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Multicenter Analysis of Gestational Trophoblastic Neoplasia in Turkey

  • Ozalp, Sabit Sinan;Telli, Elcin;Oge, Tufan;Tulunay, Gokhan;Boran, Nurettin;Turan, Taner;Yenen, Mufit;Kurdoglu, Zehra;Ozler, Ali;Yuce, Kunter;Ulker, Volkan;Arvas, Macit;Demirkiran, Fuat;Bese, Tugan;Tokgozoglu, Nedim;Onan, Anil;Sanci, Muzaffer;Gokcu, Mehmet;Tosun, Gokhan;Dikmen, Yilmaz;Ozsaran, Aydin;Terek, Mustafa Cosan;Akman, Levent;Yetimalar, Hakan;Kilic, Derya Sakarya;Gungor, Tayfun;Ozgu, Emre;Yildiz, Yunus;Kokcu, Arif;Kefeli, Mehmet;Kuruoglu, Serkan;Yuksel, Hasan;Guvenal, Tevfik;Hasdemir, Pinar Solmaz;Ozcelik, Bulent;Serin, Serdar;Dolanbay, Mehmet;Arioz, Dagistan Tolga;Tuncer, Nadire;Bozkaya, Hasan;Guven, Suleyman;Kulaksiz, Deniz;Varol, Fusun;Ali, Yanik;Ogurlu, Gonca;Simsek, Tayyup;Toptas, Tayfun;Dogan, Selen;Camuzoglu, Hakan;Api, Murat;Guzin, Kadir;Eray, Caliskan;Doger, Emek
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3625-3628
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    • 2014
  • Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.

A Retrospective Study of the Radiotherapy Care Patterns for Patients with Laryngeal Cancer and Comparison of Different Korean Hospitals Treated from 1998 through 1999 (한국인 후두암 환자의 방사선치료 과정 및 내용에 관한 분석 (1998~1999년도))

  • Chung, Woong-Ki;Kim, Il-Han;Yoon, Mee-Sun;Ahn, Sung-Ja;Nam, Taek-Keun;Song, Ju-Young;Chung, Jae-Uk;Nah, Byung-Sik;Lee, Joon-Kyoo;Wu, Hong-Gyun;Lee, Chang-Geol;Lee, Sang-Wook;Park, Won;Ahn, Yong-Chan;Kang, Ki-Moon;Kim, Jung-Soo;Oh, Yoon-Kyeong;Cho, Moon-June;Park, Woo-Yoon;Kim, Jin-Hee;Choi, Doo-Ho;Yun, Hyong-Geun;Kim, Woo-Cheol;Yang, Dae-Sik;Sohn, Seung-Chang;Suh, Hyun-Suk;Ahn, Ki-Jung;Chun, Mi-Son;Lee, Kyu-Chan;Choi, Young-Min;Jeung, Tae-Sik;Kang, Jin-Oh
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.201-209
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    • 2009
  • Purpose: To investigate the care patterns for radiation therapy and to determine inter-hospital differences for patients with laryngeal carcinoma in Korea. Materials and Methods: A total of 237 cases of laryngeal carcinoma (glottis, 144; supraglottis, 93) assembled from 23 hospitals, who underwent irradiation in the year of 1998 and 1999, were retrospectively analyzed to investigate inter-hospital differences with respect to radiotherapy treatment. We grouped the 23 hospitals based on the number of new patients annually irradiated in 1998; and designated them as group A (${\geq}$900 patients), group B (${\geq}$400 patients and <900 patients), and group C (<400 patients). Results: The median age of the 237 patients was 62 years (range, 25 to 88 years), of which 216 were male and 21 were female. The clinical stages were distributed as follows: for glottis cancer, I; 61.8%, II; 21.5%, III; 4.2%, IVa; 11.1%, IVb; 1.4%, and in supraglottic cancer, I; 4.3%, II; 19.4%, III; 28.0%, IVa; 43.0%, IVb; 5.4%, respectively. Some differences were observed among the 3 groups with respect to the dose calculation method, radiation energy, field arrangement, and use of an immobilization device. No significant difference among 3 hospital groups was observed with respect to treatment modality, irradiation volume, and median total dose delivered to the primary site. Conclusion: This study revealed that radiotherapy process and patterns of care are relatively uniform in laryngeal cancer patients in Korean hospitals, and we hope this nationwide data can be used as a basis for the standardization of radiotherapy for the treatment of laryngeal cancer.

