• Radiation Oncology Journal
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• v.18 no.1
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• pp.17-25
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• 2000

Purpose : To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and III rectal cancer who had undergone curative resection were randomized to 'early radiotherapy group (arm I)' or' late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. Materials and Methods . From January 1996 to March 1999, 313 patients with curatively resected stages II and III rectal cancer have been randomized to' early' or' late' radiation therapy group and received combined chemotherapy (5-FU 375 mg/m$^{2}$/day, ieucovorin 20 mg/m$^{2}$, IV bolus daily Dl-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/s weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was peformed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. Results :Local recurrence occurred in 11 patients (9.7$\%$) for arm I and 9 patients (8$\%$) for arm 11. There was no significant difference between both groups ( p=0.64). However, distant metastasis was found in 22 patients (19.5$\%$) for arm I and 35 patients (31.0$\%$) for arm II and which showed statistically significant difference between the two groups ( p=0.046). And neither 3-year disease-free survival (70.2$\%$ vs 59.2$\%$, p=0.2) nor overall survival (89.4$\%$ vs 88.0$\%$, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3$\%$ and 79.9$\%$ respectively but leukopenia more than RTOG grade 3 was only 2.1$\%$ and 6.0$\%$ respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2$\%$ vs 41.6$\%$, p=0.02) but this complication was controlled with supportive cares. Conclusion : Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy after curative resection for rectal cancer, local recurrence rate was low with combined chemoradlotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.

• Korean Journal of Heritage: History & Science
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• v.53 no.4
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• pp.150-169
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• 2020

Surveys of Buddhist ruins at Namsan in Gyeongju began in earnest during the Japanese colonial era, undertaken by Japanese scholars. These surveys of Buddhist remains in Namsan made during the colonial period should be seen as previous research which cannot be ignored in any in-depth study of Buddhist ruins in Gyeongju. Full-scale surveys of Buddhist ruins at Namsan began in the 1920s. Previous surveys conducted around the time of the Japanese annexation of Korea in 1910 are generally viewed as only representing preliminary investigations and, thus, have not received much attention. However, these early surveys are significant in that they led to the Buddhist ruins on Namsan becoming widely known in the 1910s and served as the foundations for later studies. The removal of the Seated Medicine Buddha from Samneung Valley in Gyeongju in 1915 and its subsequent exhibition at the Joseon Local Products Expo, which marked the fifth anniversary of the Japanese administration of Korea, was especially important in garnering attention for Namsan's wealth of Buddhist artifacts, as the statue was placed in the main hall of the art museum and attracted a great deal of interest from visitors. It is typically thought that this Seated Medicine Buddha was exhibited in 1915 because it was the most beautiful and well-preserved statue from Namsan. However, the removal of this statue was closely related to the proposed move of the Seokguram statue to Seoul around the time of Korea's annexation. The plan to move Seokguram to Seoul was primarily devised by Terauchi Masatake, and the plan, based on Ilseontongjo-ron ('日鮮同祖論'), a historical theory that prehistoric Korean and Japanese people were of the same blood, and Joseon Jeongcheasoeng-ron ('朝鮮停滯性論'), a historical theory arguing that development had stagnated in Korea, was intended to be a visual demonstration of a new era for Korea. This new era was to proceed under the rule of the Japanese Empire through the dissolution of Gyeongbokgung, the symbol of the Joseon Dynasty, which would be replaced with past glories as symbolized by the statue of Buddha. However, as the plan floundered, the replacement for Seokguram in Seoul ended up being none other than the Seated Medicine Buddha of Samneung Valley. Surveys of the Seated Medicine Buddha began in 1911, administered by Sekino Tadashi, but he likely learned of the statue's location from Moroga Hideo or Kodaira Ryozo, Japanese residents of Gyeongju. It is also probable that these Japanese residents received a request from the Japanese Government General of Korea to find a Buddha statue that was worthy of being displayed at exhibitions. In this way, we can say that the transfer of the Seated Medicine Buddha to Seoul was the result of close cooperation between the Government General, Sekino Tadashi, and Japanese residents of Gyeongju. This also had the effect of removing the magical veil which had shrouded the Buddhist ruins of Namsan. In other words, while the early surveys of Buddhist ruins on Namsan are significant, it is difficult to argue that the surveys were undertaken for purely academic purposes, as they were deeply related to the imperial ambitions of Governor-General Terauchi which encompassed the plans to move Seokguram to Seoul and the successful hosting of the 1915 Expo. It should also be pointed out that the failure of the plan to move Seokguram to Seoul and the preservation of the Seated Stone Buddha of Mireuggok at Namsan was in no small part due to resistance from Korean residents in Gyeongju. Although it is not described in detail in the paper, research is needed which shows that the Korean residents of Gyeongju were not simple bystanders, but agents of history.

