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Performance Improvement on Short Volatility Strategy with Asymmetric Spillover Effect and SVM (비대칭적 전이효과와 SVM을 이용한 변동성 매도전략의 수익성 개선)

  • Kim, Sun Woong
    • Journal of Intelligence and Information Systems
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    • v.26 no.1
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    • pp.119-133
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    • 2020
  • Fama asserted that in an efficient market, we can't make a trading rule that consistently outperforms the average stock market returns. This study aims to suggest a machine learning algorithm to improve the trading performance of an intraday short volatility strategy applying asymmetric volatility spillover effect, and analyze its trading performance improvement. Generally stock market volatility has a negative relation with stock market return and the Korean stock market volatility is influenced by the US stock market volatility. This volatility spillover effect is asymmetric. The asymmetric volatility spillover effect refers to the phenomenon that the US stock market volatility up and down differently influence the next day's volatility of the Korean stock market. We collected the S&P 500 index, VIX, KOSPI 200 index, and V-KOSPI 200 from 2008 to 2018. We found the negative relation between the S&P 500 and VIX, and the KOSPI 200 and V-KOSPI 200. We also documented the strong volatility spillover effect from the VIX to the V-KOSPI 200. Interestingly, the asymmetric volatility spillover was also found. Whereas the VIX up is fully reflected in the opening volatility of the V-KOSPI 200, the VIX down influences partially in the opening volatility and its influence lasts to the Korean market close. If the stock market is efficient, there is no reason why there exists the asymmetric volatility spillover effect. It is a counter example of the efficient market hypothesis. To utilize this type of anomalous volatility spillover pattern, we analyzed the intraday volatility selling strategy. This strategy sells short the Korean volatility market in the morning after the US stock market volatility closes down and takes no position in the volatility market after the VIX closes up. It produced profit every year between 2008 and 2018 and the percent profitable is 68%. The trading performance showed the higher average annual return of 129% relative to the benchmark average annual return of 33%. The maximum draw down, MDD, is -41%, which is lower than that of benchmark -101%. The Sharpe ratio 0.32 of SVS strategy is much greater than the Sharpe ratio 0.08 of the Benchmark strategy. The Sharpe ratio simultaneously considers return and risk and is calculated as return divided by risk. Therefore, high Sharpe ratio means high performance when comparing different strategies with different risk and return structure. Real world trading gives rise to the trading costs including brokerage cost and slippage cost. When the trading cost is considered, the performance difference between 76% and -10% average annual returns becomes clear. To improve the performance of the suggested volatility trading strategy, we used the well-known SVM algorithm. Input variables include the VIX close to close return at day t-1, the VIX open to close return at day t-1, the VK open return at day t, and output is the up and down classification of the VK open to close return at day t. The training period is from 2008 to 2014 and the testing period is from 2015 to 2018. The kernel functions are linear function, radial basis function, and polynomial function. We suggested the modified-short volatility strategy that sells the VK in the morning when the SVM output is Down and takes no position when the SVM output is Up. The trading performance was remarkably improved. The 5-year testing period trading results of the m-SVS strategy showed very high profit and low risk relative to the benchmark SVS strategy. The annual return of the m-SVS strategy is 123% and it is higher than that of SVS strategy. The risk factor, MDD, was also significantly improved from -41% to -29%.

The Expression of Adhesion Molecules on BAL Cells and Serum Soluble ICAM-1 Level after the Radiotherapy for the Lung Cancer and Its Relationship to the Development of of Radiation Pneumonitis and Fibrosis (방사선 치료후 기관지-폐포세척액내 폐포대식세포 및 임파구의 접착분자발현 변화와 방사선에 의한 폐렴 및 폐섬유증발생의 예측인자로서의 의의)

