• Clinical and Experimental Reproductive Medicine
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• v.34 no.4
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• pp.285-291
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• 2007

Objective: To evaluate the outcomes of in vitro fertilization and embryo transfer (IVF-ET) in women over 40 years of age. Methods: A total of 170 patients (271 cycles) over 40 years of age who underwent IVF-ET at Seoul Women's Hospital (Incheon, Korea) were analyzed in this study retrospectively. The patients were grouped into the women <44 years old group and the women $\geq$44 years old group. Statistical analysis was performed using Student's t-test and Fisher's exact test as appropriate. Results: An overall clinical pregnancy rate per retrieval was 11% (30/271). Of these, clinical miscarriage rate were 33% (10/30) and the overall delivery rate was 7.4% (20/271) per retrieval, respectively. The women $\geq$44 years old group had significantly higher cancellation rate (13% vs. 25%), lower number of retrieved oocytes (6.17$\times$4.62 vs. 4.13$\times$4.07), decreased number of 2PN (4.83$\times$3.61 vs. 3.46$\times$3.12), and reduced embryos for transfer (3.52$\times$1.72 vs. 2.81$\times$1.83) than the women <44 years old group. We found significantly lower clinical pregnancy rate (13.0% vs. 2.1%) and live birth rate (9.0% vs. 0.0%) in the women $\geq$44 years old group than the women <44 years old group. Conclusion: The present study has shown that IVF outcome is seriously impaired in the women $\geq$44 years old.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.195-203
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• 2008

Purpose: To investigate the treatment outcome and failure patterns after definitive chemoradiation therapy in locally advanced, unresectable esophageal cancer. Materials and Methods: From February 1994 to December 2002, 168 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated by definitive chemoradiation therapy. External beam radiation therapy (EBRT) ($42{\sim}46\;Gy$) was delivered to the region encompassing the primary tumor and involved lymph nodes, while the supraclavicular fossa and celiac area were included in the treatment area as a function of disease location. The administered cone-down radiation dose to the gross tumor went up to $54{\sim}66\;Gy$, while the fraction size of the EBRT was 1.8-2.0 Gy/fraction qd or 1.2 Gy/fraction bid. An optional high dose rate (HDR) intraluminal brachytherapy (BT) boost was also administered (Ir-192, $9{\sim}12\;Gy/3{\sim}4\;fx$). Two cycles of concurrent FP chemotherapy (5-FU $1,000\;mg/m^2$/day, days $2{\sim}6$, $30{\sim}34$, cisplatin $60\;mg/m^2$/day, days 1, 29) were delivered during radiotherapy with the addition of two more cycles. Results: One hundred sixty patients were analyzable for this review [median follow-up time: 10 months (range $1{\sim}149$ months)). The number of patients within AJCC stages I, II, III, and IV was 5 (3.1%), 38 (23.8%), 68 (42.5%), and 49 (30.6%), respectively. A HDR intraluminal BT was performed in 26 patients. The 160 patients had a median EBRT radiation dose of 59.4 Gy (range $44.4{\sim}66$) and a total radiation dose, including BT, of 60 Gy (range $44.4{\sim}72$), while 144 patients received a dose higher than 40 Gy. Despite the treatment, the disease recurrence rate was 101/160 (63.1%). Of these, the patterns of recurrence were local in 20 patients (12.5%), persistent disease and local progression in 61 (38.1%), distant metastasis in 15 (9.4%), and concomitant local and distant failure in 5 (3.1%). The overall survival rate was 31.8% at 2 years and 14.2% at 5 years (median 11.1 months). Disease-free survival was 29.0% at 2 years and 22.7% at 5 years (median 10.4 months). The response to treatment and N-stage were significant factors affecting overall survival. In addition, total radiation dose (${\geq}50\;Gy$ vs. < 50 Gy), BT and fractionation scheme (qd. vs. bid.) were not significant factors for overall survival and disease-free survival. Conclusion: Survival outcome after definitive chemoradiation therapy in unresectable esophageal cancer was comparable to those of other series. The main failure pattern was local recurrence. Survival rate did not improve with increased radiation dose over 50 Gy or the use of brachytherapy or hyperfractionation.