Potential Study for the Sedimentary Exhalative Pb-Zn Mineralization in Dyusembay Area, Kazakhstan (카자흐스탄 듀셈바이지역의 퇴적분기형 연-아연 광화작용에 대한 잠재력 연구)

  • No, Sang-gun;Lee, Seung-han;Park, Ki-woong;Jeong, Hyeon-guk;Yun, Ji-seong;Kim, Sun-ok;Park, Maeng-eon
    • Economic and Environmental Geology
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    • v.51 no.3
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    • pp.213-222
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    • 2018
  • Metasediment-hosted Pb-Zn mineralized zone has been found in Dyusembay of Kazakhstan. Its petrological properties, metal index, alteration index and redox-sensitivity are compared with those of SEDEX type deposit. Mineralization is developed along foliation of host rock (graphitic phyllite) and controlled by folds and faults; major ore minerals including pyrite, pyrrhotite, sphalerite, and galena are disseminated or interlayered with fine-grained quartz. The margin of the mineralized zone is metamorphosed accompanying sericite and chlorite. Hydrothermal brecciation and Pb-Zn mineralization formed in quartz-calcite stockworks are confirmed at the around of Maytyubin granitoid intrusions. The mineralization is classified into three types according to those of occurrence, paragenesis, chemical composition and isotopic characteristics. Type 1 whose fine-grained pyrite, pyrrhotite and sphalerite are formed in parallel yet discontinuous to well-developed foliations of the host rock; its geochemistry is similar to those of the earlier stage in SEDEX-type mineralization. In case of type 2, the ore minerals of which are concentrated being parallel to a foliation by regional metamorphism, and most of them associated with quartz and muscovite (${\pm}$ biotite) paragenetically. Type 3 is formed in the hydrothermal breccia zone whose ore minerals are controlled by foliation and breccia and developed in quartz ${\pm}$ calcite veins having a form such as stratification, stockwork or veinlets. Host rocks in the mineralized zone indicate homogeneous metamorphic grade and there is no specific alteration zonation. Also, all types (type 1, type 2, and type 3) represent similar REEs patterns, it can be interpreted that these are originated from a same source. Sulphides occurred in mineralized zone indicate a limited range of sulphur isotope values (type 2, ${\delta}^{34}S=-13.3{\sim}-11.7$‰; type 3, ${\delta}^{34}S=-13.9{\sim}-8.2$‰), and a result of geothermometry presents different temperature ranges: type 2($251{\pm}38^{\circ}C{\sim}277{\pm}40^{\circ}C$); type 3($360{\pm}2^{\circ}C$ to $537{\pm}29^{\circ}C$). It is estimated to be due to the effect of metamorphism and Maytyubin granitoid intrusions, respectively. In addition, ternary chart of thorium, scandium, and zircon for discrimination of tectonic setting and redox sensitivity using V/Mo values indicate that hydrothermal sediments put on reduction environment after precipitation, before being affected by metamorphism and intrusion activity. Geochemical data are plotted on a distal trend of SEDEX-type with discrimination plot using SEDEX index. As a result, petrological-geochemical properties demonstrate that Dyusembay Pb-Zn mineralized zone is comparable to distal-type of SEDEX deposit.

