• 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.

• Radiation Oncology Journal
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• v.28 no.3
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• pp.125-132
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• 2010

Purpose: To retrospectively assess the advantages and side effects of prophylactic Paraaortic irradiation in cervical cancer patients with common iliac nodal involvement, the results for survival, patterns of failure, and treatment-related toxicity. Materials and Methods: From May 1985 to October 2004, 909 patients with cervical carcinoma received postoperative radiotherapy at the Seoul National University Hospital. Among them, 54 patients with positive common iliac nodes on pathology and negative Paraaortic node were included in the study. In addition, 44 patients received standard pelvic irradiation delivered 50.4 Gy per 28 fractions (standard irradiation group), and chemotherapy was combined in 16 of them. The other 10 patients received pelvic irradiation at a dose of 50.4 Gy per 28 fractions in addition to Paraaortic irradiation at 45 Gy per 25 fractions (extended irradiation group). In addition, all of them received chemotherapy in combination with radiation. Follow-up times for pelvic and Paraaortic irradiation ranged from 6 to 201 months (median follow-up time, 58 months) and 21 to 58 months (median follow-up time, 47 months), respectively. Results: The 4-year overall survival, disease free survival, and distant metastasis free survival in the standard irradiation group and extended irradiation group were 67.2% vs. 90.0% (p=0.291), 59.0% vs. 70.0% (p=0.568) and 67.5% vs. 90.0% (p=0.196), respectively. The most common site of first failure for the standard irradiation group was the paraaortic lymph node, while no paraaortic failure was observed in the extended irradiation group. Relatively, hematologic toxicity grade 3 or greater was common in the extended irradiation group (2/10 extended vs. 2/44 standard), while gastrointestinal toxicity of grade 3 or greater was lower (2/10 extended vs. 6/44 standard), and urologic toxicity of grade 3 or greater was observed in the standard irradition group only (0/10 vs. 3/44). Conclusion: Concurrent chemotherapy and prophylactic Paraaortic irradiation in patients with common iliac nodal involvement showed slightly improved clinical outcomes aside from increased hematologic toxicity, which was statistically insignificant. Considering the relatively small number of patients and short follow-up times, additional studies are needed to obtain more conclusive outcomes.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.845-855
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• 2004

Background: No general consensus has been available regarding the necessity of postoperative radiation therapy (PORT) and its optimal techniques in the patients with chest wall invasion (pT3cw) and node negative (N0) non-small cell lung cancer (NSCLC). We did retrospective analyses on the pT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. And we compared them with the pT3cwN0 NSCLC patients who did not received PORT during the same period. Material and Method: From Aug. of 1994 till June of 2002, 22 pT3cwN0 NSCLC patients received PORT-PORT (＋) group- and 16 pT3cwN0 NSCLC patients had no PORT-PORT (-) group. The radiation target volume for PORT (＋) group was confined to the tumor bed plus the immediate adjacent tissue only, and no regional lymphatics were included. The prognostic factors for all patients were analyzed and survival rates, failure patterns were compared with two groups. Result: Age, tumor size, depth of chest wall invasion, postoperative mobidities were greater in PORT (-) group than PORT (＋) group. In PORT (-) group, four patients who were consulted for PORT did not receive the PORT because of self refusal (3 patients) and delay in the wound repair (1 patient). For all patients, overall survival (OS), disease-free survival (DFS), loco-regional recurrence-free survival (LRFS), and distant metastases-free survival (DMFS) rates at 5 years were 35.3%, 30.3%, 80.9%, 36.3%. In univariate and multivariate analysis, only PORT significantly affect the survival. The 5 year as rates were 43.3% in the PORT (＋) group and 25.0% in PORT (-) group (p=0.03). DFS, LRFS, DMFS rates were 36.9%, 84.9%, 43.1 % in PORT (＋) group and 18.8%, 79.4%, 21.9% in PORT(-) group respectively. Three patients in PORT (-) group died of intercurrent disease without the evidence of recurrence. Few suffered from acute and late radiation side effects, all of which were RTOG grade 2 or lower. Conclusion: The strategy of adding PORT to surgery to improve the probability not only of local control but also of survival could be justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. Authors were successful in the marked reduction of the incidence as well as the severity of the acute and late side effects of PORT, without taking too high risk of the regional failures by eliminating the regional lymphatics from the radiation target volume.

