• Title/Summary/Keyword: Close up

Search Result 1,260, Processing Time 0.042 seconds

GIS-based review of Goguryeo's defense system during the Gungnaeseong Period with the focus on the upper and middle reaches of the Amnok River and the mid-stream region of the Liohe River (GIS를 활용한 고구려 국내성 시기의 관방체계 검토 - 압록강 중상류~요하 중류를 중심으로 -)

  • Hong, Balgeum;Kang, Dongseok
    • Korean Journal of Heritage: History & Science
    • /
    • v.54 no.1
    • /
    • pp.260-279
    • /
    • 2021
  • The Goguryeo kingdom established a unique defense system centered on a series of mountain fortresses. However, modern-day studies on its defense system have tended to focus on how they were positioned and generally consist of little more than individual surveys or introductions to the relevant materials, leaving much to be desired. This study attempts to extend the scope of studies about fortresses dating back to the Goguryeo period, taking into account the limitations of the available materials. As such, this study reviews the defense system of Goguryeo during the Gungnaeseong Period (i.e., the period when Gungnaeseong was the capital of Goguryeo) using the GIS system, with the focus on fortresses that are thought to have been built in the area extending from the middle and upper reaches of the Amnok River to the mid-stream region of the Liohe River, based on the aforementioned studies. The results of the study are as follows. First, the major roads built during the Gungnaeseong Period were as stated in the foregoing studies to some extent. Researchers believed that during the middle period of the dynasty, a major road ran along the Suzihe, Fuer and Xinkai rivers before finally reaching Jian. The study found that fortified walls and fortress strongholds were built along this road. Second, there were seven fortresses between the middle and upper reaches of the Amnokgang River and the midstream region of the Liaohe River. A primary defense line was closely established between the strongholds and the nearby walls, with secondary and tertiary defense lines established more loosely and encompassing a much wider area. Third, regarding the defense system along the major roads, the Choejinbosanseong, Goisanseong and Cheolbaesanseong fortresses served as strongholds along the 60-kilometer-long primary defense line, with 80-kilometer-long secondary and tertiary defense lines set up behind it. The final 120-kilometer-long defense line of the capital was established along with the Onyeosanseong Fortress, while a stumbling block was set up close to the capital as a defense system, rather than building a fortified wall. To summarize, a primary defense system was established centered on a series of fortresses, with each stronghold maintaining a closely-knit defense system in connection with other nearby strongholds to repel invaders.

Blended IT/STEM Education for Students in Developing Countries: Experiences in Tanzania (개발도상국 학생들을 위한 블랜디드 IT/STEM교육: 탄자니아에서의 경험 및 시사점)

  • Yoon Rhee, Ji-Young;Ayo, Heriel;Rhee, Herb S.
    • Journal of Appropriate Technology
    • /
    • v.6 no.2
    • /
    • pp.151-162
    • /
    • 2020
  • Education is one of the priority sectors specified in Tanzania, and it has committed to provide 11 years of compulsory free basic education for all from pre-primary to lower secondary level. Despite the Government's efforts to provide free basic education to all children, there are 2.0 million (23.2 per cent) out of 8.5 million children at the primary school age of 7-13, who are out of school in Tanzania. The ICT class should be offered as a regular class in all secondary schools in Tanzania, recommended by the ministry of education. However, many schools are struggling to implement this mandate. Most of schools offer the ICT class with theory without any real hardware. Some schools were given with computers but they were not maintained for operation. There is a huge task to make ICT education universal. Main issues include: remoteness (off-grid area), lack of ICT teachers, lack of resources such as hardware, infrastructure, and lack of practical lessons or projects to be used at schools. An innovative blended ICT/STEM education program is being conducted not only for Tanzanian public and private/international schools, but also for out-of-school adolescents through institutions, NGO centers, home visits and at the E3 Empower academy center. For effective STEM education to take place and remain sustainable, more practical curriculum, and close-up teacher support need to be accompanied concurrently. Practical, project-based simple coding lessons have been developed and employed that students experience true learning. The effectiveness of the curriculum has been demonstrated in various project centers, and it showed that students are showing new interests in exploring new discovery, even though this was a totally new area for them. It has been designed for an easy replication, thus students who learned can repeat the lessons themselves to other students. The ultimate purpose of this project is to have IT education offered as universally as possible throughout the whole Tanzania. Quality education for all children is a key for better future for all. Previously it was hoped that education with discipline will improve the active learning. But now more than ever, we believe that children have the ability to learn on their own with given proper STEM education tools, guidelines and environment. This gives promising hope to all of us, including those in the developing countries.

