• Journal of Chest Surgery
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• v.41 no.5
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• pp.610-618
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• 2008

Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

• Radiation Oncology Journal
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• v.19 no.4
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• pp.335-344
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• 2001

Purpose : The aim of this study was to clarify the role of VEGF expression as an independent prognostic factor and to identify the patients at high risk for poor prognosis in stage IB cervical cancer. Materials and methods : A total of 118 patients with stage IB cervical cancer who had radical hysterectomy and pelvic lymph node dissection were included in the study. All known high risk factors of the patients were pathologically confirmed from the surgical specimen. Of the 118 patients, n patients were treated with postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry in formalin-fixed, paraffin-embedded specimens of post-hysterectomy surgical materials. A semiquantitative analysis was made using a scoring system of 0, +, ++, and +++ for increasing intensity of stain. We classified the patients with scores from 0 to ++ as low VEGF expression and the patients with a score of +++ as high VEGF expression. Results : Of the 118 patients, 35 patients $(29.7\%)$ showed high VEGF expression. Strong correlations were found between the high VEGF expression and both deep stromal invasion (p=0.01) and the positive pelvic node (p=0.03). The 5-year overall and disease-free survival rates for all 118 patients were $95.5\%\;and\;93.8\%$. The 5-year overall (p=0.03) and disease-free survival (p<0.001) rates were $98.5\%\;and\;100%$ for low VEGF expression (0, +, and ++) and $85.5\%\;and\;79.7\%$ for high VEGF expression, respectively. Pelvic and distant failures for low versus high VEGF expression were $1.2\%$ versus $17.1\%$, (p=0.001) and $0\%$ versus $14.3\%$ (p<0.001), respectively. In a Cox multivariate analysis of survival, the high VEGF expression (p=0.02) and the bulky mass (p=0.02) were significant prognostic factors for overall survival. The high VEGF expression (p=0.002), and bulky mass (p=0.01) demonstrated as significant prognostic indicators for disease free survival. Conclusion : These results showed that VEGF expression was a highly significant predictor for pelvic and distant failure and the most significant prognostic factor of overall and disease free survival for the patients with stage IB cervix cancer treated with radical surgery. We strongly suggest that the immune-histochemistry for VEGF expression be performed in a routine clinical setting in order to identify the patients at high risk for poor prognosis in early stage cervical cancer. Furthermore, postoperative and/or chemotherapy did not reduce the pelvic failure and distant metastasis. To improve the cure rate for the patients with high VEGF expression in stage IB cervical cancer, antiangiogenic therapy including anti-VEGF Ab may be new treatment option.

• Tuberculosis and Respiratory Diseases
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• v.52 no.5
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• pp.485-496
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• 2002