• Radiation Oncology Journal
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• v.24 no.2
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• pp.116-122
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• 2006

Purpose: To determine treatment policy for early stage endometrial carcinoma, we analyzed the results of postoperative radiotherapy. Materials and Methods: From Oct. 1994 to Aug. 2002, 42 patients with FIGO stage I endometrial carcinoma received postoperative radiotherapy. All patients received curative surgery and pelvic lymph node dissection was done in 25 patients. Based on the FIGO staging system, 3 were at stage IA, 21 were at stage IB and 18 were at stage IC. Histologically, there were 14 grade 1, 16 grade 2, and 12 grade 3. Nineteen patients received intracavitary brachytherapy and 23 patients did whole pelvic radiotherapy. The median period of follow-up was 41 months (22 to 100 months). Results: Five-year overall survival, disease-free survival, local control, and regional control rates of all patients were 85.0%, 87.9%, 100%, and 97.5%, respectively. All failures were distant metastases in 5 patients and two patients had simultaneous regional recurrences. There was no intrapelvic failure in patients who received intracavitary radiotherapy. Grade 3 chronic complications were found in 1 patient (4.3%), who received whole pelvic radiotherapy. Conclusion: We achieved high rates of loco-regional control and survival by curative surgery and post-operative radiotherapy. However, we need to select the type of radiotherapy based on the risk factors for recurrence to reduce the treatment-related complication.

• Korea journal of population studies
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• v.19 no.1
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• pp.93-122
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• 1996

This is a study of the determinants of sexual, contraceptive, and abortion behavior among unmarried female adolescents and young adults, which has emerged as a growing and serious health problem in Korea. As part of a larger project, data were gathered in three export zones: Kuro (Seoul), Kumi (Kyngbuk) Masan Changwon (Kyongnam) ; and the study samples are regrouped into three categories: 1) factory workers, i.e. , the reference group serving as program participants, 2) entertainment workers, and 3) ob-gyn patients. This study indicates that entertainment workers are at highest risk of experiencing premarital sex, STDs, contraceptive failure, unwanted pregnancies, and induced abortion. Of them, 20 percent had STDs as a result of first sexual experience: and about seven tenths had two or more pregnancies due to the adoption of low-efficacy methods. The proportion of those who had ever been pregnant was 60 percent for the group as a whole: 36 percent for the program participants: 64 percent for the entertainment workers ; and 91 percent four the ob-gyn patients. These proportions are exactly the same for abortion in each group, which means that all pregnancies ended in induced abortion. Of the respondents who said that they were sexually active at the time of survey, abortions were very high: 1.6 for the program participants, 2.3 for the entertainment workers, and 1.9 for the ob-gyn patients. About 80 percent of the women had abortions during the first trimester, and two thirds of the first abortions took place between the ages of 20 and 23. About one fourth experienced post-abortion complication, which was highest among the program participants (39 percent). Sixty percent of those with complications visited a hospital or took medicine to treat the problem. Even after the experience of induced abortion, the use of contraception was very low, except among the entertainment workers, whose level of use reached 53 percent. The most obvious recommendation, arising from this research, is that 'good-quality' counselling and family planning services be established under the auspices of both national and local government, particularly targeted for the entertainment workers as well as the factory workers in various textile, electronic, manufacturing, and other industrial sectors. We believe that entertainment sectors should be restructured radically so that young women who work for amusement bars and other entertainment sectors obtain protection from the risk of having unwanted pregnancies, STDs, and induced abortion.

