• Radiation Oncology Journal
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• v.17 no.2
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• pp.91-99
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• 1999

Propose : This study was performed to find out the prognostic factors affecting local control, survival and disease free survival rate in nasopharyngeal carcinomas treated with chemotherapy and radiation therapy. Materials and Methods : We analysed 47 patients of nasopharyngeal carcinomas, histologically confirmed and treated at Chonnam University Hospital between July 1986 and June 1996, retrospectively. Range of patients' age were from 16 to 80 years (median; 52 years). Thirty three (70$\%$) patients was male. Histological types were composed of 3 (6$\%$) keratinizing, 30 (64$\%$) nonkeratinizing squamous cell carcinoma and 13 (28$\%$) undifferentiated carcinoma. Histoiogicai type was not known in 1 patient (2$\%$). We restaged according to the staging system of 1997 American Joint Committee on Cancer Forty seven patients were recorded as follows: 71: 11 (23$\%$), T2a; 6 (13$\%$), T2b; 9 (19$\%$), 73; 7 (15$\%$), 74: 14 (30$\%$), and NO; 7 (15$\%$), Nl: 14 (30$\%$), N2; 21 (45%), N3: 5 (10%). Clinical staging was grouped as follows: Stage 1; 2 (4$\%$), IIA: 2 (4$\%$), IIB; 10 (21$\%$), III; 14 (30$\%$), IVA; 14 (30$\%$) and IVB; 5 (11$\%$). Radiation therapy was done using 6 MV and 10 MV X- ray of linear accelerator. Electron beam was used for the Iymph nodes of posterior neck after 4500 cGy. The range of total radiation dose delivered to the primary tumor was from 6120 to 7920 cGy (median; 7020 cGy). Neoadjuvant chemotherapy was performed with cisplatin +5-fluorouracil (25 patients) or cisplatin+pepleomycin (17 patients) with one to three cycles. Five patients did not received chemotherapy. Local control rate, survival and disease free suwival rate were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of survival rates between groups. multivariate analysis using Cox proportional hazard model was done for finding prognostic factors. Results: Local control rate was 81$\%$ in 5 year. Five year survival rate was 60$\%$ (median survival; 100 months). We included age, sex, cranial nerve deflicit, histologic type, stage group, chemotherapy, elapsed days between chemotherapy and radiotherapy, total radiation dose, period of radiotherapy as potential prognostic factors in multivariate analysis. As a result, cranial none deficit (P=0.004) had statistical significance in local control rate. Stage group and total radiation dose were significant prognostic factors in survival (P=0.000, P=0.012), and in disease free survival rates (P=0.003, P=0.008), respectively. Common complications were xerostomia, tooth and ear problems. Hypothyroidism was developed in 2 patients. Conclusion : In our study, cranial none deficit was a significant prognostic factor in local control rate, and stage group and total radiation dose were significant factors in both survival and disease free survival of nasopharyngeal carcinoma. We have concluded that chemotherapy and radiotherapy used in our patients were effective without any serious complication.

• 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.

• Korean Security Journal
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• no.18
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• pp.169-190
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• 2009

Today, the rapid advance of scientific technologies has brought about fundamental changes to the types and levels of terrorism while the war against the world more than one thousand small and big terrorists and crime organizations has already begun. A method highly likely to be employed by terrorist groups that are using 21st Century state of the art technology is cyber terrorism. In many instances, things that you could only imagine in reality could be made possible in the cyber space. An easy example would be to randomly alter a letter in the blood type of a terrorism subject in the health care data system, which could inflict harm to subjects and impact the overturning of the opponent's system or regime. The CIH Virus Crisis which occurred on April 26, 1999 had significant implications in various aspects. A virus program made of just a few lines by Taiwanese college students without any specific objective ended up spreading widely throughout the Internet, causing damage to 30,000 PCs in Korea and over 2 billion won in monetary damages in repairs and data recovery. Despite of such risks of cyber terrorism, a great number of Korean sites are employing loose security measures. In fact, there are many cases where a company with millions of subscribers has very slackened security systems. A nationwide preparation for cyber terrorism is called for. In this context, this research will analyze the current status of Korea's cyber security systems and its laws from a policy perspective, and move on to propose improvement strategies. This research suggests the following solutions. First, the National Cyber Security Management Act should be passed to have its effectiveness as the national cyber security management regulation. With the Act's establishment, a more efficient and proactive response to cyber security management will be made possible within a nationwide cyber security framework, and define its relationship with other related laws. The newly passed National Cyber Security Management Act will eliminate inefficiencies that are caused by functional redundancies dispersed across individual sectors in current legislation. Second, to ensure efficient nationwide cyber security management, national cyber security standards and models should be proposed; while at the same time a national cyber security management organizational structure should be established to implement national cyber security policies at each government-agencies and social-components. The National Cyber Security Center must serve as the comprehensive collection, analysis and processing point for national cyber crisis related information, oversee each government agency, and build collaborative relations with the private sector. Also, national and comprehensive response system in which both the private and public sectors participate should be set up, for advance detection and prevention of cyber crisis risks and for a consolidated and timely response using national resources in times of crisis.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.323-327
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• 2002