  • Kim, Dong-Soon;Paik, Sang-Hoon;Choi, Eun-Kyung;Chang, Hye-Sook;Choi, Jung-Eun;Lim, Chae-Man;Koh, Yun-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.75-87
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    • 1996
  • Background: Lung cancer is the second most frequent malignancy in man in Korea. Surgery is the best treatment modality for non-small cell lung cancer, but most patients were presented in far advanced stage. So radiation therapy(RT) with or without chemotherapy is the next choice and radiation-induced pneumonitis and pulmonary fibrosis is the major limiting factor for the curative RT. Radiation pneumonitis is manifested with fever, cough and dyspnea, 2~3 months after the termination of radiotherpy. Chest X ray shows infiltration, typically limited to the radiation field, but occasionally bilateral infiltration was reported. Also Gibson et al reported that BAL lymphocytosis was found in both lungs, even though the radiation was confined to one lung. The aim of this study is to investigate the change of adhesion molecules expression on BAL cells and serum soluble ICAM-1(sICAM-1) level after the RT and its relationship to the development of radiation pneumonitis. The second aim is to confirm the bilaterality of change of BAL cell pattern and adhesion molecule expression. Subjects: BAL and the measurement of sICAM level in serum and BALF were done on 29 patients with lung cancer who received RT with curative intention. The BAL was done before the RT in 16 patients and 1~2 month after RT in 18 patients. 5 patients performed BAL before and after RT. Result: Clinically significant radiation pneumonitis developed in 7 patients. After RT, total cell count in BAL was significantly increased from $(20.2{\pm}10.2){\times}10^6\;cells/ml$ to $(35.3{\pm}21.6){\times}10^6\;cells/ml$ (p=0.0344) and %lymphocyte was also increased from $5.3{\pm}4.2%$ to $39.6{\pm}23.4%$ (p=0.0001) in all patient group. There was no difference between ipsilateral and contraleteral side to RT, and between the patients with and without radiation-pneumonitis. In whole patient group, the level of sICAM-1 showed no significant change after RT(in serum: $378{\pm}148$, $411{\pm}150\;ng/ml$, BALF: $20.2{\pm}12.2$, $45.1{\pm}34.8\;ng/ml$, respectively), but there was a significant difference between the patients with pneumonitis and without pneumonitis (serum: $505{\pm}164$ vs $345{\pm}102\;ng/ml$, p=0.0253, BALF: $67.9{\pm}36.3$ vs $25.2{\pm}17.9\;ng/ml$, p=0.0112). The expression of ICAM-1 on alveolar macrophages (AM) tends to increase after RT (RMFI: from $1.28{\pm}0.479$ to $1.63{\pm}0.539$, p=0.0605), but it was significantly high in patients with pneumonitis ($2.10{\pm}0.390$) compared to the patients without pneumonitis ($1.28{\pm}0.31$, p=0.0002). ICAM-1 expression on lymphocytes and CD 18 (${\beta}2$-integrin) expression tended to be high in the patients with pneumonitis but the difference was statiastically not significant. Conclusion: Subclinical alveolitis on the basis of BAL finding developed bilaterally in all patients after RT. But clinically significant pneumonitis occurred in much smaller fraction and the ICAM-1 expression on AM and the sICAM-1 level in serum were good indicator of it.

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Change of Green Space Arrangement and Planting Structure of Apartment Complexes in Seoul (서울시 아파트단지의 녹지배치 및 식재구조 변화 연구)

  • Lee, Dong-Wook;Lee, Kyong-Jae;Han, Bong-Ho;Jang, Jae-Hoon;Kim, Jong-Yup
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.4
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    • pp.1-17
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    • 2012
  • This study was carried out to propose the improved method by analyzing the change of green space arrangement and planting structure of apartment complexes in Seoul. 12 survey sites, which have obvious differences, were selected by reflecting the change of floor area ratio, underground parking place, and green space ratio. We divided the survey sites into four types that high green ratio(over 40%) apartment on natural ground, low green ratio(under 40%) apartment on natural ground, low green ratio(under 40%) apartment on artificial ground, and high green ratio(over 40%) apartment on artificial ground each period based on green space ratio and ground structure, plant crown volume, planting density, and planting pattern. The main factors of change of green space arrangement were green space ratio and ground structure. The Green space ratio was changed by the floor area ratio with constructing underground parking place and floor area ratio was adjusted by government policy and economic status. Average width of front green area has been changed from 10.0m in high green ratio apartment on natural ground for 3.5m, 2.7m, and 4.5m each period. The average width of the buffer green area has been changed from 15.0m in high green ratio apartment on natural ground of 7.7m, and 2.7m by extending parking place in the low green ratio apartment of artificial ground, so buffer green areas have been reduced and disconnected. So buffer green area in apartment complexes has been extended that the average width of the buffer green area was 3.8m caused by growing recognition of green since 2001. The ratio of native plant in canopy layer was increased from 45.1 % in the case of the high green ratio apartment of natural ground in 1980~1983 to 55.6%. Average plant crown volume increased from $1.27m^3/m^2$ in high green ratio apartment on natural ground for $3.47m^3/m^2$ in a low green ratio apartment on natural ground. But average plant crown volume is $0.27m^3/m^2$ in the high green ratio apartment of the artificial ground plant density of canopy layer was changed from 5 individuals per $100m^2$ to 14.5 individuals per $100m^2$. We should construct the buffer green area with natural ground and get the function of ecological and beautiful environment regarding to garden concept in case of front green area, width 4.5m. We should get the function of increasing green volume by multi-layer planting with shade woody species and flower woody species in case of back-side green area, width over 5.0m. We should get the function of covering the wall and increasing green landscape by planting with high woody species in case of side green area. We should apply the ecological planting technique to buffer green area and connect buffer green area to inner green area in apartment complexes.