Inhomogeneity correction in on-line dosimetry using transmission dose (투과선량을 이용한 온라인 선량측정에서 불균질조직에 대한 선량 보정)

  • Wu, Hong-Gyun;Huh, Soon-Nyung;Lee, Hyoung-Koo;Ha, Sung-Whan
    • Journal of Radiation Protection and Research
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    • v.23 no.3
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    • pp.139-147
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    • 1998
  • Purpose: Tissue inhomogeneity such as lung affects tumor dose as well as transmission dose in new concept of on-line dosimetry which estimates tumor dose from transmission dose using the new algorithm. This study was carried out to confirm accuracy of correction by tissue density in tumor dose estimation utilizing transmission dose. Methods: Cork phantom (CP, density $0.202\;gm/cm^3$) having similar density with lung parenchyme and polystyrene phantom (PP, density $1.040\;gm/cm^3$) having similar density with soft tissue were used. Dose measurement was carried out under condition simulating human chest. On simulating AP-PA irradiation, PPs with 3 cm thickness were placed above and below CP, which had thickness of 5, 10, and 20 cm. On simulating lateral irradiation, 6 cm thickness of PP was placed between two 10 cm thickness CPs additional 3 cm thick PP was placed to both lateral sides. 4, 6, and 10 MV x-ray were used. Field size was in the range of $3{\times}3$ cm through $20{\times}20$ cm, and phantom-chamber distance (PCD) was 10 to 50 cm. Above result was compared with another sets of data with equivalent thickness of PP which was corrected by density. Result: When transmission dose of PP was compared with equivalent thickness of CP which was corrected with density, the average error was 0.18 (${\pm}0.27$) % for 4 MV, 0.10 (${\pm}0.43$) % for 6 MV, and 0.33 (${\pm}0.30$) % for 10 MV with CP having thickness of 5 cm. When CP was 10 cm thick, the error was 0.23 (${\pm}0.73$) %, 0.05 (${\pm}0.57$) %, and 0.04 (${\pm}0.40$) %, while for 20 cm, error was 0.55 (${\pm}0.36$) %, 0.34 (${\pm}0.27$) %, and 0.34 (${\pm}0.18$) % for corresponding energy. With lateral irradiation model, difference was 1.15 (${\pm}1.86$) %, 0.90 (${\pm}1.43$) %, and 0.86 (${\pm}1.01$) % for corresponding energy. Relatively large difference was found in case of PCD having value of 10 cm. Omitting PCD with 10 cm, the difference was reduced to 0.47 (${\pm}$1.17) %, 0.42 (${\pm}$0.96) %, and 0.55 (${\pm}$0.77) % for corresponding energy. Conclusion When tissue inhomogeneity such as lung is in tract of x-ray beam, tumor dose could be calculated from transmission dose after correction utilizing tissue density.

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Postoperative Radiotherapy in the Rectal Cancers Patterns of Care Study for the Years of $1998\~1999$ (직장암의 방사선치료에 대한 Patterns of Care Study: $1998{\sim}1999$년도 수술 후 방사선치료 환자들의 특성 및 치료내용에 대한 분석결과)

  • Kim, Jong-Hoon;Oh, Do-Hoon;Kang, Ki-Moon;Kim, Woo-Cheol;Kim, Won-Dong;Kim, Jung, Soo;Kim, June-Sang;Kim, Jin-Hee;Kil, Hak-Jae;Suh, Chang-Ok;Sohn, Seung-Chang;Ahn, Yong-Chan;Yang, Dae-Sik
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.22-31
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    • 2005
  • Purpose : To conduct a nationwide survey on the principals in radiotherapy for rectal cancer, and produce a database of Korean Patterns of Care Study. Materials and Methods : We developed web-based Patterns of Care Study system and a national survey was conducted using random sampling based on power allocation methods. Eligible patients were who had postoperative radiotherapy for rectal cancer without gross residual tumor after surgical resection and without previous history of other cancer and radiotherapy to pelvis. Data of patients were Inputted to the web based PCS system by each investigators in 19 institutions. Results : Informations on 309 patients with rectal cancer who received radiotherapy between 1998 and 1999 were collected. Male to female ratio was 59 : 41, and the most common location of tumor was lower rectum ($46\%$). Preoperative CEA was checked in $79\%$ of cases and its value was higher than 6 ng/ml in $32\%$. Pathologic stage were I in $1.5\%$, II in $32\%$, III in $53\%$, and IV in $1.6\%$. Low anterior resection was the most common type of surgery and complete resection was peformed in $95\%$ of cases. Distal resection margin was less than 2 cm in $30\%$, and number of lymph node dissected was less than 12 in $31\%$. Chemotherapy was peformed in $91\%$ and most common regimen was 5-FU and leucovorine ($59\%$). The most common type of field arrangement used for the initial pelvic field was the four field box (Posterior-Right-Left) technique ($65.0\%$), and there was no AP-PA parallel opposing field used. Patient position was prone in $81.2\%$, and the boost field was used in $61.8\%$. To displace bowel outward, pressure modulating devices or bladder filling was used in $40.1\%$. Radiation dose was prescribed to isocenter in $45.3\%$ and to isodose line in 123 cases ($39.8\%$). Percent delivered dose over $90\%$ was achieved in $92.9\%$. Conclusion : We could find the Patterns of Care for the radiotherapy in Korean rectal cancer patients was similar to that of US national survey. The type of surgery and the regimen of chemotherapy were variable according to institutions and the variations of radiation dose and field arrangement were within acceptable range.