Background : The NF-${\kappa}B$ transcription factors control various biological processes including the immune response, acute phase reaction and cell cycle regulation. NF-${\kappa}B$ complexes are retained in the cytoplasm in the basal state and various stimuli cause a translocation of the NF-${\kappa}B$ complexes into the nucleus where they bind to the ${\kappa}B$ elements and regulate the transcription of the target genes. Recent reports also suggest that NF-${\kappa}B$ proteins are involved in oncogenesis, tumor growth and metastasis. High expression of NF-${\kappa}B$ expression was reported in many cancer cell lines and tissues. The constitutive activation of NF-${\kappa}B$ was also reported in several cancer cell lines supporting its role in cancer development and survival. The anti-apoptotic action of NF-${\kappa}B$ is important for cancer survival. NF-${\kappa}B$ also controls the expression of several proteins that are important for cellular adhesion (ICAM-1, VCAM-1) suggesting a role in cancer metastasis. In lung cancer, high expression levels of the NF-${\kappa}B$ subunit p50 and c-Rel were reported. In fact, high expression does not mean a high activity, and the activation pattern of NF-${\kappa}B$ in lung cancer has not been reported. Materials and Methods : In this study, the NF-${\kappa}B$ nuclear binding activity in the basal and TNF-${\alpha}$ stimulated states were exmined in various lung cancer cell lines and compared with the normal bronchial epithelial cell line. Twelve lung cancer cell lines including the non-small cell and small cell lung cancer cell lines (A549, NCI-H358, NCI-H441, NCI-H552, NCI-H2009, NCI-H460, NCI-H1229, NCI-H1703, NCI-H157, NCI-H187, NCI-H417, NCI-H526) and BEAS-2B bronchial epithelial cell line were used. To evaluate the NF-${\kappa}B$ expression and DNA binding activity, western blot analysis and an electrophoretic mobility shift assay with the nuclear protein extracts. Results : The basal expressions of the p65 and p50 subunits were observed in the BEAS-2B cell line and all lung cancer cell lines except for NCI-H358 and NCI-H460. The expression levels of p65 and p50 were increased 30 minutes after stimulation with TNF-${\alpha}$ in BEAS-2B and in 10 lung cancer cell lines. In the NCI-H358 and NCI-H460 cell lines, p65 expression was not observed in the basal and stimulated states and the two p50 related protein levels were higher after stimulation with TNF-${\alpha}$ These new proteins were smaller than p50 and are thought to be variants of p50. In the basal state, NF-${\kappa}B$ was nearly activated in the BEAS-2B and all lung cancer cell lines. The DNA binding activity of the NF-${\kappa}B$ complexes was markedly higher after stimulation with TNF-${\alpha}$ In the BEAS-2B and all lung cancer cell line except for NCI-H358 and NCI-H460, the activated NF-${\kappa}B$ complex was a p65/p50 heterodimer. In the NCI-H358 and NCI-H460 lung cancer cell lines, the NF-${\kappa}B$ complex was variant of a p50/p50 homodimer. Conclusion : The NF-${\kappa}B$ activation pattern in the lung cancer cell lines and the normal bronchial epithelial cell lines was similar except for the activation of a variant of the p50/p50 homodimer in some lung cancer cell linse.

• Radiation Oncology Journal
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• v.15 no.1
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• pp.27-36
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• 1997

Purpose : This study was tried to evaluate the Potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate. overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250 cGy given 10 times up to 2500 cGy) was combined with $6mg/m^2$ of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up Period ranged from 36 months to 105 months with median of 62 months. Result : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%, CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%. The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for Patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a Prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs 6% and bone marrow toxicities (25% vs. 15.6% were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%. The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%. In analyses for relationship of field size and Pulmonary toxicity, the Patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

• Journal of Korean Society of Archives and Records Management
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• v.1 no.1
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• pp.201-230
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• 2001

Conserving the recored cultural inheritance is actually the duty of all of us. Above all, the management and conservation of archives and documents is up to archivists who have technical knowledge about archival science. Archivists have to not only conserve archives and documents but also carry out classifying and appraising them in order to define them as current historic ones. The fundamental education about archival science is made up of history and law. Because Archive is the organisation which manage archives and documents produced by legal and administrative actions. Although there are still arguments about technical knowledge and degree archivists have to acquire, most of them prefer the studies related with history and emphasize legal studies to be the general boundary of archivits' ideology and trust. The training course about conservation of archives is conducted in about 9 National Archives of Torino, Milano, Venezia, Genova, Bologna, Parma, Roma, Napoli, Palermo. The training course in 19th was mostly based on the lectures of Phaleography, Diplomatics. There were not the education about archival science yet. Toward the end of 19th and 20th, people stressed the most basic subject in the training course of National Archive was not Phaleography and Diplomatics but archival science. The goal of archival science is to study the institution and organisation transferring archives and documents to Archive. And also it help archivists not wander about with ignorance of organisational and original procedures and divisions but know exactly theirs works. Like this, the studies on institution and organisation have got in the saddle as a branch of archival science since a few ten years. While archival science didn't evoke sympathy among people and experienced the tedious and difficult path in italy and other countries, Archive was managed by experts of other branches. As a result, there were a lot of faults in Archival Science. Specializing training course for Italian archivists came into being under the backdrop of Social Science Institute of Roma National University in 1925. The archival course of universities accomplished by the studies of history, law and economy. And such as Eugenio Casanova and Giorgio Cencetti were devoted archival science was abled to settle down in national archive. The training course for experts of 'archival science, 'Phaleography and Diplomatics' in National Archive of Bologna(Archivio di Stato di Bologna) is one of courses conducted in 17 National Archives in italy. This course is gratuitous and made up of 8 subjects(Archivistica, Paleografia, Diplomatica, Storia dell' Archivio, Notariato e documenti privati, istituzione medievale, istituzione moderna, istituzione contemporanea) students have to complete for two years. Students can receive the degree through passing twice written exam and once oral test. After department of Culture and education finally puts the marks of students, the chief Nationa Archive of Bologna confer the degree of 'archival science Phaleography and Diplomatics' on students passing the exams. This degree authenticates trainees' qualification which enables him to work at the archive in province, district and administrative capital city and archive of comunity and so on. Italian training course naturally leads archivists to keep in contact with valuable cultural inheritance through training in Archive. And it shows the intention to strengthen the affinity with each documents in the spot of archival management before training archivists. Also this is appraised as one of positive policies to conserve the local cultual inheritante in connection with the original qualitity of national archive with testify the history of each region. Traning course for archivist in Italy shows us the way how we have to prepare and proceed it. First, from producing documents to conserving than forever there has introduced 'original order that is to say a general rule to respect the first order given at the time producing documents'. Management of administrative documents is related consistently with one of historical documents. Second, the traning course for archivist is managing around 17 national archives. because italian national archive lay stress not or rducation of theory bus on train for archivest working in the first time of archival science. Third, diplomatics and phaleography for studies about historical document support archives. Forth, the studies on history id proceeding by cooperation between archivist and historian around archive. How our duties is non continuinf disputer who has to conserve and manage document and archives, but traing experts who having ability, vision and flexible thought, responsibility about archivals.