Evaluation of Multiple System Atrophy and Early Parkinson's Disease Using $^{123)I$-FP-CIT SPECT ($^{123)I$-FP-CIT SPECT를 이용한 다중계위축증 및 조기 파킨슨병에서의 평가)

  • Oh, So-Won;Kim, Yu-Kyeong;Lee, Byung-Chul;Kim, Bom-Sahn;Kim, Ji-Sun;Kim, Jong-Min;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.10-18
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    • 2009
  • Purpose: We investigated quantification of dopaminergic transporter (DAT) and serotonergic transporter (SERT) on $^{123}I$-FP-CIT SPECT for differentiating between multiple systemic atrophy (MSA) and idiopathic Parkinson's disease (IPD). Materials and Methods: N-fluoropropyl-$2{\beta}$-carbomethoxy-$3{\beta}$-4-[$^{123}I$]-iodophenylnortropane SPECT ($^{123}I$-FP-CIT SPECT) was performed in 8 patients with MSA (mean age: $64.0{\pm}4.5yrs$, m:f=6:2), 13 with early IPD (mean age: $65.5{\pm}5.3yrs$, m:f=9:4), and 12 healthy controls (mean age: $63.3{\pm}5.7yrs$, m:f=8:4). Standard regions of interests (ROls) of striatum to evaluate DAT, and hypothalamus and midbrain for SERT were drawn on standard template images and applied to each image taken 4 hours after radiotracer injection. Striatal specific binding for DAT and hypothalamic and midbrain specific binding for SERT were calculated using region/reference ratio based on the transient equilibrium method. Group differences were tested using ANOVA with the postHoc analysis. Results: DAT in the whole striatum and striatal subregions were significantly decreased in both patient groups with MSA and early IPD, compared with healthy control (p<0.05 in all). In early IPD, a significant increase in the uptake ratio in anterior and posterior putamen and a trend of increase in caudate to putamen ratio was observed. In MSA, the decrease of DAT was accompanied with no difference in the striatal uptake pattern compared with healthy controls. Regarding the brain regions where $^{123}I$-FP-CIT binding was predominant by SERT, MSA patients showed a decrease in the binding of $^{123}I$-FP-CIT in the pons compared with controls as well as early IPD patients (MSA: $0.22{\pm}0.1$ healthy controls: $0.33{\pm}0.19$, IPD: $0.29{\pm}0.19$), however, it did not reach the statistical significance. Conclusion: In this study, the differential patterns in the reduction of DAT in the striatum and the reduction of pontine $^{123}I$-FP-CIT binding predominant by SERT could be observed in MSA patients on $^{123}I$-FP-CIT SPECT. We suggest that the quantification of SERT as well as DAT using $^{123}I$-FP-CIT SPECT is helpful to differentiate parkinsonian disorders in early stage.