A study on Development Process of Fish Aquaculture in Japan - Case by Seabream Aquaculture - (일본 어류 양식업의 발전과정과 산지교체에 관한 연구 : 참돔양식업을 사례로)

  • 송정헌
    • The Journal of Fisheries Business Administration
    • /
    • v.34 no.2
    • /
    • pp.75-90
    • /
    • 2003
  • When we think of fundamental problems of the aquaculture industry, there are several strict conditions, and consequently the aquaculture industry is forced to change. Fish aquaculture has a structural supply surplus in production, aggravation of fishing grounds, stagnant low price due to recent recession, and drastic change of distribution circumstances. It is requested for us to initiate discussion on such issue as “how fish aquaculture establishes its status in the coastal fishery\ulcorner, will fish aquaculture grow in the future\ulcorner, and if so “how it will be restructured\ulcorner” The above issues can be observed in the mariculture of yellow tail, sea scallop and eel. But there have not been studied concerning seabream even though the production is over 30% of the total production of fish aquaculture in resent and it occupied an important status in the fish aquaculture. The objectives of this study is to forecast the future movement of sea bream aquaculture. The first goal of the study is to contribute to managerial and economic studies on the aquaculture industry. The second goal is to identify the factors influencing the competition between production areas and to identify the mechanisms involved. This study will examine the competitive power in individual producing area, its behavior, and its compulsory factors based on case study. Producing areas will be categorized according to following parameters : distance to market and availability of transportation, natural environment, the time of formation of producing areas (leaderㆍfollower), major production items, scale of business and producing areas, degree of organization in production and sales. As a factor in shaping the production area of sea bream aquaculture, natural conditions especially the water temperature is very important. Sea bream shows more active feeding and faster growth in areas located where the water temperature does not go below 13∼14$^{\circ}C$ during the winter. Also fish aquaculture is constrained by the transporting distance. Aquacultured yellowtail is a mass-produced and a mass-distributed item. It is sold a unit of cage and transported by ship. On the other hand, sea bream is sold in small amount in markets and transported by truck; so, the transportation cost is higher than yellow tail. Aquacultured sea bream has different product characteristics due to transport distance. We need to study live fish and fresh fish markets separately. Live fish was the original product form of aquacultured sea bream. Transportation of live fish has more constraints than the transportation of fresh fish. Death rate and distance are highly correlated. In addition, loading capacity of live fish is less than fresh fish. In the case of a 10 ton truck, live fish can only be loaded up to 1.5 tons. But, fresh fish which can be placed in a box can be loaded up to 5 to 6 tons. Because of this characteristics, live fish requires closer location to consumption area than fresh fish. In the consumption markets, the size of fresh fish is mainly 0.8 to 2kg.Live fish usually goes through auction, and quality is graded. Main purchaser comes from many small-sized restaurants, so a relatively small farmer and distributer can sell it. Aquacultured sea bream has been transacted as a fresh fish in GMS ,since 1993 when the price plummeted. Economies of scale works in case of fresh fish. The characteristics of fresh fish is as follows : As a large scale demander, General Merchandise Stores are the main purchasers of sea bream and the size of the fish is around 1.3kg. It mainly goes through negotiation. Aquacultured sea bream has been established as a representative food in General Merchandise Stores. GMS require stable and mass supply, consistent size, and low price. And Distribution of fresh fish is undertook by the large scale distributers, which can satisfy requirements of GMS. The market share in Tokyo Central Wholesale Market shows Mie Pref. is dominating in live fish. And Ehime Pref. is dominating in fresh fish. Ehime Pref. showed remarkable growth in 1990s. At present, the dealings of live fish is decreasing. However, the dealings of fresh fish is increasing in Tokyo Central Wholesale Market. The price of live fish is decreasing more than one of fresh fish. Even though Ehime Pref. has an ideal natural environment for sea bream aquaculture, its entry into sea bream aquaculture was late, because it was located at a further distance to consumers than the competing producing areas. However, Ehime Pref. became the number one producing areas through the sales of fresh fish in the 1990s. The production volume is almost 3 times the production volume of Mie Pref. which is the number two production area. More conversion from yellow tail aquaculture to sea bream aquaculture is taking place in Ehime Pref., because Kagosima Pref. has a better natural environment for yellow tail aquaculture. Transportation is worse than Mie Pref., but this region as a far-flung producing area makes up by increasing the business scale. Ehime Pref. increases the market share for fresh fish by creating demand from GMS. Ehime Pref. has developed market strategies such as a quick return at a small profit, a stable and mass supply and standardization in size. Ehime Pref. increases the market power by the capital of a large scale commission agent. Secondly Mie Pref. is close to markets and composed of small scale farmers. Mie Pref. switched to sea bream aquaculture early, because of the price decrease in aquacultured yellou tail and natural environmental problems. Mie Pref. had not changed until 1993 when the price of the sea bream plummeted. Because it had better natural environment and transportation. Mie Pref. has a suitable water temperature range required for sea bream aquaculture. However, the price of live sea bream continued to decline due to excessive production and economic recession. As a consequence, small scale farmers are faced with a market price below the average production cost in 1993. In such kind of situation, the small-sized and inefficient manager in Mie Pref. was obliged to withdraw from sea bream aquaculture. Kumamoto Pref. is located further from market sites and has an unsuitable nature environmental condition required for sea bream aquaculture. Although Kumamoto Pref. is trying to convert to the puffer fish aquaculture which requires different rearing techniques, aquaculture technique for puffer fish is not established yet.