• Radiation Oncology Journal
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• v.22 no.3
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• pp.192-199
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• 2004

Purpose: To determine the patterns on evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was peformed. Materials and Methods: A web-based database system for korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998$\~$1999 from 15 hospitals were reviewed. Results: The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9$\%$) followed by medullary carcinoma (4.2$\%$) and infiltrating lobular carcinoma (1.5$\%$). Pathologic T stage by AJCC was T1 in 59.7$\%$ of the casses, T2 in 29.5$\%$ of the cases, Tis in 8.8$\%$ of the cases. Axillary lymph node dissection was peformed I\in 91.2$\%$ of the cases and 69.7$\%$ were node negative. AJCC stage was 0 in 8.8$\%$ of the cases, stage I in 44.9$\%$ of the cases, stage IIa in 33.3$\%$ of the cases, and stage IIb in 8.4$\%$ of the cases. Estrogen and progesteron receptors were evaluated in 71.6$\%$, and 70.9$\%$ of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2$\%$, wide excision in 11.5$\%$, quadrantectomy in 23$\%$ and partial mastectomy in 27.5$\%$ of the cases. A pathologically confirmed negative margin was obtained in 90.8$\%$ of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90$\%$ of the planned radiotherapy dose. Radiotherapy volume was breast only In 88$\%$ of the cases, breast+supraclavicular fossa (SCL) in 5$\%$ of the cases, and breast+ SCL+ posterior axillary boost in 4.2%$\%$of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45$\~$59.4 Gy (median 50.4) and boost dose was 8$\~$20 Gy (median 10 Gy). The total radiation dose delivered was 50.4$\~$70.4 Gy (median 60.4 Gy). Conclusion: There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.

• (The) Research of the performance art and culture
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• no.22
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• pp.287-325
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• 2011

