• Journal of Chest Surgery
• /
• v.40 no.6 s.275
• /
• pp.428-434
• /
• 2007

Background: Recent studies have suggested that UFT may be an effective adjuvant therapy for completely resected IB (pT2N0) non-small cell lung cancer (NSCLC). We designed this study to clarify the feasibility of performing adjuvant chemotherapy with UFT for completely resected IB nor-small cell lung cancer, Material and Method: We randomly assigned patients suffering with completely resected IB non-small cell lung cancer to receive either UFT 3g for 2 year or they received no treatment. All patients had to be followed until death or the cut-off date (December 31 2006). Result: From June 2002 through December 2004, 64 patients were enrolled. Thirty five patients were assigned to receive UFT (the UFT group) and 29 patients were assigned to observation (the control group). A follow-up surrey on the 3 year survival rate was successfully completed for all the patients. The median follow-up time for all the patients was 32.8 months. In the UFT group, the median time of administration was 98 weeks (range: $2{\sim}129$ weeks). The rate of compliance was 88.2% at 6 months, 87.5% at 12 months, 80.6% at 18 month and 66.7% at 24 months. Seven recurrences (24.1%) occurred in the control group and six (17.1%) occurred in the UFT group (p=0,489). The three-year disease free survival rate was 71.3% for the control group and 82.0% for the UFT group (p=0.331). On the subgroup analysis, the three-year disease free survival rate for the patients with adenocacinoma was 45.0% for the control group and 75.2% for the UFT group (p=0.121). The three-year disease free survival rate for the patients with non-adenocarcinoma was 88.1% for the control group and 88.9% for the UFT group (p=0.964), Conclusion: Postoperative oral administration of UFT was well-tolerated. Adjuvant chemotherapy with UFT for completely resected pT2N0 adenocarcinoma of the lung could be expected to improve the disease free survival, but this failed to achieve statistical significance. A prospective randomized study for a large number of patients will be necessary.

• Journal of Chest Surgery
• /
• v.40 no.6 s.275
• /
• pp.407-413
• /
• 2007

Background: The brain natriuretic peptide (BNP) level has been reported in some studies to be associated with the occurrence of atrial fbrillation (AF). The aim of this study is to evaluate the potential usefulness of the BNP level as a predictor of the occurrence of postoperative (postop) AF and to assess the relationship of the BNP level with the onset of AF and the restoration of sinus rhythm. Material and Method: From January 1, 2005 to February 28, 2006, 82 patients without a history of atrial arrhythmia that had undergone cardiac surgery were enrolled in the study. Blood samples for plasma BNP were drawn daily for all these patients from the preoperative (preop) day to the 7th postop day. The patient records were reviewed and postop EKGs were checked daily for AF until the time of discharge. Result: Patients were divided into two groups based on development of postop AF. Postoperative AF developed in 26 patients (31.7%). There was no significant statistical difference in age, sex distribution, preop left ventricle ejection fraction, hypertension, left ventricular hypertrophy, or the use of beta blockers between the non-postop AF and postop AF group. More patients in the AF group had undergone valve surgery (39.3% versus 76.9%, p=0.002). The preop left atrium size was significantly larger in the AF patients ($43.8{\pm}10.3 mm$ versus $49.8{\pm}11.5 mm$, p=0.029). The preop plasma BNP levels were higher in the postop AF patients ($144.1{\pm}20.8 pg/mL$ versus $267.5{\pm}68 pg/mL$, p=0.034). In the postop AF group, the plasma BNP level was the highest on the 3rd postop day. Postop AF developed in most patients by the 3rd postop day; restored sinus rhythm developed by the 7th postop day. Conclusion: Elevated plasma BNP levels may lead to the occurrence of postop AF in patients undergoing cardiac surgery. Patients who have a high risk of postop AF should be considered for aggressive prophylactic antiarrhythmic therapy.