  • PDF

An Analysis of Determinants of Health Knowledge, Attitude and Practice of Housewives in Korea (한국부인의 보건지식, 태도 및 실천에 영향을 미치는 제요인분석)

  • 남철현
    • Korean Journal of Health Education and Promotion
    • /
    • v.2 no.1
    • /
    • pp.3-50
    • /
    • 1984
  • The levels of health knowledge, attitude and practice of housewives considerably effect to the health of households, communities and the nation. This study was designed to grasp the levels of health knowledge, attitude and practice of houswives and analyse the various factors effecting to health in order to provide health education services as well as materials for effective formulation and implementation of health policy to improve the health of the nation. This study has been conducted through interviews by trained surveyers for 4,281 housewives selected from 4,500 households throughout the country for 40 days during July 11-August 20, 1983. The results of survey were analysed by stepwise multiple regression and path analysis are summarized as follows; 1. Based on the measurement instrument applied to this study, the levels of health knowledge, attitude and practice of housewives were extremely low with 54.5 points out of 100 points in full. Higher level with 72 points and above was approximately 21 percent and lower level with 39 points and below was approx. 24 percent. The middle level was approx. 55 percent. In order to implement health programs successively, health education should be more strengthened and to improve the level of health knowledge, attitude and practice (KAP) of the nation, political consideration as a part of spiritual reformation must be concentrated on health. 2. The level of health knowledge indicated the highest points with 57.3 the level of attitude was the second with 55.0 points and the practice level was the lowest with 50.0 point. Therefore, planning and implementation of health education program must be based on the persuasion and motivation that health knowledge turn into practice. 3. Housewives who had higher level of health knowledge, showed their practice level was relatively lower and those who had middle or low level of it practice level was the reverse. 4. Correlations among health knowledge, attitude and practice (KAP) were generally higher and statistically significant at 0.1 percent level. Correlation between total health KAP level and health knowledge was the highest with r=.8092. 5. Health KAP levels showed significant differences according to the age, number of children, marital status, self-assessed health status and concern on health of the housewives interviewed (p<0.001) 6. Health KAP levels also showed significant differences according to the education level, economic status, employment before marriage and grown-up area of the housewives interviewed. (p<0.001) 7. Heath KAP levels showed significant differences according to health insurance benificiary and the existence of patients in the family. (p<0.001). 8. Health KAP levels showed significant differences according to distance to government organizations, schools, distance to health facilities, telephone possession rate, television possession rate, newspaper reading rate and activities of Ban meeting and Women's club. (p<0.001) 9. Health KAP levels showed significant differences according to electric mass communication media such as television, radio and village broadcasting etc. and printed media such as newspaper, magazine and booklets etc., IEC variables such as individual consultation and husband-wife communication, however, there was no significance with group training. 10. Health KAP of the housewives showed close correlation with personal characteristics variables, i.e., education level (r=.5302), age (r=-.3694) grown-up area (r=.3357) and employment before marriage. In general, correlation of health knowledge level was higher than the levels of attitude or practice. In case of health concern and health insurance, correlation of practice level was higher than health knowledge level. 11. Health KAP levels showed higher correlation with community environmental characteristics, Ban meeting and activity of Women's club, however, no correlation with New-village movement. 12. Among IEC variables, husband-wife communication showed the highest correlation with health KAP levels and printed media, electric mas communication media and health consultation in order. Therefore, encouragement of husband-wife communication and development of training program for men should be included in health education program. 