This paper studies the time-space and appreciation of the performance culture of Gwanseo region, which is considered to have formed a characteristic culture in late Joseon period. For this purpose, 4 gasa written in hangeul (Korean alphabet), as well as 4 yeonhaeng gasa, 108 articles of Gwanseoakbu were examined. Plus, among the 9 types of yeonhaengrok (Documents of Performance culture) written in Chinese character, those parts which describe the performance traits have been analyzed. Then, 'main list of terminology' has been deduced based on the categorization according to the following points : 1) subjects of performance and appreciation 2) time and period of performance 3) space of performance 4) contents of performance 5) background and motive for performance and 6) method of performance. Through this process, various 'nouns' and 'predicate verbs' in relation to performance culture emerged, which were systemized according to types of performance elements and categories. Major terminology includes predicate verbs and symbolic verbs such as nokuihongsang,' 'baekdaehongjang,' 'jeolsaekgeumga,' 'cheonga,' 'hwaryu,' 'gamuja,' and 'tongsoja,' as well as the terms already known such as gisaeng, iwon, yangbang, akgong, and jeonak, which refer to musicians and dancers. Subjects of performance were divided into performers and listeners, categorized into concert, music, and dance, according to performance form. In the case for music, it was divided into instrumental or vocal, solo or accompanied (byeongju, self-accompaniment). In the case for vocal music, noteworthy was the inclusion of profesional artist's singing (called gwangdae or uchang). The record of 23 names of popular artists from Gwanseo region, with mention of special talents for each person, reflects the degree of activeness and artistic level of the province. Depending on the appreciating patrons, the audience were indicated as the terms including 'yugaek (party guest),' jwasang,' 'on jwaseok,' and 'sonnim (guests).' It seems that appraisal for a certain performance was very much affected by the tastes, views, and disposition of the appreciating patrons. Therefore it is interesting to observe different comparative reviews of concerts of different regions given by literary figures, offering various criticism on identical performance. In terms of performance space, it has been divided into natural or architectural space, doing justice to special performance sites such as a famous pavilion or an on-the-boat performance. Specific terms related to the scale and brightness of stage, as well as stage props and cast, based on descriptions of performance space were found. The performance space, including famous pavilions; Yeongwangjeong, Bubyeokru, Baeksangru, Wolparu, and Uigeomjeong, which are all well-known tourist sites of Gwanseo province, have been often visited by viceroys. governors, and envoys during a tour or trip. This, and the fact that full-scale performances were regularly held here, and that more than 15 different kinds of boats which were used for boat concert are mentioned, all confirm the general popularity of boat concerts at the time. Performance time, categorized by season or time of day (am/pm/night) and analyzed in terms of time of occurrence and duration, there were no special limitation as to when to have a performance. Most morning concerts were held as part of official duties for the envoys, after their meeting session, whereas evening concerts were more lengthy in duration, with a greater number of people in the audience. In the case of boat concert, samples include day-time concert and performances that began during the day and which lasted till later in the evening. Major terminology related to performance time and season includes descriptions of time of day (morning, evening, night) and mention of sunset, twilight, moonlight, stars, candles, and lamps. Such terms which reflect the flow of time contributed in making a concert more lively. Terminology for the contents of performance was mostly words like 'instrumental,' 'pungak,' or 'pungnyu.' Besides, contextual expressions gave hints as to whether there were dance, singing, ensemble, solo, and duets. Words for dance and singing used in Gwanseo province were almost identical to those used for gasa and jeongjae in the capital, Hanyang. However, many sentences reveal that performances of 'hangjangmu' of hongmunyeon, sword dance, and baettaragi were on a top-quality level. Moreover, chants in hanmun Chinese character and folk songs, which are characteristic for this region, show unique features of local musical performance. It is judged that understanding the purpose and background of a performance is important in grasping the foundation and continuity of local culture. Concerts were usually either related to official protocol for 'greeting,' 'sending-off,' 'reports,' and 'patrols' or for private enjoyment. The rituals for Gwanseo province characteristically features river crossing ceremony on the Daedong river, which has been closely documented by many. What is more, the Gwanseo region featured continued coming and goings of Pyeongan envoys and local officers, as well as ambassadors to and fro China, which required an organized and full-scale performance of music and dance. The method of performance varied from a large-scale, official ones, for which female entertainers and a great banquet in addition to musicians were required, to private gatherings that are more intimate. A performance may take the form of 'taking turns' or 'a competition,' reflecting the dynamic nature of the musical culture at the time. This study, which is deduction of terminology in relation to the time-space and appreciation culture of musical performances of Gwanseo region in late Joseon period, should be expanded in the future into research on 'the performance culture unique to Gwanseo region,' in relation to the financial and administrative aspects of the province, as well as everyday lifestyle. Furthermore, it could proceed to a more intensive research by a comparative study with related literary documents and pictorial data, which could serve as the foundation for understanding the use of space and stage, as well as the performance format characteristic to Korean traditional performing arts.