• Radiation Oncology Journal
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• v.27 no.3
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• pp.126-132
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• 2009

Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.316-322
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• 2002

Objective : A retrospective study was peformed to evaluate whether postoperative adjuvant radiotherapy can improve survival and decrease recurrence as compared with surgery alone in resected esophageal cancer. Materials and Methods : From Jan. 1985 to Dec. 1993, among 94 esophageal cancer Patients treated with surgery, fifty-one patients were included in this study. Transthoracic esophagectomy was peformed in 35 patients and transhiatal esophagectomy in 16. Postoperative adjuvant radiotherapy was peformed 4 weeks after surgery in 26 among 38 patients in stage II and III. A total dose of $30\~60\;Gy$ in 1.8 Gy daily fraction, median 54 Gy over 6 weeks, was delivered in the mediastinum+both supraclavicular lymph nodes or celiac lymph nodes according to the tumor location. Forty-seven patients$(92\%)$ had squamous histology. The median follow-up period was 38 months. Results : The overall 2-year and 5-year survival and median survival were $56.4\%,\;36.8\%$ and 45 months. Two-year and 5-year survival and median survival by stage were $92\%,\;60.3\%$ for stage I, $63\%,\;42\%$ and 51 months for stage II and $34\%,\;23\%$ and 19 months for stage III (p=0.04). For stage II and III patients, 5-year survival and median survival were $22.8\%$, 45 months for the surgery alone group and $37.8\%$, 22 months for the postoperative RT group (p=0.89). For stage III patients, 2-year survival and median survival were $0\%$, 11 months for the surgery alone group and $36.5\%$, 20 months for the postoperative RT group (p=0.14). Local and distant failure rates for stage II and III were $50\%,\;16\%$ for the surgery alone and $39\%,\;31\%$ for the postoperative RT group. For N1 patients, local failure rate was $71\%$ for the surgery alone group and $37\%$ for the postoperative RT group (p=0.19). Among 10 local failures in the postoperative RT group, in-field failures were 2, marginal failures 1, out-field 5 and anastomotic site failures 2. Conclusion : There were no statistically significant differences in either the overall survival or the patterns of failure between the surgery alone group and the postoperative RT group for resected stage II and III esophageal cancer. But this study showed a tendency of survival improvement and decrease in local failure when postoperative RT was peformed for stage III or N1 though statistically not significant. To decrease local failure, a more generous radiation field encompassing the supraclavicular, mediastinal, and celiac lymph nodes and anastomotic site in postoperative adjuvant treatment should be considered.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.353-358
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• 2002

Purpose : To investigate the clinical usefulness of a follow-up examination using serum squamous cell carcinoma antigen (SCC) for the early detection of recurrence in patients treated for conical squamous cell carcinoma. Materials and Methods : 20 patients who were treated for recurrent cervical squamous cell carcinoma between 1997 and 1998, who had experienced a complete remission after radiotherapy and who underwent an SCC test around the time when recurrence was detected, were included in this study. The levels of SCC were measured from the serum of the patients by immunoassay and values less than 2 ng/mL were regarded as normal. The sensitivity of the SCC test for use in the detection of recurrence, the association between the SCC values and the recurrence patterns and the tumor size and stage, and the temporal relation between the SCC increment and recurrence detection were evaluated. Results : The SCC values were above normal in 17 out of 20 patients, so the sensitivity of the SCC test for the detection of recurrence was $85\%$, and the mean and median of the SCC values were 15.2 and 9.5 ng/mL, respectively. No differences were observed in the SCC values according to the recurrence sites. For 11 patients, the SCC values were measured over a period of 6 months before recurrence was detected, and the mean and median values were 13.6 and 3.6 ng/mL, respectively. The SCC values of 7 patients were higher than the normal range, and the SCC values of the other 4 patients were normal but 3 among them were above 1.5 ng/mL. At the time of diagnosis, the SCC valuess were measured for 16 of the 20 recurrent patients, and the SCC values of the patients with a bulky tumor $(\geq4\;cm)$ or who were in stage IIb or III were higher than those of the patients with a non-bulky tumor or who were in stage Ib or IIa. Conclusion : The SCC test is thought to be useful for the early detection of recurrence during the follow up period in patients treated for cervical squamous cell carcinoma. When an effective salvage treatment is developed in the future, the benefit of this follow-up SCC test will be increased.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.31-45
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• 2000