• Journal of Korean Biological Nursing Science
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• v.2 no.1
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• pp.1-19
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• 2000

The purpose of this study was to define the content of the requisite knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for clinical knowledge for nursing practice. Contents of knowlege on pathological physiology, clinical microbiology, and mechanisms and effects of drugs were constructed from syllabus of basic nursing subjects in 4 colleges of nursing, and textbooks. The degree of need of 72 items was measured with a 4 point scale. The subjects of this study were college-graduated 136 nurses from seven university hospital in Seoul and three in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, and hospice ward. The results were as follows : 1. The highest scored items of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice were side effects of drugs, anticoagulants, mechanisms of drugs, antihypertensive drugs, tolerance and addiction of drugs, interactions among drugs, hospital infection in the order of importance. The lowest scored item was structure of microorganisms. 2. The highest order of need according to unit was repair in tissue injury unit, definition etiology classification of inflammation in inflammation unit, transplantation and immunologic response in alterations in immunity unit, thrombus and thrombosis in disorders of cardiovascular function unit, gene disorders in genetic disorders unit, hospital infection in infection unit, virus in microorganisms unit, side reactions of drugs in introduction unit, anticonvulsants in drugs for central nervous system unit, local anesthesia in anesthesia unit, anticoagulants in drugs for cardiovascular system unit, anti-inflammatory drugs in antibiotics unit, anti-ulcer drugs in drugs for digestive system unit, and bronchodilators in drugs for respiratory system unit. 3. The common content of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for all clinical areas in nursing were side effects of drugs, anticoagulants, interactions among drugs, and hospital infection. However, the degree of need of each pathological physiology, clinical microbiology, clinical microbiology, and mechanisms and effects of drugs was different depending on clinical areas. 4. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as tissue changes due to injurious stimuli, degenerative changes of tissue, alterations in metabolism of carbohydrates, ischemia, hyperemia and congestion, hospital infection, structure of microorganism, classification of microorganism, bacteria, virus, antidepressants, antipsychotic drugs, antiemetic drugs, antiparkinsonism drugs, antianxiety drugs, antibiotics, tuberculostatics, antiviral drugs, antifungal drugs, parasiticides, antiulcer drugs, antidiarrheais, and anti constipation drugs were shown according to the work area. 5. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as transplantation and immunologic response, alterations in the metabolism of uric acid, structure of microorganism, classification of microorganism, immunosuppressants, drugs for congestive heart failure were demonstrated according to the duration of work. Based on these findings, all the 72 items constructed by Korean Academic Society of Basic Nursing science should be included as contents of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs.

• Radiation Oncology Journal
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• v.11 no.1
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• pp.79-82
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• 1993

From October 1989 to March 1992, ten patients diagnosed as primary central nervous system (CNS) lymphoma were treated with radiation therapy at Asan Medical Center. To obtain pathologic diagnosis, five patients had stereotactic biopsy and the others underwent craniotomy & tumor removal. According to the classification by International Working Formulation, seven of 10 patients showed diffuse large cell types and the remaining 3 had diffuse mixed cell types. Computed tomographic scans of the brain disclosed solitary (6 cases) or multiple (4 cases) intracranial lesions. All patients received 4000 cGy/20 fx to the whole brain followed by an additional 2000 cGy/10 fx boost to the primary lesion. Six patients with initial cerebrospinal fluid (CSF involvement were treated with whole brain irradiation and intrathecal Methotrexate (IT-MTX) chemotherapy. One of them received an additional spinal irradiation after 3 cycles of IT-MTX chemotherapy because of MTX induced arachnoiditis. One patient received 3 cycles of systemic chemotherapy prior to rodiation therapy and one received 5 cycles of salvage chemotherapy for recurrence. With a median follow up time of 8 months, all patients were followed from 7 to 26 months. Radiologically seven patients showed complete remission and the remaining three showed partial remission at one month after radiotherapy. The 1 and 2 year survival rate was $86{\%}\;and\;69{\%}$ respectively. Until now, two patients expired at 7 and 14 months. These patients developed extensive CSF seeding followed by local failure. Considering initial good response to radiation therapy and low incidence of extraneural dissemination in primary CNS lymphoma, we propose to increase total tumor dose to the primary lesion by hyperfractionated radiotherapy or stereotactic radiosurgery. For the patients with CSF involvement at diagnosis, we propose craniospinal irradiation with IT MTX chemotherapy.

