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P53 Overexpression and Outcome of Radiation Therapy in Head & Neck Cancers (두경부종양 환자에서 p53의 과발현과 방사선치료결과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Ji Young;Kim Kyung Mi;Park Kyung Shin;Young Shin Kim;Kang Chang Suk;Cho Seung Ho;Kim Hyung Tae
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.1-8
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    • 1999
  • Purpose : Experimental studies have implicated the wild type p53 In cellular response to radiation. Whether altered p53 function can lead to changes in clinical radiocurability remains an area of ongoing study. This study was performed to investigate whether any correlation between change of p53 and outcome of curative radiation therapy in patients with head and neck cancels. Methods : Immunohistochemical analysis with a mouse monoclonal antibody (DO-7) specific for human p53 was used to detect to overexpression of protein in formalin fixed, paraffin-embedded tumor sample from 55 head and neck cancer patients treated with curative radiation therapy (median dose of 7020 cGy) from February 1988 to March 1996 at 51. Mary's Hospital. Overexpression of p53 was correlated with locoregional control and survival using Kaplan-Meier method. A Cox regression multi-variate analysis was peformed that included all clinical variables and status of p53 expression. Results : Thirty-seven (67.2$\%$) patients showed overexpression of p53 by immunohistochemical staining in their tumor. One hundred percent of oral cavity, 70$\%$ of laryngeal, 66.7$\%$ of oropharyngeal, 66.7$\%$ of hypopharyngeal cancer showed p53 overexpression (P=0.05). The status of p53 had significant relationship with stage of disease (P=0.03) and history of smoking (P=0.001). The overexpression of p53 was not predictive of response rate to radiation therapy. The locoregional control was not significantly affected by p53 status. Overexpression of p53 didn't have any prognostic implication for disease free survival and overall survival. Primary site and stage of disease were significant prognostic factors for survival. Conclusions : The p53 overexpression as detected by immunohistochemical staining had significant correlation with stage, primary site of disease and smoking habit of patients. The p53 overexpression didn't have any predictive value for outcome of curative radiation therapy in a group of head and neck cancers.

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A Study on the Strategies of Growth in Small & Medium Construction Firms (강원지방 중소건설업의 성장전략에 관한 연구)

  • Kim, Beom-Jin;Cho, Chang-Jin
    • Korean Business Review
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    • v.19 no.1
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    • pp.53-80
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    • 2006
  • This research has been accomplished to build up the growth strategies of Kangwon district's small & medium-sized construction firms. For this purpose, we made an investigation of the present situation and status for existing regional small & medium construction firms by analyzing data. Based on the results from this study, the following growth strategies are suggested to gain their competitive advantages. Firstly, most of all, the role of the top manager is the most important factor since most of the top manager for the small & medium-sized construction firms coincide with the owner the firms. Secondly, the specialization strategy is to establish. Above all they concentrate their business capacities on core business. Then, this growth strategy should be based on the selective escalation of functions in order to maintain an appropriate level of construction works. Thirdly, the specialized skills and skilled workers are ensured for competitive advantages. For human resource development, they should train workers to be multi-functioned on the assumption the they could stay at firm until they wish to retire. Finally, the government must also spare no effort to encourage the small & medium-sized construction firms to build up it's competitive power and cultivate it's spontaneous generation power though the reformation of system related whit the small and medium construction industry.

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A Study on the Structural Equation Model Among Components of Positive Experiences about Science (과학 긍정경험 구성 변인 간의 구조방정식 모형에 관한 연구)

  • Kim, Heekyong;Kwak, Youngsun;Kang, Hunsik;Shin, Youngjoon;Lee, Sunghee;Lee, Soo-Young
    • Journal of The Korean Association For Science Education
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    • v.37 no.3
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    • pp.507-521
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    • 2017
  • The purpose of this study is to investigate a meaningful path model among the components of students' positive experiences about science and science learning to understand the interactive relationships among different variables of affective domains. Positive Experiences about Science (PES) means whole experiences that have positive effects on students' affectional achievement related with science learning, which consists of science academic emotion, science-related self-concept, science learning motivation, science-related attitude, and science-related career aspiration. We conducted an online survey with 1,841 students consisting of 4th, 6th, 8th, and 10th graders from 17 provinces and cities using Test for Indicators of Positive Experiences about Science (TIPES). To explore the structural relationships among variables, we selected and analyzed an optimal structural equation model and then conducted multigroup analyses among groups. According to the analysis of the structural equation model, 'positive as well as negative science academic emotion' has effects on science learning motivation, science-related attitude, and science-related career aspiration via science-related self-concept. According to the independent t-test results for TIPES scores by participants' characteristics, there were statistically significant differences in the average scores of five sub-components of PES depending on gender, school-level, school location, and participation in science-related activities. According to the multi-group analysis results, the difference of path coefficients by gender and school-level were statistically significant, whereas the difference of path coefficients by school location and participation were not significant. Discussed in the conclusion are the implications of this research for science education research and ways to help students' affectional achievement related with science learning.