• Journal of Chest Surgery
• /
• v.42 no.6
• /
• pp.738-743
• /
• 2009

Background: There is no standardized tool and parameter that can accurately assess the sympathetic function before and after performing sympathectomy in patients with primary palmar hyperhidrosis. We examined the effective-ness of the sympathetic skin response (SSR) study for documenting the change of sympathetic denervation before and after performing selective thoracic sympathicotomy. Material and Method: We prospectively investigated the SSR from 12 healthy subjects who were diagnosed with primary hyperhidrosis. Each SSR was recorded on the right palm or sole with electrical stimuli applied to the skin at the left wrist and foot and vice versa for the controlateral side. This test was performed before, 2 weeks and 1 year after selective thoracic sympathicotomy. The data was corrected for the onset latency and the amplitude of the SSR (n=24). Result: The mean age of the 12 patients was $24.6{\pm}0.4$ years (range: 19~36) and the gender ratio was 1 : 0.7. The mean values of the preoperative, postoperative 2 weeks and postoperative 1 year onset latency and amplitude of the palmar side (n=24) were $1.46{\pm}0.24$ msec and $6,043{\pm}2,339{\mu}V$, $1.63{\pm}0.42$ msec and $823{\pm}638{\mu}V$, and $1.44{\pm}0.39$ msec and $2,412{\pm}1,546{\mu}V$, respectively. The mean values of the plantar side (n=38) were $1.83{\pm}0.42$ msec and $2,816{\pm}1,694{\mu}V$, $2.16{\pm}0.39$ msec and $1,445{\pm}1,281{\mu}V$ and $1.95{\pm}0.25$ msec and $1,622{\pm}865{\mu}V$, respectively. Among the documented parameters, only the palmar amplitude (p=0.002) showed statistical significance in recording the change of the sympathetic system within the same individual for the pre and postoperative period. Conclusion: The SSR amplitude ratio may be a useful parameter for documenting the efficacy of sympathetic denervation after selective sympathicotomy.

• Journal of Chest Surgery
• /
• v.40 no.9
• /
• pp.607-612
• /
• 2007

Background: Surgical resection is a standard treatment for pulmonary metastases in patients with osteosarcoma, but the role of performing repeated resections is not clear. This study was designed to clarify the feasibility of performing a repeated pulmonary metastasectomy and the prognostic factors for pulmonary metastases in patients with osteosarcoma. Material and Method: Between January 1990 and July 2005, 62 patients with osteosarcoma were diagnosed with pulmonary metastases and 36 patients underwent pulmonary resection. We reviewed the patients retrospectively. Result: The total number of pulmonary metastasectomies was 62 in 30 patients. Among 36 patients, 18 had a second metastasectomy, 7 had a third metastasectomy, and one patient had a fourth metastasectomy. There was no distinctive difference between the first and second metastatectomy in terms of median survival time, and the 3-year and 5-year survival rate (first resection: 20.5 months, 32.0% and 29,4%; second resection: 11.3 months, 34.9% and 34.%). However, the median survival time (7.1 months) was shorter in patients with a third metastatectomy than in patients with one metastatectomy (p=0.01). In long-term survivors, the number of female patients, patients with a disease free time longer than 12 months, patients with a single metastasis and patients with anatomic resection was larger when compared to non-long term survivors, but showed no statistical significance. Conclusion: Repeated pulmonary metastasectomy is expected to prolong survival time in patients with osteosarcoma, and is expected to increase long-term survival in selected cases. Further studies with a large number of patients are necessary.

• Journal of Korea Water Resources Association
• /
• v.51 no.10
• /
• pp.905-916
• /
• 2018

The purpose of this study is to evaluate the climate change impact on watershed hydrology and flow duration in Geum River basin ($9,645.5km^2$) especially by extreme scenarios. The rainfall related extreme index, STARDEX (STAtistical and Regional dynamical Downscaling of EXtremes) was adopted to select the future extreme scenario from the 10 GCMs with RCP 8.5 scenarios by four projection periods (Historical: 1975~2005, 2020s: 2011~2040, 2050s: 2041~2070, 2080s: 2071~2100). As a result, the 5 scenarios of wet (CESM1-BGC and HadGEM2-ES), normal (MPI-ESM-MR), and dry (INM-CM4 and FGOALS-s2) were selected and applied to SWAT (Soil and Water Assessment Tool) hydrological model. The wet scenarios showed big differences comparing with the normal scenario in 2080s period. The 2080s evapotranspiration (ET) of wet scenarios varied from -3.2 to +3.1 mm, the 2080s total runoff (TR) varied from +5.5 to +128.4 mm. The dry scenarios showed big differences comparing with the normal scenario in 2020s period. The 2020s ET for dry scenarios varied from -16.8 to -13.3 mm and the TR varied from -264.0 to -132.3 mm respectively. For the flow duration change, the CFR (coefficient of flow regime, Q10/Q355) was altered from +4.2 to +10.5 for 2080s wet scenarios and from +1.7 to +2.6 for 2020s dry scenarios. As a result of the flow duration analysis according to the change of the hydrological factors of the Geum River basin applying the extreme climate change scenario, INM-CM4 showed suitable scenario to show extreme dry condition and FGOALS-s2 showed suitable scenario for the analysis of the drought condition with large flow duration variability. HadGEM2-ES was evaluated as a scenario that can be used for maximum flow analysis because the flow duration variability was small and CESM1-BGC was evaluated as a scenario that can be applied to the case of extreme flood analysis with large flow duration variability.

