows: Tla; U (73$\%$), Tlb; 3 (8$\%$), 72: 7 (19$\%$). Radiation therapy was done using 6 MV X-ray of linear accelerator The range of total radiation dose delivered to the glottic lesion was between 5,040 cGy and 7,020 cGy (median; 6,600 cGy). Median follow-up period was U months. local control rates were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of control rates between comparable groups. Multivariate analysis using Cox proportional hazard model was done to find out prognostic factors affecting local control. Results:5 year survival rate of 37 patients was 89$\%$. Local control rate of 37 patients was 74$\%$ in 5 years. We included age, 7-stage, anterior commissure involvement, fraction size, total radiation dose, treatment time of radiotherapy as potential prognostic factors in univariate and multivariate analysis. As a result, treatment time had statistical significance in local control rate in both univariate (p=0.026) and multivariate (p=0.017) analysis. Complication was not recorded except one patient with hypothyroidism. Conclusion :This study revealed that overall treatment time of radiation was a significant factor affecting local control rate.

• Fire Science and Engineering
• /
• v.17 no.1
• /
• pp.8-20
• /
• 2003

Natural gas has been supplied through underground pipelines and valve stations as a new city gas in Seoul. In contrast to its handiness the natural gas has very substantial hazards due to fires and explosions occurring from careless treatments or malfunctions of the transporting system. The main objectives of this study are to identify major hazards and to perform risk assessments after assessing reliabilities of the composing units in dealing with typical pipeline networks. there-fore two method, fault tree analysis ;1nd event tree analysis, are used here. Random valve stations are selected and considered its situation in location. The value of small leakage, large rupture, and no supply of liquefied natural gas is estimated as that of top event. By this calculation the values of small leakage are 3.29 in I)C valve station, 1.41 in DS valve station, those of large rup-lure are $1.90Times10_{-2}$ in DC valve station, $2.32$\times$10^{-2}$ in DS valve station, and those of no supply of LNG to civil gas company are $2.33$\times$10 ^{-2}$ , $2.89$\times$10^{-2}$ in each valve station. And through minimal cut set we can find the parts that is important and should be more important in overall system. In DC valve station one line must be added between basic event 26,27 because the potential hazard of these parts is the highest value. If it is added the failure rate of no supply of LNG is reduced to one fourth. In DS valve station the failure rate of basic event 4 is 92eye of no supply of LNG. Therefore if the portion of this part is reduced (one line added) the total failure rate can be decreased to one tenth. This analytical study on the risk assessment is very useful to prepare emergency actions or procedures in case of gas accidents around underground pipeline networks and to establish a resolute gas safety management system for loss prevention in Seoul metropolitan area.