Purpose : To evaluate the outcome of early stage non-small cell lung cancer patients who were treated with radiation therapy alone and define the optimal radiotherapeutic regimen for these patients. Materials and Methods : A retrospective review was peformed on patients with sage I or II non-small cell carcinoma of the lung that were treated at our institution between June, 1987 and May, 2000. A total of 21 patients treated definitively with radiation therapy alone were included in this study. The age of the patients ranged from 53 to 81 years with a median of 66 years. All the patients were male. The medical reasons for inoperability were lack of pulmonary reserve, cardiovascular disease, poor performance status, old age, and patient refusal in the decreasing order. Pathological evidence was not adequate to characterize the non-small cell subtype in two patients. Of the remaining 19 patients, 16 had squamous cell carcinoma and 3 had adenocarcinoma. Treatment was given with conventional fractionation, once a day, five times a week. The doses to the primary site ranged from 56 Gy to 59 Gy. No patients were lost to follow-up. Results : The overall survival rates for the entire group at 2, 3 and 5 years were 41, 30 and $21\%$, respectively. The cause specific survivals at 2, 3 and 5 years were 55, 36 and $25\%$, respectively. An intercurrent disease was the cause of death in two patients. The cumulative local failure rate at 5 years was $43\%$. Nine of the 21 patients had treatment failures after the curative radiotherapy was attempted. Local recurrences as the first site of failure were documented in 7 patients. Therefore, local failure alone represented $78\%$ of the total failures. Those patients whose tumor sizes were less than 4 cm had a significantly better 5 year disease free survival than those with tumors greater than 4 cm $(0\%\;vs\;36\%)$. Those patients with a Karnofsky performance status less than 70 did not differ significantly with respect to actuarial survival when compared to those with a status greater than 70 $(25\%\;vs\;26\%,\;p>0.05)$. Conclusion : Radiation therapy 리one is an effective and safe treatment for early stage non-small ceil lung cancer patients who are medically inoperable or refuse surgery. Also we believe that a higher radiation dose to the primary site could improve the local control rate, and ultimately the overall survival rate.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.299-346
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• 2016

There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.33-44
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• 2003

Background : Mycobacterium avium complex(MAC) is the most common respiratory pathogen in nontuberculous mycobacterial pulmonary disease. This study described the clinical characteristics of the patients with pulmonary disease caused by MAC. Materials and Methods : The clinical characteristics of 24 patients with pulmonary disease caused by the MAC, who fulfilled the 1997 American Thoracic Society diagnostic criteria for nontuberculous mycobacterial pulmonary disease, were retrospectively analyzed. Results : Fourteen patients(58%) were male and the median age at diagnosis was 61 years(range 46-75). Of the 24 patients, 16(67%) had a M. intracellulare infection, 7(29%) had a M. avium infection and one patient was not identified. Coughing (92%) and sputum (88%) were most frequently observed symptoms. The sputum smear for acid-fast bacilli was positive in 17(71%) patients. Fourteen(58%) patients had the upper lobe cavitary form and 10(42%) patients had the nodular bronchiectatic form. In a comparison between the patients with the upper lobe cavitary form and those with the nodular bronchiectatic form, significant differences were found according to sex(male 86% vs. 20%, p=0.003), smoking history(79% vs. 10%, p=0.008), the presence of an underlying disease(64% vs. 20%, p=0.036), the pulmonary function(% forced vital capacity, median 71% vs. 88%, p=0.022; % forced expiratory volume in one second, median 69% vs. 89%, p=0.051) and bilateral disease at chest radiography(29% vs. 90%, p=0.005). The time from the onset of symptoms to diagnosis was longer in those with the nodular bronchiectatic form(median 72 months, range 8-132) than those with the upper lobe cavitary form(median 22 months, range 6-60) Conclusions : MAC pulmonary disease occurs in two distinct populations with two distinct clinical presentations. For a correct diagnosis of MAC pulmonary disease, knowledge of the diverse clinical and radiological findings is essential.