• Journal of Korean Society of Transportation
• /
• v.30 no.2
• /
• pp.101-116
• /
• 2012

Accident prediction models have been utilized to predict accident possibilities in existing or projected freeways and to evaluate programs or policies for improving safety. In this study, a traffic accident prediction model for freeways was developed for the above purposes. When selecting variables for the model, the highest priority was on the ease of both collecting data and applying them into the model. The dependent variable was set as the number of total accidents and the number of accidents including casualties in the unit of IC(or JCT). As a result, two models were developed; the overall accident model and the casualty-related accident model. The error structure adjusted to each model was the negative binomial distribution and the Poisson distribution, respectively. Among the two models, a more appropriate model was selected by statistical estimation. Major nine national freeways were selected and five-year dada of 2003~2007 were utilized. Explanatory variables should take on either a predictable value such as traffic volumes or a fixed value with respect to geometric conditions. As a result of the Maximum Likelihood estimation, significant variables of the overall accident model were found to be the link length between ICs(or JCTs), the daily volumes(AADT), and the ratio of bus volume to the number of curved segments between ICs(or JCTs). For the casualty-related accident model, the link length between ICs(or JCTs), the daily volumes(AADT), and the ratio of bus volumes had a significant impact on the accident. The likelihood ratio test was conducted to verify the spatial and temporal transferability for estimated parameters of each model. It was found that the overall accident model could be transferred only to the road with four or more than six lanes. On the other hand, the casualty-related accident model was transferrable to every road and every time period. In conclusion, the model developed in this study was able to be extended to various applications to establish future plans and evaluate policies.

• Radiation Oncology Journal
• /
• v.24 no.1
• /
• pp.58-66
• /
• 2006

Purpose: Renal irradiation can lead to the development of radiation nephropathy, and this is characterized by the accumulation of extracellular matrix and final fibrosis. To determine the possible role of the glomerular epithelial cell, the radiation-induced changes in the expression of its genes associated with the extracellular matrix were analyzed. Materials and Methods: Rat glomerular epithelial cells (GEpC) were irradiated with a single dose of 0, 2, 5, 10 and 20 Gy with using 6 MV LINAC (Siemens, USA), and the samples were collected 6, 24, 48 and 72 hours post-irradiation, respectively. Northern blotting, western blotting and zymography were used to measure the expression level of fibronectin (Fn), plasminogen activator inhibitor-1 (Pai-1), matrix metalloproteinases-2, 9 (MMP-2, 9), tissue inhibitor of metalloproteinase-2 (TIMP-2), tissue-type plasminogen activator (t-PA) and urokinase-type plasminogen activator (u-PA). Results: Irradiation with a single dose of 10 Gy resulted in a significant increase in Fn mRNA since 24 hours post-irradiation, and a single dose of 5 and 10 Gy significantly increased the Fn immunoreactive protein measured 48 hours post-irradiation. An increase in Pai-1 mRNA and protein was also observed and especially, a single dose of 10 Gy significantly increased the mRNA measured 24 and 48 hours post-irradiation. The active MMP-2 measured 24 hours post-irradiation slightly increased in a dose dependent manner, but this increase did not reach statistical significance. The levels of MMP-9, TIMP-2, t-PA and u-PA appeared unaltered after irradiation. Conclusion: Irradiation of the glomerular epithelial cells altered the expression of genes associated with the extracellular matrix, implying that the glomerular epithelial cell may be involved in the development of radiation nephropathy.

• Radiation Oncology Journal
• /
• v.19 no.3
• /
• pp.287-292
• /
• 2001

Prupose : We analyzed setup errors induced by using air-vacuum cushion as immobilization device in patients with rectal cancer. Materials and methods : We had treated the twenty patients with rectal cancer by 6 MV, 10 MV X-ray from Aug. 1998 to Aug. 1999 at Chungnam National University Hospital. All patients were treated at prone position. They were separated to two groups, control group, 10 patients using styrofoam, and test group, 10 patients using styrofoam and air-vacuum cushion. We measured errors of posterior field for x, y axis and lateral field for z, y axis with simulation film and EPID image using a matching technique. Results : In control group, the mean displacement values of pelvic bone landmark for x axis and y axis were 0.02 mm. 0.78 mm, respectively and the standard deviations of systematic error were 2.13 mm, 2.40 mm, respectively and the standard deviation of random error were 1.46 mm. 1.51 mm, respectively. In test group, the mean displacement values of x axis and y axis were -0.33 mm. 0.81 mm, respectively and the standard deviations of systematic error were 1.71 mm, 3.08 mm, respectively and the standard deviations of random errors were 1.40 mm. 1.88 mm, respectively. The mean displacement values of z axis and y axis were 2.98 mm. 0.74 mm, respectively and the standard deviations of systematic error were 4.75 mm, 2.65 mm, respectively and standard deviations of random error were 2.69 mm. 1.86 mm, respectively. The statistical difference of field size by using air vacuum cushion between two groups in posterior direction and lateral direction was not shown. Conclusion : We think that use of air-vacuum cushion may not be an advantage for improving setup accuracy in rectal cancer patients.