13. Mass media such as electric mass com. and printed media were effective for knowledge transmission and husband-wife communication and individual consultation were effective for health practice. Group training was significant for knowledge transmission, however, but not significant for attitude formation or turning to health practice. To improve health KAP levels, health knowledge should be transmitted via mass media and health consultation with health professionals and field health workers should be strengthened. 14. Correlation of health KAP levels showed that knowledge level was generally higher than that of practice and recognized that knowledge was not linked with attitude or practice. 15. The twenty-five variables effecting health KAP levels of housewives had 41 per cent explanation variances among which education level had great contribution (β=.2309) and electric mass com. media (β=.1778), husband-wife communication (β=.1482), printed media, grown-up area, and distance to government organizations in order. Variances explained (R²) of health KAP were 31%, 15%, and 30% respectively. 16. Principal variables contributed to health KAP were education level (β=.12320, β=.1465), electric mass comm. media (β=.1762, β=.1839), printed media, (β=.1383, β=.1420) husband-wife communication (β=.1004, β=.1067), grown-up area and distance to government organizations, in order. Since education level contributes greatly to health KAP of the housewives, health education including curriculum development in primary, middle and high schools must be emphasized and health science must be selected as one of the basic liberal arts subject in universities. 17. Variences explained of IEC variables to health KAP were 19% in total, 14% in knowledge, 9% in attitude, and 10% in health practice. Contributions of IEC variables to health KAP levels were printed media (β=.3882), electric mass comm media (β=.3165), husb-band wife com. (β=.2095,) and consultation on health (β=.0841) in order, however, group training showed negative effect (β=-.0402). National fund must be invested for the development of Health Program through mass media such as TV and radio etc. and for printed materials such as newspaper, magazines, phamplet etc. needed for transmission of health knowledge. 18. Variables contributed to health KAP levels through IEC variables with indirect effects were education level (Ind E=0.0410), health concern (Ind E=.0161), newspaper reading rate (Ind E=.0137), TV possession rate and activity of Ban meeting in order, however, health facility showed negative effect (Ind E=-.0232) and other variables showed direct effect but not indirect effect. 19. Among the variables effecting health KAP level, education level showed the highest in total effect (TE=.2693) then IEC (TE=.1972), grown-up city (TE=.1237), newspaper reading rate (TE=.1020), distance to government organization (TE=.095) in order. 20. Variables indicating indirect effects to health KAP levels were; at knowledge level with R²=30%, education level (Ind E=.0344), newspaper reading rate (Ind E=.0112), TV possession rate (Ind E=.0689), activity of Ban meeting (Ind E=.0079) in order and at attitude level with R²=13%, education level (Ind E=. 0338), activity of Ban meeting (Ind E=.0079), and at practice level with R²=29%. education level (Ind E=.0268), health facility (Ind E=.0830) and concern on health (Ind E=.0105). 21. Total effect to health KAP levels and IEC by variable characteristics, personal characteristics variables indicated larger than community characteristics variables. 22. Multiple Correlation Coefficient (MCC) expressed by the Personal Characteristic Variable was .5049 and explained approximately 25% of variances. MCC expressed by total Community environment variable was .4283 and explained approx. 18% of variances. MCC expressed by IEC Variables was .4380 and explained approx. 19% of variances. The most important variable effected to health KAP levels was personal characteristic and then IEC variable, Community Environment variable in order. When the IEC effected with personal characteristic or community characteristic, the MCC or the variances were relatively higher than effecting alone. Therefore it was identified that the IEC was one of the important intermediate variable.