A study on Palpation of the back-shu points (배유혈(背兪穴) 안진(按診)에 관(關)한 고찰(考察))

  • Hong, Mun-Yeup;Park, Won-Hwan
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.155-173
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    • 2000
  • The diagnosis in Oriental medicine is done by inspection, auscultation and olfaction, interrogation, four diagnostics of pulse feeling and palpation, and various system of identification like identification according to Qi(vital energy), Xue and body fluids, identification according to fair principles, identification according to principles of Wei, Qi, Ying and Xue, identification according to Sanjiao(the triple heater), identification according to four type physical constitution. Sometimes, symptoms and diagnosis techniques according to symptoms is selectively applied for the diagnosis. Among them the pulse feeling and palpation diagnosis technique using the sense of finger and palm of the hand is divided into feeling of pulse and palpation and pressing maneuver. Pressing maneuver is a diagnosis technique pressing and rubbing the affected part in order to attain data of identification including inside and outside condition of the body with regard to the nature, condition and relative seriousness of disease. There are palpation of the skin, palpation the hand and foot, palpation the chest and the abdomen, palpation shu points in pressing maneuver. The diagnosis of the Back Shu points is a technique to examine the change of disease condition from pressure ache, spontaneous ache, tension, relaxation, solidification revealed through channels and collaterals. I investigates starting disease and an attack of disease of twelve pulse and pulse condition through the study relative to the substance and technique of pressing maneuver, and adjusts diagnosis techniques of a region for acupuncture and matters to be attended. The conclusions are as follows. 1. The Shu or stream points in which pathogenic factors go are important to medical treatment of dormant diseases like bowels disease, cold symptom complex and insufficiency symptom complex. 2. Disease classified by system is diagnosed by the condition of process part like pro-trusion, cave-in, tension, relaxation, pressure ache through palpating the Shu or stream points, that is pressing upward or downward left and right sides of the backbone process by hands. 3. In real clinic pressing maneuver of one's back side is very important to patient's diagnosis treatment. Thus, pressing maneuver of one's back side have to be done without omission. 4. Diagnosis must be accomplished through the perception about the diversity of diagnosis technique of bowels disease, the exact knowledge about pressing maneuver of one's back side for enlargement of treatment range and rising of treatment rate, and pressing maneuver of the Shu or the stream points.

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The Efficacy of the Change in Belly Board Aperture Location by the Addition of Bladder Compression Device for Radiotherapy of Rectal Cancer (직장암 환자의 골반 방사선치료에서 벨리보드 하위 경계 위치 변화의 영향)