Studies on the Effect of Feeding Pelleted Diets on Energy Metabolism and Nitrogen Retention in Growing Chickens (Pellet사료(飼料)의 급여(給與)가 병아리의 대사(代謝)에너지와 질소축적(窒素蓄積)에 미치는 영향(影響))

  • Park, Chang Sik;Kwon, Soon Ki;Min, Tae Hyuk
    • Korean Journal of Agricultural Science
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    • v.10 no.2
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    • pp.206-211
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    • 1983
  • This study was carried out to compare the feed utilization between pelleted and all-mash diet of similar composition by growing chickens. Day-old broilers (Hubbard) and egg-type chickens(Hy-line) of commercial strain were employed in this experiment. The results obtained were summarized as follows. 1. The chickens fed pelleted diets were heavier than those of birds fed all-mash diets. The Hubbard broilers and Hy-line chickens fed pelleted diets weighed 2,702g and 812g respectively, at 9 weeks of age. In comparison, the Hubbard broilers and Hy-line chickens fed all-mash diets weighed 2,571g and 777g respectively, at 9 weeks of age. 2. The pellet-fed chickens consumed more feeds than birds fed all-mash diets in both types of strain. Feed efficiencies (gain/feed) of Hubbard and Hy-line chickens were 0.38 and 0.26 in pellet feeding groups, and 0.36 and 0.25 in all-mash feeding groups, respectively. The Hy-line chickens fed pelleted diets drank more water than birds fed all-mash diets. 3. Pellet feeding groups produced more dry matter excreta as compared with all-mash feeding groups, reflecting the pattern of feed consumption by these chickens. Nitrogen retention ratio of the Hubbard and Hy-line chickens were 57-67% and 65-73%, respectively. Chickens fed pelleted diets showed 1-4% higher nitrogen retention than chickens fed all-mash diets. 4. The ME/GE ratio of the Hubbard and the Hy-line at 8 weeks of age were 73.4-74.3% and 82.8-83.8%, respectively. Pellet feeding groups showed 1% higher ME/GE ratio than all-mash feeding groups. 5. The dietary productive energy calculated from respiratory quotient was $94.1-102.6kca/kg^{\frac{3}{4}}$ BW/day in pellet feeding groups. The ratios of PE/GE were 41.3-48.9% in pellet feeding groups and 39.0-45.8% in all-mash feeding groups. 6. It appears that pelleting the all-mash diet increases feed consumption and body weight gain of growing chickens. Feed efficiency and energy utilization were also improved by pelleting process. More research work should be done to establish the relationship clearly between feed pelleting and heat increments.

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The Patterns of CH4 and N2O fluxes from used Litter Stockpile from Korean Native Cattle (Hanwoo) (사용한 한우 깔짚에서 배출되는 CH4 및 N2O의 배출 특성)

  • Park, Kyu-Hyun;Choi, Dong-Yoon;Yoo, Yong-Hee
    • Journal of Animal Environmental Science
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    • v.18 no.3
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    • pp.145-150
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    • 2012
  • This study was conducted to measure methane ($CH_4$) and nitrous oxide ($N_2O$) emissions from the 6 month old litter stockpile used for korean native cattle (Hanwoo) from August 3, 2007 to October 4, 2007. Daily mean $CH_4$ emissions was peaked to 273.013 ${\mu}g\;m^{-2}\;s^{-1}$ (SE : ${\pm}1.047{\mu}g\;m^{-2}\;s^{-1}$) on first day and then gradually decreased to 2.309 ${\mu}g\;m^{-2}\;s^{-1}$ (SE : ${\pm}0.061{\mu}g\;m^{-2}\;s^{-1}$) at the end of this experiment. Daily mean $N_2O$ emissions was as little as 0.269 ${\mu}g\;m^{-2}\;s^{-1}$ (SE : ${\pm}0.018{\mu}g\;m^{-2}\;s^{-1}$) on first day, but exponentially increased up to 3.569 ${\mu}g\;m^{-2}\;s^{-1}$ (SE : ${\pm}0.454{\mu}g\;m^{-2}\;s^{-1}$) on 43rd day and then slowly decreased to 1.888 ${\mu}g\;m^{-2}\;s^{-1}$ (SE : ${\pm}0.012{\mu}g\;m^{-2}\;s^{-1}$) at the end of this experiment. Carbon dioxide equivalent ($CO_2$-eq), calculated by global warming potentials of $CH_4$ or $N_2O$, of $CH_4$ on first day occupied approximately 99% of sum of $CO_2$-eq of $CH_4$ and $N_2O$. Methane emissions decreased and $N_2O$ emissions increased so that $CO_2$-eq ratio of $CH_4$ to $N_2O$ was 50:50 on 34th day. The effect of $N_2O$ on the ratio was increase thereafter. The ratio of daily mean $CH_4$ and $N_2O$ emissions to daily error of the mean was calculated to find daily fluctuation of $CH_4$ and $N_2O$ emissions. The ratio of $CH_4$ was less than 1.0% till 11th day but increased to 10.9% on 57th day. The ratio of $N_2O$ (0.4%~51.0%) was higher than that of $CH_4$, showing high in early stage and then gradually decrease, which was different from the pattern of $CH_4$. The ratio of daily mean emissions to daily error of the mean was little in case of active $CH_4$ or $N_2O$ generation period, which would be caused by the temporal and spatial heterogeneity of composting process. Hence more air supply on early stage to decrease $CH_4$ generation and proper turning to reduce spatial heterogeneity are needed to mitigate greenhouse gas emissions.