• Tuberculosis and Respiratory Diseases
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• v.47 no.6
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• pp.775-785
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• 1999

Background : Though surgery plays an important role in the management of patients with Mycobacterium tuberculosis infection, there is little information regarding the timing of resection. We tried to find out the ideal timing of operation. Method: A retrospective review was performed in 69 patients underwent pulmonary resection for pulmonary tuberculosis between January 1993 and December 1997. They were categorized into various groups according to the length of preoperative specific drug therapy. The rates of treatment failure, realpse and complication in each group were compared statistically by $x^2$-test. Results: Eighty one point two percent were men and 18.8 % women with a median age of 33 years(range, 16 to 63 years). The mean number of resistant drugs was 3.l(range, 0 to 9). Patients were treated preoperatively with multidrug regimens, which mean number of preoperative specific drugs was 4.6, in an effort to reduce the mycobacterial burden with the mean length of preoperative drug therapy, 5.0 months. Postoperative treatment was conducted for a mean period of 13.0 months with a mean number of postoperative specific drugs, 4.4. Postoperative treatment failures were confirmed in 8 among 69 patients(11.6%). 2 of these 8 patients were showed up in the preoperative 3 to 4 months medication group and each of the rest was occurred in the preoperative 2 to 3, 5 to 6, 6 to 7, 12 to 13, 17 to 18 months, less than one month medication group, respectively. 59 of 69 patients were available for evaluation of the relapse rate with the mean duration of the postoperative follow-up, 19.8 months. In 4 patients bacterial relapse was confirmed(6.8%). Each of these 4 was in the preoperative 1 to 2, 2 to 3, 3 to 4, 5 to 6 months medication group. Categorized into various groups according to the length of preoperative specific therapy, there were no statistical significances of the treatment failure rate, relapse rate and complication rate in the groups. There were seven treatment failures of 28 who were AFB culture positive until the time of operation(25%, p<0.01). Categorized the preoperative AFB culture positive group into various groups according to the length of preoperative drug therapy, there were no statistical significances, either. Conclusion: We believe that operation plays an important ancillary role in the treatment of pulmonary tuberculosis. Our results indicate that the timing of resection according to the length of preoperative drug therapy may not cause trouble.

• Journal of Intelligence and Information Systems
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• v.20 no.3
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• pp.19-43
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• 2014