  • Yoon, Hong-In;Chung, Yoon-Sun;Kim, Joo-Ho;Park, Hyo-Kuk;Lee, Sang-Kyu;Kim, Young-Suk;Choi, Yun-Seon;Kim, Mi-Sun;Lee, Ha-Yoon;Chang, Jee-Suk;Cha, Hye-Jung;Seong, Jin-Sil;Keum, Ki-Chang;Koom, Woong-Sub
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.231-237
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    • 2010
  • Purpose: We investigated the effect of location changes in the inferior border of the belly board (BB) aperture by adding a bladder compression device (BCD). Materials and Methods: We respectively reviewed data from 10 rectal cancer patients with a median age 64 years (range, 45~75) and who underwent computed tomography (CT) simulation with the use of BB to receive pelvic radiotherapy between May and September 2010. A CT simulation was again performed with the addition of BCD since small bowel (SB) within the irradiated volume limited boost irradiation of 5.4 Gy using the cone down technique after 45 Gy. The addition of BCD made the inferior border of BB move from symphysis pubis to the lumbosacral junction (LSJ). Results: Following the addition of BCD, the irradiated volumes of SB and the abdominopelvic cavity (APC) significantly decreased ($174.3{\pm}89.5mL$ vs. $373.3{\pm}145.0mL$, p=0.001, $1282.6{\pm}218.7mL$ vs. $1,571.9{\pm}158mL$, p<0.001, respectively). Bladder volume within the treated volume increased with BCD ($222.9{\pm}117.9mL$ vs. $153.7{\pm}95.5mL$, p<0.001). The ratio of irradiated bladder volume to APC volume with BCD ($33.5{\pm}14.7%$) increased considerably compared to patients without a BCD ($27.5{\pm}13.1%$) (p<0.001), and the ratio of irradiated SB to APC volume decreased significantly with BCD ($13.9{\pm}7.6%$ vs. $24.2{\pm}10.2%$, p<0.001). The ratios of the irradiated SB volume and irradiated bladder volume to APC volume negatively correlated (p=0.001). Conclusion: This study demonstrated that the addition of BCD, which made the inferior border of BB move up to the LSJ, increased the ratio of the bladder to APC volume and as a result, decreased the irradiated volume of SB.

APICAL FITNESS OF NON-STANDARDIZED GUTTA-PERCHA CONES IN SIMULATED ROOT CANALS PREPARED WITH ROTARY ROOT CANAL INSTRUMENTS (전동화일로 형성된 근관에서 비표준화 Gutta-percha Cone의 적합성)

  • Kwon, O-Sang;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.25 no.3
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    • pp.390-398
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    • 2000
  • The purpose of this study was to evaluate the apical fitness of non-standardized gutta-percha cones in root canals prepared with rotary Ni-Ti root canal instruments of various tapers and apical tip sizes. Simulated sixty curved root canals of plastic blocks were prepared with crown-down technique using rotary root canal instruments of Maillefer ProFile$^{(R)}$ .04 and .06 taper (Maillefer Instrument SA, Switzerland). Specimens were divided into six groups and prepared as follows: Group 1, prepared up to size 25 of .04 taper ; Group 2, prepared up to size 30 of .04 taper ; Group 3, prepared up to size 35 of .04 taper ; Group 4, prepared up to size 25 of .06 taper ; Group 5, prepared up to size 30 of .06 taper ; Group 6 ; prepared up to size 35 of .06 taper. After cutting off the coronal portion of plastic, blocks perpendicular to the long axis of the canal with the use of a diamond saw, apical 5mm of canal space was analyzed. Prepared apical canal spaces were duplicated using rubber base impression material to evaluate two dimensional total area of apical canal space. Various sized gutta-percha cones were applied in the 5mm-apical canal space, which were size 25, size 30 and size 35 standardized gutta-percha cone, Diadent Dia-Pro ISO-.04$^{TM}$ and .06$^{TM}$(Diadent, Korea), and medium-fine (MF), fine (F), fine-medium (FM) and medium (M) sized non-standardized gutta-percha cones (Diadent, Korea). Coronal excess gutta-percha were cut off with a sharp blade. Photographs of impressed apical canal spaces and gutta-percha cones were taken with a CCD camera under a stereomicroscope and stored in a computer. Areas of the total canal space and gutta-percha cones were calculated using a digitalized image analysing program, CompuScope (Sungjin Multimedia Co., Korea). Ratio of apical fitness was obtained by calculating the area of gutta-percha cone to the total area of the canal space. The data were analysed statistically using One-way Analysis of Variance and Duncan's Multiple Range Test. The results were as follows: 1. In canals prepared up to size 25 ProFile$^{(R)}$ of .04 taper, non-standardized MF and F cones occupied significantly more canal space than Dia-Pro ISO-.04$^{TM}$ or size 25 standardized ones (p<0.05). 2. In canals prepared up to size 30 ProFile$^{(R)}$ of .04 taper, non-standardized F cones occupied significantly more canal space than Dia-Pro ISO-.04$^{TM}$ or size 30 standardized ones (p<0.05), and non-standardized MF cones occupied more canal space than size 30 standardized ones (p<0.05). 3. In canals prepared up to size 35 ProFile$^{(R)}$ of .04 taper, there was no significant difference in canal space occupation among non-standardized MF and F, size 35 standardized, and Dia-Pro ISO-.04$^{TM}$ cones (p>0.05). 4. In canals prepared up to size 25 ProFile$^{(R)}$ of .06 taper, non-standardized MF and F cones occupied significantly more canal space than Dia-Pro ISO-.06$^{TM}$, or size 25 standardized ones (p<0.05), and Dia-Pro ISO-.06$^{TM}$, cones occupied significantly more space than size 25 standardized ones (p<0.05). 5. In canals prepared up to size 30 ProFile$^{(R)}$ of .06 taper, non-standardized FM cones occupied significantly more canal space than Dia-Pro ISO-.06$^{TM}$ or size 30 standardized ones (p<0.05), and non-standardized F cones occupied significantly more canal space than size 30 standardized ones (p<0.05). 6. In canals prepared up to size 35 ProFile$^{(R)}$ of .06 taper, non-standardized M and FM, Dia-Pro ISO-.06$^{TM}$ occupied significantly more canal space than size 35 standardized ones (p<0.05). In summary, in both canals prepared with .04 or .06 taper ProFile$^{(R)}$, non-standardized cones showed better fitness than Dia-Pro ISO$^{TM}$ or standardized ones, which was more characteristic in smaller canals.