Randomized Trial of Early Versus Late Alternating Radiotherapy/ Chemotherapy in Limited-Disease Patients with Small Cell Lung Cancer (국한성병기 소세포폐암 환자에서 조기 혹은 지연 교대 방사선-항암제치료의 전향적 비교연구)

  • Lee Chang Geol;Kim Joo Hang;Kim Sung Kyu;Kim Sei Kyu;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.116-122
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    • 2002
  • Purpose : A randomized prospective study was conducted to compare the efficacy of early or late alternating schedules of radiotherapy, and carboplatin and ifosfamide chemotherapy in patients with limited-disease small cell lung cancer. Materials and Methods: From August 1993 to August 1996, a total of 44 patients with newly diagnosed, limited-disease small cell lung cancer, PS $H0\~2$, wt $loss<10\%$ were enrolled in a randomized trial which compared early alternating radiotherapy (RT)/chemotherapy (CT) and late alternating RT/CT. The CT regimen included ifosfamide $1.5\;g/m^2$ IV, d1-5 and carboplatin AUC 5/d IV, d2 peformed at 4 week intervals for a total of 6 cycles. RT (54 Gy/30 fr) was started after the first cycle of CT (early arm, N=22) or after the third cycle of CT (late arm, N=22) with a split course of treatment. Results : The pretreatment characteristics between the two arms were well balanced. The response rates in the early $(86\%)$ and late $(85\%)$ arm were similar. The median survival durations and 2-year survival rates were 15 months and $22.7\%$ in the early arm, and 17 months and $14.9\%$ in the late arm (p=0.47 by the log-rank test). The two-year progression free survival rates were $19.1\%$ in the early arm and $19.6\%$ in the late arm (p=0.52 by the log-rank test). Acute grade 3 or 4 hematologic and nonhematologic toxicities were similar between the two arms. Eighteen patients $(82\%)$ completed 6 cycles of CT in the early arm and 17 $(77\%)$ in the late arm. Four patients received less than 45 Gy of RT in the early arm and two in the late arm. There was no significant difference in the failure patterns. The local failure rate was $43\%$ in the early arm and $45\%$ in the late arm. The first site of failure was the brain in $24\%$ of the early arm patients compared to $35\%$ in the late arm (p=0.51). Conclusion : There were no statistical differences in the overall survival rate and the pattern of failure between the early and late alternating RT/CT in patients with limited-disease small cell lung cancer.

Utilization Pattern of Complementary Therapy in Hypertension, Diabetes and Chronic Arthritis Patients Visited to Local Health Center (일개 보건소를 방문하는 고혈압, 당뇨 및 관절염환자의 보완요법 이용실태)