The Pareto principle, also known as the 80-20 rule, states that roughly 80% of the effects come from 20% of the causes for many events including natural phenomena. It has been recognized as a golden rule in business with a wide application of such discovery like 20 percent of customers resulting in 80 percent of total sales. On the other hand, the Long Tail theory, pointing out that "the trivial many" produces more value than "the vital few," has gained popularity in recent times with a tremendous reduction of distribution and inventory costs through the development of ICT(Information and Communication Technology). This study started with a view to illuminating how these two primary business paradigms-Pareto principle and Long Tail theory-relates to the success of virtual knowledge collaboration. The importance of virtual knowledge collaboration is soaring in this era of globalization and virtualization transcending geographical and temporal constraints. Many previous studies on knowledge sharing have focused on the factors to affect knowledge sharing, seeking to boost individual knowledge sharing and resolve the social dilemma caused from the fact that rational individuals are likely to rather consume than contribute knowledge. Knowledge collaboration can be defined as the creation of knowledge by not only sharing knowledge, but also by transforming and integrating such knowledge. In this perspective of knowledge collaboration, the relative distribution of knowledge sharing among participants can count as much as the absolute amounts of individual knowledge sharing. In particular, whether the more contribution of the upper 20 percent of participants in knowledge sharing will enhance the efficiency of overall knowledge collaboration is an issue of interest. This study deals with the effect of this sort of knowledge sharing distribution on the efficiency of knowledge collaboration and is extended to reflect the work characteristics. All analyses were conducted based on actual data instead of self-reported questionnaire surveys. More specifically, we analyzed the collaborative behaviors of editors of 2,978 English Wikipedia featured articles, which are the best quality grade of articles in English Wikipedia. We adopted Pareto ratio, the ratio of the number of knowledge contribution of the upper 20 percent of participants to the total number of knowledge contribution made by the total participants of an article group, to examine the effect of Pareto principle. In addition, Gini coefficient, which represents the inequality of income among a group of people, was applied to reveal the effect of inequality of knowledge contribution. Hypotheses were set up based on the assumption that the higher ratio of knowledge contribution by more highly motivated participants will lead to the higher collaboration efficiency, but if the ratio gets too high, the collaboration efficiency will be exacerbated because overall informational diversity is threatened and knowledge contribution of less motivated participants is intimidated. Cox regression models were formulated for each of the focal variables-Pareto ratio and Gini coefficient-with seven control variables such as the number of editors involved in an article, the average time length between successive edits of an article, the number of sections a featured article has, etc. The dependent variable of the Cox models is the time spent from article initiation to promotion to the featured article level, indicating the efficiency of knowledge collaboration. To examine whether the effects of the focal variables vary depending on the characteristics of a group task, we classified 2,978 featured articles into two categories: Academic and Non-academic. Academic articles refer to at least one paper published at an SCI, SSCI, A&HCI, or SCIE journal. We assumed that academic articles are more complex, entail more information processing and problem solving, and thus require more skill variety and expertise. The analysis results indicate the followings; First, Pareto ratio and inequality of knowledge sharing relates in a curvilinear fashion to the collaboration efficiency in an online community, promoting it to an optimal point and undermining it thereafter. Second, the curvilinear effect of Pareto ratio and inequality of knowledge sharing on the collaboration efficiency is more sensitive with a more academic task in an online community.

• Journal of Intelligence and Information Systems
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• v.19 no.1
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• pp.79-94
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• 2013

Recently, the high value added business is steadily growing in the culture and art area. To generated high value from a performance, the satisfaction of audience is necessary. The flow in a critical factor for satisfaction, and it should be induced from audience and measures. To evaluate interest and emotion of audience on contents, producers or investors need a kind of index for the measurement of the flow. But it is neither easy to define the flow quantitatively, nor to collect audience's reaction immediately. The previous studies of the group flow were evaluated by the sum of the average value of each person's reaction. The flow or "good feeling" from each audience was extracted from his face, especially, the change of his (or her) expression and body movement. But it was not easy to handle the large amount of real-time data from each sensor signals. And also it was difficult to set experimental devices, in terms of economic and environmental problems. Because, all participants should have their own personal sensor to check their physical signal. Also each camera should be located in front of their head to catch their looks. Therefore we need more simple system to analyze group flow. This study provides the method for measurement of audiences flow with group synchronization at same time and place. To measure the synchronization, we made real-time processing system using the Differential Image and Group Emotion Analysis (GEA) system. Differential Image was obtained from camera and by the previous frame was subtracted from present frame. So the movement variation on audience's reaction was obtained. And then we developed a program, GEX(Group Emotion Analysis), for flow judgment model. After the measurement of the audience's reaction, the synchronization is divided as Dynamic State Synchronization and Static State Synchronization. The Dynamic State Synchronization accompanies audience's active reaction, while the Static State Synchronization means to movement of audience. The Dynamic State Synchronization can be caused by the audience's surprise action such as scary, creepy or reversal scene. And the Static State Synchronization was triggered by impressed or sad scene. Therefore we showed them several short movies containing various scenes mentioned previously. And these kind of scenes made them sad, clap, and creepy, etc. To check the movement of audience, we defined the critical point, ${\alpha}$and ${\beta}$. Dynamic State Synchronization was meaningful when the movement value was over critical point ${\beta}$, while Static State Synchronization was effective under critical point ${\alpha}$. ${\beta}$ is made by audience' clapping movement of 10 teams in stead of using average number of movement. After checking the reactive movement of audience, the percentage(%) ratio was calculated from the division of "people having reaction" by "total people". Total 37 teams were made in "2012 Seoul DMC Culture Open" and they involved the experiments. First, they followed induction to clap by staff. Second, basic scene for neutralize emotion of audience. Third, flow scene was displayed to audience. Forth, the reversal scene was introduced. And then 24 teams of them were provided with amuse and creepy scenes. And the other 10 teams were exposed with the sad scene. There were clapping and laughing action of audience on the amuse scene with shaking their head or hid with closing eyes. And also the sad or touching scene made them silent. If the results were over about 80%, the group could be judged as the synchronization and the flow were achieved. As a result, the audience showed similar reactions about similar stimulation at same time and place. Once we get an additional normalization and experiment, we can obtain find the flow factor through the synchronization on a much bigger group and this should be useful for planning contents.