The Analysis of the Trend of Research on Gastric Cancer Reported in Professional Journals in the Field of Surgery in Korea (국내 전문 학술지에 의한 위암 외과의 연구 경향에 대한 분석)

  • Oh, Cheong-Ah;Kim, Dae-Hoon;Oh, Seung-Jong;Cho, Hyun-Jin;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Bae, Jae-Moon;Kim, Sung
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.186-192
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    • 2009
  • Purpose: The aim of this study was to analyze the trend of the literature reported in the Journal of Korean Gastric Cancer Association (JKGCA) and the Journal of Korean Surgical Society (JKSS) in order to suggest new directions for the future studies on gastric cancer. Materials and Methods: The papers published in the Journal of Korean Gastric Cancer Association (JKGCA) and the Journal of Korean Surgical Society (JKSS) between 2001 and 2008 were compared and summarized in terms of the following categories, retrospective study, prospective study, case report, biomolecular study, genetic study, tumor marker study, review article, and report. Results: For recent 8 years, while the number of review articles in JKSS had initially increased, gradually fallen down and recently increased again, only a few (only 6 publications) in JKGCA have been published. The number of case reports in JKSS has gradually increased and fallen down. On the other hand, a few of case reports (1~3 publications) has been annually published in JKSS. Uniquely, reports were published only in JKGCA with the noticeable increase during the period from 2004 to 2005. For retrospective studies, in JKGCA the number started off very high and decreased, and finally increased again (U-shaped), whereas it had a bell-shaped trend in JKSS. The number of prospective studies in JKGCA had a bell-shaped trend, but the one in JKSS continued to decrease. Few papers of molecular biologic study, tumor marker study and genetic study had been published in both journals. Conclusion: We concluded that the transition from retrospective studies to prospective studies as well as a comprehensive multi-disciplinary team management of a clinical research would represent a desirable strategy in gastric cancer research.

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Laparoscopy Assisted versus Open Distal Gastrectomy with D2 Lymph Node Dissection for Advanced Gastric Cancer: Design and Rationale of a Phase II Randomized Controlled Multicenter Trial (COACT 1001)

  • Nam, Byung Ho;Kim, Young-Woo;Reim, Daniel;Eom, Bang Wool;Yu, Wan Sik;Park, Young Kyu;Ryu, Keun Won;Lee, Young Joon;Yoon, Hong Man;Lee, Jun Ho;Jeong, Oh;Jeong, Sang Ho;Lee, Sang Eok;Lee, Sang Ho;Yoon, Ki Young;Seo, Kyung Won;Chung, Ho Young;Kwon, Oh Kyoung;Kim, Tae Bong;Lee, Woon Ki;Park, Seong Heum;Sul, Ji-Young;Yang, Dae Hyun;Lee, Jong Seok
    • Journal of Gastric Cancer
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    • v.13 no.3
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    • pp.164-171
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    • 2013
  • Purpose: Laparoscopy-assisted distal gastrectomy for early gastric cancer has gained acceptance and popularity worldwide. However, laparoscopy-assisted distal gastrectomy for advanced gastric cancer is still controversial. Therefore, we propose this prospective randomized controlled multi-center trial in order to evaluate the safety and feasibility of laparoscopy assisted D2-gastrectomy for advanced stage gastric cancer. Materials and Methods: Patients undergoing distal gastrectomy for advanced gastric cancer staged cT2/3/4 cN0/1/2/3a cM0 by endoscopy and computed tomography are eligible for enrollment after giving their informed consent. Patients will be randomized either to laparoscopyassisted distal gastrectomy or open distal gastrectomy. Sample size calculation revealed that 102 patients are to be included per treatment arm. The primary endpoint is the non-compliance rate of D2 dissection; relevant secondary endpoints are three-year disease free survival, surgical and postoperative complications, hospital stay and unanimity rate of D2 dissection evaluated by reviewing the intraoperative video documentation. Discussion: Oncologic safety is the major concern regarding laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Therefore, the non-compliance rate of clearing the N2 area was chosen as the most important parameter for the technical feasibility of the laparoscopic procedure. Furthermore, surgical quality will be carefully reviewed, that is, three independent experts will review the video records and score with a check list. For a long-term result, disease free survival is considered a secondary endpoint for this trial. This study will offer promising evidence of the feasibility and safety of Laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Trial Registration: NCT01088204 (international), NCCCTS-09-448 (Korea).