  • Park, Ae-Ju;Park, Jae-Yong;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.107-122
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    • 2003
  • Objectives: The objective of this study is to investigate the use rate and some aspect of complementary therapies used by patients with chronic illness(hypertension, diabetic mellitus and chronic arthritis). Methods: 600 patients visiting the health center for one month(Jan. 2001) were interviewed on their complementary therapies used by the subjects for the previous year. Results: About fourteen-eight percent of the respondents used therapies; 35% of patients with hypertension, 44.6% of patients with diabetic mellitus and 62.9% of patients with chronic arthritis, which shows the highest rate among patients with three chronic disease. The use rate of complementary therapies indicates few meaningful differences according to the general characteristics of the interviewees. Hypertension patients used herb medication(31.0%) acupuncture(29.6%) and most of all the other therapies. Diabetic patients used dietary therapy(57.5%) and herb medication(35.1%). Chronic arthritis patients used acupuncture(85%) and herb medication(34.7%). 36.8% of all the patients who used complementary therapies tried more than two therapies. 18.3% of hypertension patients, 24.1% of diabetic patients and 55.9% of chronic arthritis patients used more than two therapies. Acupuncture(47%) was used most frequently, followed by herb medications(26.3%), health assistance utensils(21.8%). oriental therapy(21.8%), physical therapy(9.5%), health assistance food(8.4%), herb(7.7%), Korea hand acupuncture(3.2%), abdomen respiration(1.1%), and pore therapy(0.7%) Oriental clinic was visited most frequently(42.8%), which was used to cure diseases(61.8%), and to relieve symptoms(26.0%). (p<0.001) The cost spent on complementary therapies last year was 90,000 won(40.3%) and there are some cases of more than 500,000 won(31.2%). Most of the patients(56.1%) were satisfied with the complementary therapies, with 6% of them having side effects. 74% of the patients used complementary therapies answered that they would continue them and 56.1% of them also answered that they would continue them and 56.1% of them also answered that they would advise other patients to do them. Advantages(compared with those of orthodox medical treatment) are psychological comfort(28.1%), body protection(26.0%), effectiveness(20.0%). 34% of the patients using complementary therapies wanted to have informational orientation on complementary therapies. These findings reveal that a considerable number of patients with chronic illness(47.5%) tried a variety of complementary therapies. Though 6% of the patients using therapies had side effects, most of the subjects seemed satisfied with them and they are supposed to continue them. Conclusions: In conclusion, health center personnels and medical doctors should pay more attention to the complementary therapies used by patients with chronic illness. They also have to try their best to advise more scientific and informative complementary programs with less side effects and more help to improve their conditions.

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Effects of Adjuvant Radiation Therapy and Chemotherapy Following Curative Surgery in Locally Advanced Rectal Cancer (국소 진행된 직장암에서 근치적 절제술 후 방사선치료와 항암화학요법과의 병용치료에 대한 효과)

  • Kang, Ki-Mun;Choi, Ihl-Bohng;Kim, In-Ah;Jang, Jee-Young;Shin, Kyung-Sub;Jang, Suck-Kyun;Lee, Jae-Hak;Kim, Young-Ha;Won, Chong-Man;Choi, Dong-Hwan;Kim, Jin-Seung;Park, Shinn-Hee
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.121-128
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    • 1997
  • Purpose : To evaluate the effect of postoperative adjuvant radiation therapy and chemotherapy on the survival, pattern of failure and complication for locally advanced rectal carcinoma Materials and Methods : From October 1992 to September 1995, twenty eight patients with rectal carcinoma were treated by postoperative adjuvant radiation therapy and chemotherapy Radiation therapy was delivered with 6MV and 15MV linear accelerator, 180c0y fractions 5 day per week. Total radiation doses were 5040cGy in $B_{2+3}$ and 5580cGy in $C_{2+3}$. Within 4 weeks after radical surgery. 5-FU$(400mg/m^2/day)\;and\;Leucovorin(20mg/m^2/day)$ were administered by intravenous injection for 4 days during the first and fifth week of radiation therapy. The median follow up was 19 months with a range 2 to 47 months. Results : The 2 year overall survival and disease free survival rates were $78.6\%\;and\;70.8\%$, respectively. The 2 year overall survival was $93.0\%\;in\;B_{2+3}$ and $76.2\%\;in\;C_{2+3}$(p=0.11) The 2 year disease free survival was $79.4\%\;in\;B_{2+3}\;and\;69.2\%\;in\;C_{2+3}(p=0.13)$. The overall failure rate was $21.42\%$(6/28) including $10.72\%$(3/28) locoregional recurrence, $3.62\%$(1/28) distant metastasis and $7.12\%$(2/28) locoregional recurrence with distant metastasis. The overall locoregional recurrence rate was $17.92\%$(5/28). The 2 year locoregional recurrence rates were $13.32\%(2/15)\;and\;23.12\%$(3/13) for respectively for $B_{2+3}\;and\;C_{2+3}$ The difference between the locoregional recurrence of $B_{2+3}\;and\;C_{2+3}$ patients was not significant(p=0.07). Complications developed in 13 patients$(46.42\%)$, including 8 dermatitis, 7 loose stool, 6 leukopenia, 4 tenesmus, 2 diarrhea. In Univariate analysis, there was no statistically significant factor except for tumor grade in locoregional recurrence, disease free survival and overall survival rate(p=0.04, 0.05, 0.04). Conclusion : This study sugges1s that postoperative adjuvant radiation therapy and chemotherapy is effective in patients with locally advanced rectal cancer. Therefore these results need to be confirmed with a long term follow-up and larger number of patients with the further clinical trials including prospective controlled studies.