• The Journal of Korean Philosophical History
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• no.23
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• pp.99-128
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• 2008

This research analyzes some Korean historical figures and presents the core values of their leaderships so that we can bring up the theory of leadership which would be compatible with the current circumstances around Korea. Through this work, we expected that we would not only find out typical examples among historical leaders but also reaffirm our identities in our history. As a result of the research, it was possible to classify some figures in history into several patterns and discover their archetypal qualities. Those qualities were 'transform(實事)', 'challenge(決死)', 'energize(風流)', 'create(創案)', and 'envision(開新)' respectively. Among the qualities, this research concentrated on the quality of 'challenge', exclusively 'death-defying spirit'. This spirit is the one with which historical leaders could sacrifice their lives for their great causes. This research selected twelve figures as incarnations of death-defying spirit, who are Gyebaek(階伯), Ganggamchan(姜邯贊), Euljimundeok(乙支文德), Choeyoung(崔瑩),ChungMongju(鄭夢周), Seongsammun (成三問), Yisunsin(李舜臣), Gwakjaewoo(郭再祐), Choeikhyeon(崔益鉉), Anjunggeun(安重根), Yunbonggil(尹奉吉), Yijun(李儁). Through analyzing their core values and abilities and categorizing some historical cases into four spheres such as a private sphere, relations sphere, a community sphere, and a society sphere, we came to find a certain element in common among those figures. It was that they eventually took the lead by showing the goal and the ideal to their people at all times. Moreover, their goals were always not only obvious but also unwavering. In the second chapter, I described the core value in a private sphere, so called '志靑靑'. It implies that a leader should set his ultimate goal and then try to attain it with an unyielding will. Obvious self-confidence and unfailing self-creed are core values in a private sphere. In the third chapter, I described the core value in a relative sphere, the relationship between one and others. It is '守信結義'. It indicates that a leader should win confidence from others by discharging his duties in the relation with others. Confidence is the highest leveled affection to others. Thus, mutual reliance should be based on truthful sincerity and affection toward others. Stubbornness and strictness are needed not to be prompted by pity simultaneously. In the fourth chapter, I described the core value in a community sphere. It is '丹心合力'. For this value, what are required to a leader are both his community spirit and his loyalty to one's community. Moreover, the strong sense of responsibility and the attitude of taking an initiative among others are also required. Thus, it can be said that the great power to conduct the community is so called fine teamwork. What's more, the attitude of the leader can exert a great influence on his community. In the fifth chapter, I described the core value of death defying spirit in the society sphere. This value might be more definite and explicit than other ones described above. A leader should prepare willingly for one's death to fulfill his great duties. 'What to do' is more important for a leader than 'how to do'. That is to say, a leader should always do righteous things. Efficiency is nothing but one of his interests. A leader must be the one who behaves himself always according to righteousness. Unless a leader's behaviors are based on righteousness, it is absolutely impossible that a leader exerts his leadership toward people very efficiently. Thus, it can be said that a true leader is the one not only who is of morality and but also who tries to fulfill his duties.