Objectives : The present study was performed to reveal differences between female and male cases of alopecia in their alopecia related variables such as patterns of hair loss, psychiatric characteristics, associate illnesses, and methods of treatment, and to use them as basic materials for proper management and early prevention of the alopecia prone cases. Methods : In order to analysis the gender difference in hair losses, the subjects were divided into two subgroups as the 51 cases of female alopecia and the 42 cases of male alopecia, who had visited to the department of psychiatry consulted from the department of dermatology, Yongsan hopital, ChungAng University, Seoul, Korea, from January 1998 to December 1998. In data analysis, the subjects were statistically assesed by chi-squre test and analysis of varaiance, through SPSS-$PC^+$ 9.0V. Results : 1) Female subjects were more likely showed lower socio-economical level including lower eonomical level, lower educational level, or lower occupational level in their parent's job, were more likely to have larger number of siblings and to have many sisters comparison to the male cases. 2) Female subjects were more likely visited to the department of dermatology, more history of alopecia in their female family members, lesser history of alopecia in their male family members, more loss of hairs in vertex or frontal region of scalp, lesser loss of hairs in occipital region, and lesser nail changes in comparison to the male cases. 3) Female subjects were more suffered from intra-familial conflicts and economical changes, or their introverted personality makeup, lesser likely suffered from changes of business and health changes, and showed lesser conflicts related with poorer adaptaion in their job life. 4) Female subjects were more likely diagnosed as depression or conversion disorders, more frequently complaint anxiety symptoms or depressive symptoms, higher level of anxiety index, lesser complaint somatization or obsessive compulsive symptoms, and lesser diagnosed as anxiety disorder in comparison to the male cases. 5) Female subjects were more likely tended to show personality makeup such as the introverted, the lie, the repressed, or the feminine trends than the male cases. 6) Female subjects were more significantly treated by antianxiety drug such as etizolam and dermatological therapies include tretinoin, and lesser treated by clotiazepam and prednicarbonate in comparison to the male cases. Conclusion : From the facts that The most important factors in developing hair loss in the female subjects in comparison to the male cases seems to be closely correlated with the serious psychopathology such as the presence of mental disorders including depression, the presence of complaining anxiety or depressive symptomatology, the presence of stressful life events such as intrafamilial life changes, and the presence of personality makeup such as the introverted, the lie, the repressed, or the feminine trends, the authors confirmed that dermatologists act as the primary care physician are in a unique position to recognize psychiatric comorbidity and execute meaningful intervention for female patients with the alopecia with psychiatrists.

• Journal of Korean Society of Forest Science
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• v.33 no.1
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• pp.1-32
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• 1977

This study has been made to find out more effective way of vegetation establishment on severely denuded forest land from the viewpoint of soil moisture regimes. Various environmental factors were measured to estimate soil moisture conditions of different sites. Soil moisture influence on growth of over vegetations, water requirement and drought resistance were analyzed. The efficiency of water use was also reckoned at different fertility levels and different soil moisture conditions. This research is composed of field experiment and green house experiment. Field experiment includes height growth, survival and coverage analysis of cover vegetations (Robinia pseudoacacia L., Lespedeza bicolor Turcz, Arundinella hirta Tanaka var. ciliare Koidzumi.) with 4 fertility level treatments on 3 slopes (Steep: $37^{\circ}$, Moderate: $25^{\circ}$, Gentle; $17^{\circ}$) during dry season (1 April-30 June) and wet season (1 July-10 September). At the same time temperature, relative humidity and precipitation were measured to understand the environmental changes. Soil moisture conditions were measured with soil moisture meter with 24 soil cells. Green house experiment comprised height, fresh weight and dry weight measurements of cover vegetations with 4 fertility levels and 3 moisture conditions for 70 days. The results extracted from experiments are as follews. 1. Cover vegtations have 3 patterns of water requirement at the early stage of growth. a) Robinia type has high water requirement and weaker drought resistance. b) Lespedeza type has low water requirement and stronger drought resistance. c) Arundinella type has moderate water requirement and weaker drought resistance. 2. The vegetations have different optimum fertility levels in different soil moisture supply condition. a) Robinia needs a low fertility level in dry condition and a high level in wet condition. b) Lespedeza needs only low fertility level in all conditions. c) Arundinella needs a low fertility level in dry condition and a high level in wet condition. 3. The efficiency of water use (Water/1g dry weight) by fertility levels is different from one another. Robinia and Arundinella have a good efficiency at low fertility level in dry condition and at high fertility level in wet condition. Lespedeza has a good efficiency at low fertility level in all conditions. 4. $P_2O_5$ requirement of Robinia and Lespedeza is high, but that of Arundinella is low. Soil moisture condition has a great influence on $P_2O_5$ absorption in dendued forest land. Once Vegetations are established on suitable sites with optimum fertitity level according to different moisture condition, even the small amount of soil water in denuded land can he used with high efficiency and the effect of fertility treatment can be maximized.