• Clinical and Experimental Reproductive Medicine
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• v.34 no.3
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• pp.189-196
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• 2007

Objectives: The purpose of this study is to investigate the clinical significance of age and basal serum FSH in predicting the outcomes of in vitro fertilization (IVF) in patients with poor-ovarian response. Methods: From January 2000 to December 2004, 85 second IVF cycles of 85 poor-ovarian response patients under the age of 42 with a back-ground of the first IVF cycles at our infertility center and 5 or less oocytes were retrieved and their basal serum FSH levels of 15$\sim$25 mIU/ml were enrolled in this study. Exclusion criteria were patients with a male factor for the etiology of infertility and undergoing genetic diagnosis of embryo such as PGD. Flare-up protocol was used for ovarian stimulation in all cases. Results: When we stratified the study groups by patient's age, the younger age group (age<35, n=35) showed significantly higher implantation rate (19.0% versus 4.0%, p<0.05) and higher ongoing pregnancy rate (100% versus 14.3%, p<0.05) than the older age group (age$\geq$35, n=50). And then, when we stratified the study populations by basal serum FSH level, the lower FSH group (basal serum FSH<20 mIU/ml, n=58) showed significantly higher number of retrieved oocytes (4.6$\pm$0.7 versus 2.2$\pm$0.5, p<0.05) and lower cancellation rate (19.0% versus 55.6%, p<0.05) than higher FSH group (basal serum FSH$\geq$20 mIU/ml, n=27). Conclusions: In conclusion, it was suggested that the patient's age could predict the IVF outcomes in respect to its potency of pregnancy and ongoing pregnancy. Serum basal FSH levels could predict more accurately the ovarian response of cycle, but not clinical outcomes.

• Radiation Oncology Journal
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• v.16 no.2
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• pp.147-157
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• 1998

Purpose : The aim of this retrospective study is to assess the necessity of s1aging laparotomy in the management of supradiaphragmatic CS I-II Hodgkin's disease. Prognostic factors and the usefulness of prognostic factor groups were also analyzed. Materials and Methods : From 1985 to 1995, fifty one Patients who were diagnosed as supradiaphragmatic CS I-II Hodgkin's disease at Yonsei Cancer Center in Seoul, Korea were enrolled in this study Age range was 4 to 67 with median age of 30. The number of patients with each CS IA, II A, and IIB were 16, 25, and 10, respectively. Radiotherapy(RT) was delivered using 4 or 6 MV photon beam to a total dose of 19.5 to 55.6Gy (median dose : 45Gy) with a 1.5 to 1.BGy per fraction. Chemotherapy(CT) was given in 2-12 cycles(median : 6 cycles). Thirty one Patients were treated with RT alone, 4 patients with CT alone and 16 patients with combined chemoradiotherapy. RT volumes varied from involved fields(3), subtotal nodal fields(18) or mantle fields(26). Results : Five-year disease-free survival rate(DFS) was $78.0\%$ and overall survival rate(05) was $87.6\%$. Fifty Patients achieved a complete remission after initial treatment and 8 patients were relapsed. Salvage therapy was given to 7 patients, 1 with RT alone, 4 with CT alone, 2 with RT+CT. Only two patients were successfully salvaged. Feminine gender and large media-stinal adenopathy were significant adverse prognostic factors in the univariate analysis for DFS. The significant adverse prognostic factors of OS were B symptom and clinical stage. When patients were analyzed according to European Organization for Research and Treatment of Cancer(EORTC) prognostic factor groups, the DFS in Patients with very favorable, favorable and unfavorable group was 100, 100 and $55.8\%$(p<0.05), and the 05 in each patients' group was 100, 100 and $75.1\%$(p<0.05), respectively. In very favorable and favorable groups, the DFS and 05 were all $100\%$ by RT alone, but in unfavorable group, RT with CT had a lesser relapse rate than RT alone. The subtotal nodal irradiation had better OFS than mantle RT in patients treated with RT. Conclusion : In present study, the DFS and OS in patients who did not undergo s1aging laparotomy were similar with the results in the literatures of which patients were surgically staged. Therefore, we may suggest that staging laparotomy would not influence the outcome of treatments. In univariate analysis, gender, large mediastinal adenopathy. B symptoms and clinical stage were significant prognostic factors for the survival rate. We confirm the usefulness of EORTC prognostic factor groups which may be a good.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.17-25
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• 1998

Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

• Radiation Oncology Journal
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• v.13 no.2
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• pp.149-156
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• 1995

Purpose : Since February 1991 a Prospective study for non-small cell lung cancer patients who underwent radical resection and had a risk factor of positive resection margin or regional lymph node metastasis has been conducted to evaluate the effect of MVP chemotherapy and radiotherapy on the pattern of failure, disease free and overall survival. and tolerance of combined treatment. Materials and Methods: Twenty nine patients were registered to this study until Sep. 1993; of these 26 received planned therapy Within 3 weeks after radical resection, two cycles of MVP(Mitomycin C $6mg/m^2,$ Vinblastin $6mg/m^2,$ Cisplatin $60mg/m^2$) chemotherapy was given with 4 weeks intervals. Radiotherapy (5040cGy tumor bed dose and 900cGy boost to high risk area) was started 3 to 4 weeks after chemotherapy. Results: One and two year overall survival rates were $76.5\%\;and\;58.6\%$ respectively. Locoregional failure developed in 6 patients$(23.1\%)$ and distant failure in 9 patients$(34.6\%)$ Number of involved lymph nodes, resection margin positivity showed some correlation with failure pattern but T-stage and N-stage showed no statistical significance. The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70 days showed lower incidence of distant metastasis. Postoperative combined therapy were well tolerated without definite increase of complication rate, and compliance rate in this study was $90\%$. Conclusion: 1) MVP chemotherapy showed no effect on locoregional recurrence, but appeared to decrease the distant metastasis rate and 2) combined treatments were well tolerated in all patients. 3) The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70days showed lower incidence of distant metastasis. 4) Addition of chemotherapy to radiotherapy failed to increase the overall or disease free survival.

• Korea journal of population studies
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• v.9 no.1
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• pp.41-53
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• 1986

The purpose of this paper is two-fold. One is to investigate the determinants of the demand supply of labor, and another is to project long-term demand and supply of labor. The paper consists of three parts. In the first part, theoretical models and important hypotheses are discussed: for the case of a labor supply model, issues regarding discouraged worker model, permanent wage hypothesis, and relative wage hypothesis are examined and for the case of a demand model, issues regarding estimating an employment demand equation within the framework of an inverted short-run produc- tion function are inspected. Particularly, a theoretical justification for introducing a demographic cohort variable in a labor supply equation is also investigated. In the second part, empirical results of the estimated supply and demand equations are analyzed. Supply equations are specified differently between primary and secondary labor force. That is, for the case of primary labor force groups including males aged 25 and over, attempts are made to explain the variations in participation behavior within the framework of a neo-classical economics oriented permanent wage hypothesis. On the other hand, for the case of females and young male labor force, variations in participation rates are explained in terms of a relative wage hypothesis. In other words, the participation behavior of primary labor force is related to short-rum business fluctuations, while that of secondary labor force is associated with intermediate swings of business cycles and demographic changes in the age structure of population. Some major findings arc summarized as follows. (1) For the case of males aged 14~19 and 2O~24 groups and females aged 14∼19, the effect of schhool enrollment rate is dominant and thus it plays a key role in explaining the recent declining trend of participation rates of these groups. (2) Except for females aged 20∼24, a demographic cohort variable, which captures the impact of changes in the age structure on participation behavior, turns out to show positive and significant coefficients for secondary labor force groups. (3) A cyclical variable produce significant coefficients for prime-age males and females reflecting that as compared to other groups the labor supply behavior of these groups is more closely related to short-run cyclical variations (4) The wage variable, which represents a labor-leisure trade-off turns out to yield significant coefficients only for older age groups (6O and over) for both males and females. This result reveals that unlike the experiences of other higer-income nations, the participation decision of the labor force of our nation is not highly sensitive with respect to wage changes. (5)The estimated result of the employment demand equation displays that given that the level of GNP remains constant the ability of the economy to absord labor force has been declining;that is, the elasticity of GNP with respect to labor absorption decreasre over time. In the third part, the results of long-term projections (for the period of 1986 and 1995) for age-sex specific participation rates are discussed. The participation rate of total males is anticipated to increase slightly, which is contrary to the recent trend of declining participation rates of this group. For the groups aged 25 and below, the participation rates are forecast to decline although the magnitude of decrease is likely to shrink. On the other hand, the participation rate of prime- age males (25 to 59 years old) is predicted to increase slightly during 1985 and 1990. For the case of females, except for 20∼24 and 25∼34 age groups, the participation rates are projected to decrease: the participation rates of 25∼34 age group is likely to remain at its current level, while the participation rate of 20∼24 age group is expected to increase considerably in the future (specifi- cally, from 55% in 1985 to 61% in 1990 and to 69% in 1995). In conclusion, while the number of an excess supply of labor will increase in absolute magnitude, its size as a ratio of total labor force is not likely to increase. However, the age composition of labor force is predicted to change; that is, the proportion of prime-age male and female labor force is projected to increase.