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High versus Low Dose-Rate Intracavitary Irradiation for Adenocarcinoma of the Uterine Cervix (자궁경부 선암 환자에서 고선량률 강내치료와 저선량률 강내치료의 비교)

  • Kim Woo Chul;Kim Gwi Eon;Chung Eun Ji;Suh Chang Ok;Hong Soon Won;Cho Young Kap;Loh JK
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.32-39
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    • 2000
  • Purpose :The incidence of adenocarcinoma of the uterine cervix is low. Traditionally, Low Dose Rate (LDR) brachytherapy has been used as a standard modality in the treatment for patients with carcinoma of the uterine cervix. The purpose of this report is to evaluate the effects of the High dose rate (HDR) brachytherapy in the patients with adenocarcinoma of the uterine cervix compared with the LDR. : From January 1971 to December 1992, 106 patients of adenocarcinoma of uterine cervix were treated with radiation therapy in the Department of Radiation Oncology, Yonsei University with curative intent. LDR brachytherapy was carried out on 35 patients and 71 patients were treated with HDR brachytherapy. In LDR Group, 8 patients were in stage I, 18 in stage II and 9 in stage III. External radiation therapy was delivered with 10 MV X-ray, daily 2 Gy fractionation, total dose 40$\~$46Gy (median 48 Gy). And LDR Radium intracavitary irradiation was peformed with Henschke applicator, 22$\~$59 Gy to point A (median 43 Gy). In HDR Group, there were 16 patients in stage 1, 38 in stage II and 17 in stage III. The total dose of external radiation was 40$\~$61 Gy(median 45 Gy), daily 1.8$\~$2.0 Gy. HDR Co-60 intracavitary irradiation was peformed with RALS (Remote Afterloading System), 30 $\~$ 57 Gy(median 39 Gy) to point A, 3 times a week, 3 Gy per fraction. Conclusion : The 5-year overall survival rate in LDR Group was 72.9$\%$, 61.9$\%$, 45.0$\%$ in stage I, II, III, respectively and corresponding figures for HDR were 87.1$\%$, 58.3$\%$, 41.2$\%$, respectively (p>0.05). There was no statistical difference in terms of the 5-year overall survival rate between HDR Group and LDR Group in adenocarcinoma of the uterine cervix. There was 11$\%$ of late complication rates in LDR Group and 27$\%$ in HDR Group. There were no prognostic factors compared HDR with LDR group. The incidence of the late complication rate in HDR Group stage II, III was higher than that in LDR Group(16.7$\%$ vs. 31.6$\%$ in stage II, 11.1$\%$ vs. 35.3$\%$ In stage III, p>0.05). Although the incidence of radiation induced late complication rate was higher in HDR Group stage II and III patients than that in the LDR Group, statistical significance was not detected and within acceptable level. Conclusion : There was no difference in terms of 5-year survival rate and failure pattern in the patients with adenocarcinoma of the uterine cervix treated with HDR and LDR brachytherapy. Even late complication rates were higher in the HDR group It was an acceptable range. This retrospective study suggests that HDR brachytherapy seems to replace the LDR brachytherapy in the adenocarcinoma of the uterine cervix. However, further studies will be required to refine the dose rate effects.

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