The Impacts of Smoking Bans on Smoking in Korea (금연법 강화가 흡연에 미치는 영향)

  • Kim, Beomsoo;Kim, Ahram
    • KDI Journal of Economic Policy
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    • v.31 no.2
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    • pp.127-153
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    • 2009
  • There is a growing concern about potential harmful effect of second-hand or environmental tobacco smoking. As a result, smoking bans in workplace become more prevalent worldwide. In Korea, workplace smoking ban policy become more restrictive in 2003 when National health enhancing law was amended. The new law requires all office buildings larger than 3,000 square meters (multi-purpose buildings larger than 2,000 square meters) should be smoke free. Therefore, a lot of indoor office became non smoking area. Previous studies in other counties often found contradicting answers for the effects of workplace smoking ban on smoking behavior. In addition, there was no study in Korea yet that examines the causal impacts of smoking ban on smoking behavior. The situation in Korea might be different from other countries. Using 2001 and 2005 Korea National Health and Nutrition surveys which are representative for population in Korea we try to examine the impacts of law change on current smoker and cigarettes smoked per day. The amended law impacted the whole country at the same time and there was a declining trend in smoking rate even before the legislation update. So, the challenge here is to tease out the true impact only. We compare indoor working occupations which are constrained by the law change with outdoor working occupations which are less impacted. Since the data has been collected before (2001) and after (2005) the law change for treated (indoor working occupations) and control (outdoor working occupations) groups we will use difference in difference method. We restrict our sample to working age (between 20 and 65) since these are the relevant population by the workplace smoking ban policy. We also restrict the sample to indoor occupations (executive or administrative and administrative support) and outdoor occupations (sales and low skilled worker) after dropping unemployed and someone working for military since it is not clear whether these occupations are treated group or control group. This classification was supported when we examined the answers for workplace smoking ban policy existing only in 2005 survey. Sixty eight percent of indoor occupations reported having an office smoking ban policy compared to forty percent of outdoor occupation answering workplace smoking ban policy. The estimated impacts on current smoker are 4.1 percentage point decline and cigarettes per day show statistically significant decline of 2.5 cigarettes per day. Taking into account consumption of average sixteen cigarettes per day among smokers it is sixteen percent decline in smoking rate which is substantial. We tested robustness using the same sample across two surveys and also using tobit model. Our results are robust against both concerns. It is possible that our measure of treated and control group have measurement error which will lead to attenuation bias. However, we are finding statistically significant impacts which might be a lower bound of the true estimates. The magnitude of our finding is not much different from previous finding of significant impacts. For cigarettes per day previous estimates varied from 1.37 to 3.9 and for current smoker it showed between 1%p and 7.8%p.

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A Study on the Diffusion Factor of e-finance (e-Finance의 확산요인에 관한 연구)

  • Kim, Min-Ho;Song, Chae-Hun;Song, Sun-Yok;Cha, Sun-Kwon
    • International Commerce and Information Review
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    • v.4 no.2
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    • pp.253-277
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    • 2002
  • Nowaday, the advanced technology in information and communication has been leading the dramatic change of transaction paradigm expansion from physical basis to electronic one. As we know, financial services support most of financial exchange between two business parties. So the expansion of electronic transaction paradigm affects to every financial institutions which provide financial services. Thus, financial institutions have accepted e-Finance systems and providing internet financial services to live in the competition. The purpose of this study is to contribute the qualitative enhancement of its customer service, rapid diffusion and accurate strategy establishment for e-Finance industry in the user side. Through the literature review and factor and reliability analysis, this study selects six diffusion factors such as efficiency of perceived e-Finance, reliability and safety of e-Finance in perceived e-Finance itself's characteristic; confidence, technical factors and the customer service quality of e-Finance system in perception on e-Finance System; inclination to innovation in the personal characteristic. According to result of hypothesis verification by using logistics regression analysis, technical factors and the customer service quality of e-Finance system in perception on e-Finance System and inclination to innovation in the personal characteristic gave statistically positive effect to the diffusion decision at the significant level 0.05 and 0.01. However efficiency of perceived e-Finance, reliability and safety of e-Finance in perceived e-Finance itself's characteristic didn't affect to diffusion decision and confidence of e-Finance system in perception on e-Finance System didn't have any statistical significancy. This study can be used as a basic material for the forward empirical study of diffusion factors in the user side and be able to apply to company and government policy making or embodiment, determination for customer service quality degree of financial institutions. But this study has some limitations like didn't touch satisfaction factors and its effect, only deal domestic customers and didn't use multi-regression analysis.