• Journal of Korean Public Health Nursing
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• v.12 no.1
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• pp.116-131
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• 1998

This study was undertaken to obtain the menstrual patterns and menstrual discomforts in women university students. For the data collection, self-administered questionnaire survey was made from December 10, 1996 to January 20, 1997 among the 180 women university students in Seoul. The resultant data were processed by SAS program for frequency, proportion, and chi-square test. The results of this study are as follows ; 1) The mean age of the subjects was 20.6 years old. The mean height was 162cm and weight was 52.3Kg. $26.9\%$ of the subjects responded that they had experienced the unbalanced diet, $56\%$ the irregular meal, $39.6\%$intermittent dizziness, and $63.4\%$ the premenstrual syndrome. $53.7\%$ had feeling that skin temperature of their four extremities was 'a little lower than others'. The mean BMI(Body Mass Index) was 19.8, 'normal level' was $41.8\%$. $18.7\%$ responded that their characters were 'introspective ones'. The mean age of menache was 13.8 years old. The subjects responded that the mean number of pads they used per day during menstrual periods was 4.6 sheets. The mean duration of menstruation was 5.4 days, $10.4\%$ responded that their menstrual cycles were 'extremely regular', $44.8\%$ was 'regular', $36.6\%$ was 'a little irregular', and $8.2\%$ was 'extremely irregular'. Out of them who had experienced the dysmenorrhea, $21.3\%$ had family history of dysmenorrhea in connection with their mother and $35.0\%$ in their sisters. The mean of the first time that they experienced dysmenorrhea was 15 years old. $94\%$ of the subjects responded that they had experienced the dysmeorrhea. $47.6\%$ of the subjects responded that they experienced the dysmenorrhea 'monthly' and $52.4\%$ 'intermittently'. $53.0\%$ of them who had experienced dysmenorrhea responded that dysmenorrhea was the severest 'on the first menstrual day' and $22.4\%$ 'on the second day'. $48.8\%$ of them who had experienced dysmenorrhea responded that the most painful region was 'low abdomen'. $40\%$ of them who had experienced dysmenorrhea responded that they used 'analgesics' to soothe dysmenorrhea, $24.8\%$ used nothing, $18.4\%$ lay in their beds or slept, and $12\%$ made their 'low abdomen' warm. $70.3\%$ who had used analgesics because of dysmenorrhea took analgesics 'one or two times per month', $25.7\%$ 'intermittently', and $4.0\%$ more than 3 times per month. The analgesics which they used were 'geworin$(33.8\%)$,' 'penzal$(32.4\%)$', 'tyrenol$(18.9\%)$', and 'aspirin$(4.2\%)$'. $(47.9\%)$ of them who took analgesics because of dysmenorrhea responded that the duration of analgesics effect was '4 to 8 hours'. $15.1\%$ of them who experienced dysmenorrhea responded that they had visited the hospital. 2) The incidence of premenstrual syndrome was no significant difference according to the BMI, unbalanced diet, pattern of meal, skin temperature of four extremites, and characters. 3) The incidence of dysmenorrhea was significant difference according to the BMI, unbalanced diet, pattern of meal, skin temperature of four extremites, and characters. 4) The incidence of analgesics usage was significant difference according to the BMI, subjects with low BMI took more analgesics than those with normal BMI (p<.05). The incidence of analgesics usage was significant difference in accordance with pattern of meal. The women who had a meal regularly took more analgesics than those who had a meal irregularly(p<.05). But the incidence of analgesics usage was no significant difference in accordance with the unbalanced diet, characters, the incidence of dizziness, skin temperature of four extremities, the incidence of premenstrual syndrome.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.4
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• pp.275-281
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• 2009