• Radiation Oncology Journal
• /
• v.19 no.3
• /
• pp.230-236
• /
• 2001

Purpose : To evaluate treatment results in terms of local control, complications and survival after reirraidiation in recurrent cervical cancer following definite radiation therapy. Material and methods : From November 1987 through March 1998, eighteen patients with recurrent cervical cancer following definite radiation therapy were subsequently treated with reirradiation at Keimyung University Dongsan Medical Center. In regard to the initial FIGO stage, one patient was stage la, five were stage IIa, three were IIb, two were IIb and two were IVa. The age range was 37 to 79 years old with median age of 57. The time interval from initial definite radiation therapy to recurrence ranged from 6 to 122 months with a median of 58 months. The recurrent sites were the uterine cervix in seven patients, vagina in ten and pelvic lymph node in one. Reirradiation was peformed with external radiation and intracavitary radiation in twelve patients, external radiation and implantation in four and external radiation alone in two. The range of external radiation dose was $2,100\~5,400\;cGy$ and the range of the total radiation dose was $3,780\~8,550\;cGy$. The follow-up periods ranged from 8 to 20 months with median of 25 following reirradiation. Results : Fourteen of eighteen patients $(78\%)$ had local control just after reirradiation. The two year disease free survival (2YDFS) rate was $53.6\%$. There were statistically significant differences in the 2YDFS according to both recurrent site (2YDFS $28.5\%$ in uterine cervix, $71.4\%$ in vagina, (p=0.03)) and the total dose (2YDFS $71.8\%$ in >6,000 cGy , $25\%$ in $\leq6,000$ cGy, p=0.007). Seven of ten patients who were followed for more than 20 months remain alive and disease free (7/18, $39\%$). Patients treated with external radiation and intracavitary radiation had a higher rate of 2YDFS. Seven patients including 4 patients with no local control experienced local failure in the uterus or vagina and two patients died with distant metastasis. Complications included rectal bleeding in 3 patients, bowel obstruction treated with surgery in two, hematuria in one, radiation cystitis in two, soft tissue swelling in two and vaginal necrosis spontaneously healed in one. There was no statistical difference in complications according to the total dose or the time to recurrence from initial radiation. Conclusion : In patients with recurrence following definite radiation therapy in the uterine cervical cancer, reirradiation may be effective but requires an effort to reduce radiation induced severe complications.

• Journal of Wetlands Research
• /
• v.17 no.2
• /
• pp.124-129
• /
• 2015

In order to get as ecological basic data for river restoration, vegetation investigation was conducted in natural river and analysed it synecological methods, such as ordination cluster. 29 plant communities units were identified and the major dominant plant communites were Quercus mongolica community, Pinus densiflora community, Populus davidiana community, Q. variabilis community and Prunus sargentii community. River vegetations were classified into ravine and gorge forest type and riverine softwood forest type. Ravine and gorge forest was dominanted by hardwood which located in steep slope and in high elevation, and riverine softwood forest by softwood, salix spp. Naturality was an important criterion for the selection of rivers, so many of the selected rivers are located in the upper stream and mid stream rather than the lower stream, where more human intervention is involved. Plant communities were consisted of hardwood forest(44 plots, 92%) and softwood forest(4 plot, 8%), respectively. PCA with total layer data showed 5 groups of communities: Q. mongolica community group, Prunus sargentii community group, Pinus densiflora community group, Prunus sargentii community - Pinus densiflora community group and the rest communities group. PCA with tree layer showed 3 groups: Q. mongolica community group, Prunus sargentii community group, and the rest community group. Cluster analysis also a showed a similar communities group to PCA ordination, but Magnolia sieboldii community and Prunus sargentii community were distinguished from the PCA result. From the result, it can be concluded that the plant communities of riparian be divided into hardwood and softwood forest by statistical techniques. It was appropriate to plant species such as Quercus mongolica, Pinus densiflora, Populus davidiana, Quercus variabilis and Prunus sargentii, at levee zone and high water level. And Sliax spp. were appropriate for planted plants at waterfront and low water level. The herb species to be planted on the floodplain were recommanded in the species composition co-occurred with the woody species.