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THE EFFECT OF NEW BONE FORMATION OF ONLAY BONE GRAFT USING VARIOUS GRAFT MATERIALS WITH A TITANIUM CAP ON THE RABBIT CALVARIUM (가토의 두개골에서 티타늄 반구를 이용한 다양한 onlay bone graft시 골형성 능력)

  • Park, Young-Jun;Choi, Guen-Ho;Jang, Jung-Rok;Jung, Seung-Gon;Han, Man-Seung;Yu, Min-Gi;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.469-477
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    • 2009
  • Purpose: This study was performed to evaluate the effect of various graft materials used with a titanium cap on the ability of new bone formation in the rabbit calvarium. Materials and Methods: A total of 32 sites of artificial bony defects were prepared on the calvaria of sixteen rabbits by using a trephine bur 8 mm in diameter. Each rabbit had two defect sites. 0.2 mm deep grooves were formed on the calvaria of sixteen rabbits by using a trephine bur 8 mm in diameter for the fixation of a titanium cap. The treatments were performed respectively as follows: without any graft for the control group (n=8), autogenous iliac bone graft for experimental group 1 (n=8), alloplastic bone graft ($SynthoGraft^{(R)}$, USA) for experimental group 2 (n=8), and xenogenic bone graft ($NuOss^{(R)}$, USA) for experimental group 3 (n=8). After the treatments, a titanium cap (8 mm in diameter, 4 mm high, and 0.2 mm thick) was fixed into the groove. At the third and sixth postoperative weeks, rabbits in each group were sacrificed for histological analysis. Results: 1. In gross examination, the surgical sites showed no signs of inflammation or wound dehiscence, and semicircular-shaped bone remodeling was shown both in the experimental and control groups. 2. In histological analysis, the control group at the third week showed bone remodeling along the inner surface of the cap and at the contact region of the calvarium without any specific infiltration of inflammation tissue. Also, there was no soft tissue infiltration. Bone remodeling was observed around the grafted bone and along the inner surface of the titanium cap in experimental group 1, 2, and 3. 3. Histologically, all groups at the sixth week showed the increased area of bone remodeling and maturation compared to those at the third week. In experimental group 2, the grafted bone was partially absorbed by multi nucleated giant cells and new bone was formed by osteoblasts. In group 3, however, resorption of the grafted bone was not observed. 4. Autogenous bone at the third and sixth week showed the most powerful ability of new bone formation. The size of newly formed bone was in decreasing order by autogenous, alloplastic, and heterogenous bone graft. There was no statistically significant difference among autogenous, alloplastic, and heterogenous bones(p>0.05). Summary: This result suggests that autogenous bone is the best choice for new bone formation, but when autogenous bone graft is in limited availability, alloplastic and xenogenic bone graft also can be an alternative bone graft material to use with a suitably guided membrane.

Critical Pathway for Operable Gastric Cancer (위암수술 환자에서의 Critical Pathway의 개발과 적용)

  • Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.95-100
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    • 2005
  • Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

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Development of Oligonucleotide Chip for Detection of Drug-Resistant Mycobacterium Tuberculosis (약제내성 결핵균의 검출을 위한 Oligonucleotide Chip의 개발)

  • Song, Eunsil;Park, Heekyung;Jang, Hyunjung;Kim, Hyomyung;Chang, Chulhun L.;Kim, Cheolmin
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.1
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    • pp.41-58
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    • 2003
  • Background : The resurgence of tuberculosis and the widespread emergence of multidrug-resistant M. tuberculosis have emphasized the importance of rapid and accurate diagnostic procedures. Recently, the oligonucleotide chip has proven to be a useful tool in the rapid diagnosis of infectious diseases. The purpose of this study was to rapidly and accurately detect specific mutations in the rpoB, katG and rpsL genes associated with rifampin, isoniazid and streptomycin resistance in M. tuberculosis, respectively, using a single oligonucleotide chip. Method : For detection of drug-resistance, 7 wild-type and 13 mutant-type probes for rifampin, 2 wild-type and 3 mutant-type probes for isoniazid, and 2 wild-type and 2 mutant-type probes for streptomycin were designed and spotted onto glass slides. Fifty-five cultured samples of M. tuberculosis were amplified by PCR, and then underwent hybridization and scanning. Direct sequencing was done to verify the results from the oligonucleotide chip and to analyze the types of mutations. Result : Thirty-five cases out of 40 rifampin-resistant strains(~88%) had mutations in the rpoB gene. One case had a new mutation(D516F, GAC R TTC) and another known mutation together. Twenty cases out of 42 isoniazid-resistant strains(~50%) had mutations in the katG gene, while 7 cases out of 9 streptomycin-resistant strains(~78%) had mutations in the rpsL gene. From these results, the oligonucleotide chip was confirmed to be able to detect the most frequent mutations from the genes associated with rifampin, isoniazid and streptomycin resistance. The results proved that the drug-resistance detection probes were specific. When the results from the oligonucleotide chip and DNA sequencing were compared, the types of mutations were exactly matched. Conclusion : The diagnostic oligonucleotide chip with mutation specific probes for drug resistance is a very reliable and useful tool for the rapid and accurate diagnosis of drug resistance against rifampin, isoniazid and streptomycin in M. tuberculosis infections.