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Pulmonary Resection in the Treatment of Multidrug-Resistant Tuberculosis (다제 내성 폐결핵환자의 폐절제술에 관한 연구)

  • Kwon, Eun-Soo;Ha, Hyun-Cheol;Hwang, Su-Hee;Lee, Hung-Yol;Park, Seung-Kyu;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1143-1153
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    • 1998
  • Background : Recent outbreaks of pulmonary disease due to drug-resistant strains of Mycobacterium Tuberculosis have resulted in significant morbidity and mortality in patients worldwide. We reviewed our experience to evaluate the effects of pulmonary resection on the management of multidrug-resistant tuberculosis. Method : A retrospective review was performed of 41 patients undergoing pulmonary resection for multidrug-resistant tuberculosis between January 1993 and December 1997. We divided these into 3 groups according to the radiologic findings : (1) patients who have reasonably localized lesion (Localized Lesion Group ; LLG) (2) patients who have cavitary lesions after pulmonary resection on chest roentgenogram (Remained Cavity Group : RCG) (3) patients who have Remained infiltrative lesions postoperatively (Remained infiltrative group : RIG). We evaluated the negative conversion rate after resection and overall response rate of the groups. Then they were compared with the results of the chemotherapy on the multi drug-resistant tuberculosis which has been outcome by Goble et al. Goble et al reported that negative conversion rate was 65% and overall response rate, 56% over a mean period of 5.1 months. Results : Seventy five point six percent were men and 24.4% women with a median age of 31 years (range, 16 to 60 years). Although the patients were treated preoperatively with multidrug regimens in an effort to reduce the mycobacterial burden, 22 of 41 were still sputum culture positive at the time of surgery. 20 of 22 patients(90.9%, p<0.01) responded which is defined as negative sputum cultures within 2 months postoperative. Of 26 patients with the sufficient follow up data, 19 have Remained sputum culture negative for a mean duration of 25.7 months (73.1%, p<0.05). The bulk of the disease was manifest in one lung, but lesser amounts of contralateral disease were demonstrated in 15, consisted of 8 in RIG and 7 in RCG, of 41. 12 of 12 patients (100%, p<0.01) who were sputum positive at the time of surgery in LLG converted successfully. 14 of 15 patients (93.3%, p<0.05) with the follow up have completed treatment and not relapsed for a mean period of 25. 7 months. The mean length of postoperative drug therapy of LLG was 12.2 months. In RIG, postoperative negative conversion rate was 83.3% which was not significant statistically. There was a statistical significance in overall response rate (100%, p<0.05) of RIG for a mean period of 24.4 months with a mean length of postoperative chemotherapy, 11.8 months. In RCG a statistically lower overall response rate (14.3%, p<0.01) has been revealed for a mean duration of follow up, 24.2 months. A negative conversion rate of RCG was 75% which was not significant statistically. Conclusion : Surgery plays an important role in the management of patients with multidrug-resistant Mycobacterium tuberculosis infection. Aggressive pulmonary resection should be performed for resistant Mycobacterium tuberculosis infection to avoid treatment failure or relapse. Especially all cavitary lesions on preoperative chest roentgenogram should be resected completely. If all of them could not be resected perfectly, you should not open the thorax.