• Journal of Radiation Protection and Research
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• v.39 no.2
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• pp.118-126
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• 2014

A survey was conducted on perceptions, knowledge, and attitudes of elementary, middle, and high school students, who will lead public opinion in the future, regarding irradiated food, nuclear power generation, and medical radiation. These topics urgently require general social acceptability among various fields in which radiation is used. Educational methods to enhance social acceptability were partially discovered. First, it is necessary to implement different strategies when designing courses for female and male students. Male students have higher levels of objective knowledge (p<0.039) of irradiated food, necessity (p<0.001) and objective knowledge (p<0.001) of nuclear power generation, approval of building a nuclear power plant in the nation (p<0.001), necessity (p<0.001) and objective knowledge (p<0.001) of medical radiation, and attitudes regarding using medical radiation (p<0.007, p<0.001). Second, the educational effect of explanations to help increase national understanding of the necessity and safety of nuclear power generation will increase if information on the necessity and safety of medical radiation is provided as well. Both male and female students perceived that medical radiation is the most necessary (p<0.001), medical radiation is the safest (p<0.001), and nuclear power generation is the least safe (p<0.013). Moreover, the correlation between medical radiation and nuclear power generation was the highest. Third, there is a need for different lectures between classes, since the patterns of perception vary according to the field of radiation use among elementary, middle, and high school students. Elementary school students had high interest in education on nuclear power generation (p<0.005), perceived that irradiated food is safe (p<0.001), and had the most positive attitude toward consuming irradiated food (p<0.001). Middle school students had high interest in education on nuclear power generation (p<0.018), perceived that nuclear power generation (p<0.001) and medical radiation (p<0.002) are safe, and had the most positive attitude toward using radiation for treatment (p<0.001). High school students had the highest level of objective knowledge on nuclear power generation (p<0.001) and medical radiation (p<0.001), and perceived that medical radiation is the most necessary (p<0.017); however, they perceived that nuclear power generation is the least safe (p<0.001). Attitudes toward irradiated food intake (p<0.001) and approving construction of a nuclear power plant in their neighborhood (p<0.001) were both low. Fourth, it is necessary to provide educational programs to change perceptions and improve attitudes rather than providing education focused on objective knowledge. There was no correlation between objective knowledge and necessity of irradiated food, objective knowledge and safety and interest in education on nuclear power generation, and objective knowledge and interest in education and information acquirement regarding medical radiation. In particular, high school students had the highest level of objective knowledge and yet had the least positive attitudes toward approving construction of nuclear power plants in their neighborhood and intake of irradiated food. Therefore, to increase the social acceptability of using nuclear energy and radiation in Korea, it is desirable to provide strategic educational programs to improve perceptions, knowledge, and attitudes regarding the necessity and safety of their use.

• Journal of Intelligence and Information Systems
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• v.25 no.4
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• pp.35-52
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• 2019

As public services are provided in various forms, including e-government, the level of public demand for public service quality is increasing. Although continuous measurement and improvement of the quality of public services is needed to improve the quality of public services, traditional surveys are costly and time-consuming and have limitations. Therefore, there is a need for an analytical technique that can measure the quality of public services quickly and accurately at any time based on the data generated from public services. In this study, we analyzed the quality of public services based on data using process mining techniques for civil licensing services in N city. It is because the N city's building license complaint service can secure data necessary for analysis and can be spread to other institutions through public service quality management. This study conducted process mining on a total of 3678 building license complaint services in N city for two years from January 2014, and identified process maps and departments with high frequency and long processing time. According to the analysis results, there was a case where a department was crowded or relatively few at a certain point in time. In addition, there was a reasonable doubt that the increase in the number of complaints would increase the time required to complete the complaints. According to the analysis results, the time required to complete the complaint was varied from the same day to a year and 146 days. The cumulative frequency of the top four departments of the Sewage Treatment Division, the Waterworks Division, the Urban Design Division, and the Green Growth Division exceeded 50% and the cumulative frequency of the top nine departments exceeded 70%. Higher departments were limited and there was a great deal of unbalanced load among departments. Most complaint services have a variety of different patterns of processes. Research shows that the number of 'complementary' decisions has the greatest impact on the length of a complaint. This is interpreted as a lengthy period until the completion of the entire complaint is required because the 'complement' decision requires a physical period in which the complainant supplements and submits the documents again. In order to solve these problems, it is possible to drastically reduce the overall processing time of the complaints by preparing thoroughly before the filing of the complaints or in the preparation of the complaints, or the 'complementary' decision of other complaints. By clarifying and disclosing the cause and solution of one of the important data in the system, it helps the complainant to prepare in advance and convinces that the documents prepared by the public information will be passed. The transparency of complaints can be sufficiently predictable. Documents prepared by pre-disclosed information are likely to be processed without problems, which not only shortens the processing period but also improves work efficiency by eliminating the need for renegotiation or multiple tasks from the point of view of the processor. The results of this study can be used to find departments with high burdens of civil complaints at certain points of time and to flexibly manage the workforce allocation between departments. In addition, as a result of analyzing the pattern of the departments participating in the consultation by the characteristics of the complaints, it is possible to use it for automation or recommendation when requesting the consultation department. In addition, by using various data generated during the complaint process and using machine learning techniques, the pattern of the complaint process can be found. It can be used for automation / intelligence of civil complaint processing by making this algorithm and applying it to the system. This study is expected to be used to suggest future public service quality improvement through process mining analysis on civil service.