• Radiation Oncology Journal
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• v.27 no.3
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• pp.145-152
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• 2009

Purpose: We retrospectively studied the outcomes and prognostic factors of patients with locally advanced, unresectable pancreatic cancer who were treated with concurrent chemoradiotherapy (CCRT) or radiotherapy only. Materials and Methods: Fifty-one patients with locally advanced, unresectable pancreatic cancer (stage IIA~III) who recevied radiotherapy ($\geq$30 Gy) between January 1994 and August 2008 were reviewed retrospectively. The median radiation dose was 39 Gy. Chemotherapy consisted of gemcitabine, cisplatin, or 5-FU alone or in various combinations, and was administered concurrently with radiotherapy in 38 patients. Results: The follow-up period ranged from 2~40 months (median, 8 months). The median survival, and the 1-and 2-year overall survival (OS) rates were 7 months, 15.7%, and 5.9%, respectively. Based on univariate analysis, the baseline CA19-9, performance status, and chemotherapy regimen were significant prognostic factors. The median survival was 8 months for CCRT, and 6 months for radiotherapy alone. The patients treated with gemcitabine-containing regimens had longer survival (median, 10 months) than the patients treated with radiotherapy alone (p=0.027). Twenty-three patients were available to evaluate the patterns of failure. Distant metastases (DM) occured in 18 patients and regional recurrences were demonstrated in 4 patients. Local progression developed in 14 patients. We analyzed the association between the time-to-DM and the baseline CA19-9 levels for 18 evaluable patients. The median time-to-DM was 20 months for patients with normal baseline CA19-9 levels and 2 months for patients with baseline CA19-9 levels $\geq$200 U/ml. Conclusion: CCRT with gemcitabine-based regimens was effective in improving OS in patients with locally advanced, unresectable pancreatic cancer. We suggest that the baseline CA19-9 level is valuable in determining the treatment strategy for patients with locally advanced, unresectable pancreatic cancer.

• Radiation Oncology Journal
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• v.26 no.1
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• pp.17-23
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• 2008

Purpose: The best treatment for advanced esophageal cancer is chemoradiotherapy followed by surgery. In spite of the advance of multimodality therapy, most patients with esophageal cancer are treated with radiation therapy alone. This study reports the outcome of the use of conventional external beam radiotherapy alone for the treatment of esophageal cancer. Materials and Methods: Between January 1998 and December 2005, 30 patients with squamous cell carcinoma of the esophagus were treated with external beam radiotherapy using a total dose exceeding 40 Gy. Radiotherapy was delivered with a total dose of 44-60 Gy(median dose, 57.2 Gy) over $36{\sim}115$ days(median time, 45 days). Thirteen patients(43.3%) had a history of disorders such as diabetes, hypertension, tuberculosis, lye stricture, asthma, cerebral infarct, and cancers. Four patients metachronously had double primary cancers. The most common location of a tumor was the mid-thoracic portion of the esophagus(56.7%). Tumor lengths ranged from 2 cm to 11 cm, with a median length of 6 cm. For AJCC staging, stage III was the most common (63.3%). Five patients had metastases at diagnosis. Results: The median overall survival was 8.3 months. The survival rates at 1-year and 2-years were 33.3% and 18.7%, respectively. The complete response rate $1{\sim}3$ months after radiotherapy was 20%(6/30) and the partial response rate was 70%(21/30). Sixteen patients(53.3%) had an improved symptom of dysphagia. Significant prognostic factors were age, tumor length, stage, degree of dysphagia at the time of diagnosis and tumor response. Cox regression analysis revealed the aim of treatment, clinical tumor response and tumor length as independent prognostic factors for overall survival. Twenty-eight patients had local failure and another four patients had metastases. Three patients were detected with double primary cancers in this analysis. A complication of esophageal stricture was observed in three patients(10%), and radiation pneumonitis occurred in two patients(6.7%). Conclusion: The prognosis of esophageal cancer remains poor, in spite of advances in radiotherapy techniques. Radiotherapy is one of the main treatment modalities for the relief of dysphagia and treatment related complications are minimal. It is expected that the addition of chemotherapy or another systemic modality to radiotherapy will improve tumor control and increase the survival rate in advanced esophageal cancer.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.303-308
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• 2002