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A study on the factors to affect the career success among workers with disabilities (지체장애근로자의 직업성공 요인에 관한 연구)

  • Lee, Dal-Yob
    • 한국사회복지학회:학술대회논문집
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    • 2003.10a
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    • pp.185-216
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    • 2003
  • This study was aimed at investigating important factors influencing career success among regular workers. The current researcher scrutinized the degree to which variables and factors affect the career success and occupational turnover rates of the research participants. At the same tune, two hypothetical path models established by the researcher were examined using linear multiple regression methods and the LISREL. After examining the differences among the factors of career success, a comparison was made between the disabled worker group and the non-disabled worker group. A questionnaire using the 5-point Likert scale was distributed to a group of 374 workers with disabilities and 463 workers without disabilities. For the data analysis purpose, the structural equation model, factor analysis, correlation analysis, and multiple regression analysis were carried out. The results of this study ran be summarized as follows. First, the results of factor analysis showed important categories of conceptual themes of career success. The initial conceptual factor model did not accord with the empirical one. A three-factorial model revealed categories of personal, family, and organizational factor respectively. The personal factor was composed of the self-esteem and self-efficiency. The family factor was consisted of the multi-roles stress and the number of children. Finally, the organizational factor was composed of the capacity for utilizing resources, networking, and the frequency of mentoring. In addition, the total 10 sub areas of career success were divided by two important aspects; the subjective career success and the objective career success. Second, both research participant groups seemed to be influenced by their occupational types. However, all predictive variables excluding the wage rate and the average length of work years had significant impact on job success for the disabled work group, while all the variables excluding the frequency of advice and length of working years had significant impact on job success for the non-disabled worker group. Third, the turnover rate was significantly influenced by the age and the experience of turnover of the research participants. However, the number of co-workers was the strongest predictive variable for the worker group with disabilities, but the occupation choice variable for the worker group without disabilities. For the disabled worker group, the turnover rate was differently influenced by the type of occupation, the length of working years, while multi-role stress and the average working years at the time of turnover for the worker group without disabilities. Fifth, as a result of verifying the hypothetical path model, it showed that the first model was somewhat proper and could predict the career success on both research participant groups. In the second model, the Chi-square, the degree of freedom (($x^2=64.950$, df=61, P=0.341), and the adjusted Goodness of Fit Index (AGFI) were .964, and the Comparative Fit Index (CFI) were .997, and the Root Mean Squared Residual (RMR) was respectively. .038. The model was best fitted and could predict the career success more highly because the goodness of fit index in the whole models was within the allowed range. In conclusion, the following research implications can be suggested. First, the occupational type of research participants was one of the most important variables to predict the career success for both research participant groups. It means that people with disabilities require human development services including education. They need to improve themselves in this knowledge-based society. Furthermore, for maintaining the career success, people with disabilities should be approached by considering the subjective career success aspects including wages and the promotion opportunities than the objective career success aspects.

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