Objective: This study was performed to evaluate the effect of oxytocin antagonist on the outcome of IVF/ICSI cycles in infertile patients with repeated failure of IVF/ICSI treatment. Method: Forty patients who had experienced two or more failures of IVF/ICSI treatment without low ovarian reserve, were recruited for this prospective randomized study. All patients received controlled ovarian stimulation (COS) using GnRH antagonist multidose protocol (MDP). For the intervention group, intravenous administration of atosiban (mixed vasopressin $V_{1A}$/oxytocin antagonist) started with a bolus dose 6.75 mg one hour before embryo transfer (ET) and continued at an infusion rate of 18 mg/hour. After ET, administered atosiban was reduced to 6 mg/hour and continued for 2 hours. The main efficacy endpoints were clinical pregnancy rate and implantation rate. Results: Patients' characteristics were comparable in the intervention and control groups. COS parameters and IVF results were also similar. The number of uterine contractions for 3 minutes measured just before ET was significantly lower in the intervention group than control group ($3.5{\pm}1.4$ vs $8.7{\pm}2.2$, p<0.001). While there was no statistically significant difference in the clinical pregnancy rate between control group and intervention group (20.0% and 40.0%, p=0.168), the implantation rate was significantly higher in the intervention group, with 16.9% (11/65) compared with 6.0% (4/67) in the control group (p=0.047). There were no differences in ectopic pregnancy rate and miscarriage rate between the two groups. Conclusion: This study demonstrates that administration of oxytocin antagonist during ET can improve the implantation rate probably by decreasing the frequency of uterine contractions in infertile patients undergoing IVF/ICSI treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.4
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• pp.579-589
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• 2007

The objective of this study was to compare the shear bond strengths of five adhesive systems to the enamel and dentin of primary and permanent teeth. Fifty noncarious primary and fifty permanent teeth were collected and stored in an 0.1% thymol solution at room temperature after extraction. The tested adhesives were: Adper Scotchbond Multi-purpose Plus Adhesive (SM) Adper Single bond 2 (SB), Clearfil SE Bond (SE), Adper Prompt L-Pop (PL), GBond (GB). For the shear bonding test, the labial and lingual surfaces of primary and permanent teeth were used. To obtain a flat surface, the labial and lingual surfaces of the teeth were sanded on $SiO_2$ with number 600 grit and then divided into 20 groups of 10 surfaces each. All samples were theromocycled in water $5^{\circ}C$ and $55^{\circ}C$ for 1000 cycles. The results were as follows: 1. For primary enamel, shear bond strengths of SM and SB were significantly higher than that of SE and also SM, SB, and PL were higher than GB(p<0.05). 2. For primary dentin, there were no significant differences among the shear bond strengths of any other bonding systems except difference between SE and GB. 3. For permanent enamel, SB showed significantly higher mean shear bond strength than those of any other bonding systems(p<0.05). 4. For permanent dentin, SM showed significantly higher mean shear bond strength than that of PL and GB(p<0.05). 5. Between the primary enamel and dentin, there were significant differences in SM, SB, and GB, whereas there was statistically significant difference in PL between the permanent enamel and dentin(p<0.05). 6. Between the primary and permanent teeth on enamel, there were no significant differences among all bonding systems, whereas there were statistically significant differences in SM and SB between the primary and permanent teeth on dentin(p<0.05).