Purpose : To determine the optimal radiation dose in a localized non-Hodgkin's lymphoma of the head and neck in the treatment setting for combined chemoradiotherapy. Materials an Methods :Fifty-three patients with stage I and II diffuse large ceil non-Hodgkin's lymphoma of the head and neck, who were treated with combined chemoradiotherapy between 1985 and 1998 were retrospectively reviewed. The median age was 49 years, and the male-to-female ratio was approximately 1.6. Twenty-seven patients had stage 1 disease and 26 had stage II. Twenty-three patients had bulky tumors $(\geq5\;cm)$ and 30 had non-bulky tumors (<5 cm). The primary tumors arose mainly from an extranodal organ $(70\%)$, most cases involving Waldeyer's ring $(90\%)$. All patients except one were initially treated with $3\~6$ cycles of chemotherapy, which was followed by radiotherapy. Radiation was delivered either to the primary tumor area alone $(9\%)$ or to the primary tumor area plus the bilateral neck nodes $(91\%)$ with a minimum dose of 30 Gy $(range\;30\~60\;Gy)$. The failure patterns according to the radiation field were analyzed, and the relationship between the dose and the in-field recurrence was evaluated. Results : The 10-year overall survival and the 10-year disease free survival rates were similar at $75\%\;and\;76\%$, respectively. A complete response (CR) after chemotherapy was achieved in 44 patients $(83\%)$. Subsequent radiotherapy showed a CR in all patients. Twelve patients $(23\%)$ had a relapse of the lymphoma after the initial treatment. Two of these patients had a recurrence inside the radiation field. No clear dose response relationship was observed and no significant prognostic factors for the in-field recurrences were identified because of the small number of in-field recurrences. However, for patients with tumors <5 cm in diameter, there were no in-field recurrences after a radiation dose 30 Gy. The 2 in-field recurrences encountered occurred in patients with a tumor $\geq5\;cm$. Conclusion .A dose of 30 Gy is sufficient for local control in patients with a non-bulky (<5 cm), localized, diffuse large cell non-Hodgkin's lymphoma when combined with chemotherapy. An additional boost dose in the primary site is recommended for patients with bulky tumors $(\geq5\;cm)$.

• Survey Research
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• v.6 no.1
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• pp.1-38
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• 2005

Considering the importance of corruption index measurement model and the diffusion of popular awareness about the importance of anti-corruption, this research compared and analyzed existing corruption index measurement models. This paper has selected "Anti-Corruption Index model(ACI model)" that was developed by Seoul Development Institute and "CCEJ's Corruption Index model" which is under use by the Citizens' Coaltion for Economic Justice. These two models were analyzed in terms of appropriateness of 'the indicator and index choice method', 'the research design' and 'the use of statistical data'. This analysis shows that two models have some problems. First, at the level of indicator and index choice method, the indicators of CCEJ's corruption index model is too atomized and redundant. As not putting weight of indicator, it did not consider importance of each indicator. Citizens who evaluated the level of corruption didn't participate in the weight evaluation team, which results in failure of the model to reflect the citizens' opinion. Also, because the question about Seoul Metropolis' corruption level is not included, it is not detected difference between real corruption level and perceptive corruption level. Second, in terms of appropriateness of research design, the sample of the CCEJ' corruption index model is too small to get credibility. The objectivity of research method seems to be low because survey was performed by exit interview. In addition, 38 items are overfull in the questionnire of CCEJ's corruption index model compare to 13 items in ACI model. Also, in making up questions, the terms are redundant and unobvious. Third, in regarding with feasibility of the statistical data, the CCEJ's corruption index model uses regulation data for disciplinary punishment of 25 local governments in Seoul from 1995 to 1999. But, it is common ideas of scholars that statistical data indicates the tip of an iceberg in corruption. So for using a statistical data, it needs a data of enough quantity and has a high level credibility. In addition, objective method of giving weight is not developed. In this point of view, the use of statistical data has some limits. To solve this problem, ① objective data should be included in the indicators, ② various indicators should be developed and ③ a method of giving weight should be improved.