  • PDF

Clinical Outcome after Breast Conserving Surgery and Radiation Therapy for Early Breast Cancer (초기 유방암의 유방 보존수술 후 방사선 치료 결과)

  • Cho, Heung-Lae;Kim, Cheol-Jin;Park, Sung-Kwang;Oh, Min-Kyung;Lee, Jin-Yong;Ahn, Ki-Jung
    • Radiation Oncology Journal
    • /
    • v.26 no.4
    • /
    • pp.204-212
    • /
    • 2008
  • Purpose: This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range $43.8{\sim}129.4$ months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for T is and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had $1{\sim}3$ lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close (${\leq}2\;mm$) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy ($41.4{\sim}60.4\;Gy$) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0.0001) and higher relapse rates (p=0.0507). However, patients with close margins were at equal risk of relapse and disease-free survival as with negative margins (p=1.000). Patients younger than 40 years of age had higher relapse rates (9.3% vs. 0%) and lower disease-free survival periods, but the difference was not statistically significant (p=0.1255). The relapse rates for patients with tumors was 14% for tumor stage T2, compared to 0% for tumor stage T1 tumors (p=0.0284). A univariate analysis found that disease-free survival and relapse rates, T stage, positive resection margin and mutation of p53 were significant factors for clinical outcome. Conclusion: The results of this study have shown that breast conservation surgery and radiation therapy in early breast cancer patients has proven to be a safe treatment modality with a low relapse rate and high disease-free survival rate. The patients with a positive margin, T2 stage, and mutation of p53 are associated with statistically higher relapse rates and lower disease-free survival.

Aesthetics of Samjae and Inequilateral Triangle Found in Ancient Triad of Buddha Carved on Rock - Centering on Formative Characteristics of Triad of Buddha Carved on Rock in Seosan - (고대(古代) 마애삼존불(磨崖三尊佛)에서 찾는 삼재(三才)와 부등변삼각(不等邊三角)의 미학(美學) - 서산마애삼존불의 형식미를 중심으로 -)

  • Rho, Jae-Hyun;Lee, Kyu-Wan;Jang, Il-Young;Goh, Yeo-Bin
    • Journal of the Korean Institute of Traditional Landscape Architecture
    • /
    • v.28 no.3
    • /
    • pp.72-84
    • /
    • 2010
  • This study was attempted in order to offer basic data for implementing and applying Samjonseokjo(三尊石造), which is one of traditional stone construction method, by confirming how the constructive principle is expressed such as proportional beauty, which is contained in the modeling of Triad of Buddha Carved on Rock that was formed in the period of the Three States, centering on Triad of Buddha Carved on Rock in Susan. The summarized findings are as follows. 1. As a result of analyzing size and proportion of totally 17 of Triad of Buddha Carved on Rock, the average total height in Bonjonbul(本尊佛) was 2.96m. Right Hyeopsi(右挾侍) was 2.19m. Left Hyeopsi(左挾侍) was 2.16m. The height ratio according to this was 100:75:75, thereby having shown the relationship of left-right symmetrical balance. The area ratio in left-right Hyeopsi was 13.4:13.7, thereby the two area having been evenly matched. 2. The Triad of Buddha Carved on Rock in Seosan is carved on Inam(印岩) rock after crossing over Sambulgyo bridge of the Yonghyeon valley. Left direction was measured with $S47^{\circ}E$ in an angle of direction. This is judged to target an image change and an aesthetic sense in a Buddhist statue according to direction of sunlight while blocking worshipers' dazzling. 3. As for iconic characteristics of Buddha Carved on Rock in Seosan, there is even Hyeopsi in Bangasang(半跏像) and Bongjiboju(捧持寶珠) type Bosangipsang. In the face of Samjon composition in left-right asymmetry, the unification is indicated while the same line and shape are repeated. Thus, the stably visual balance is being shown. 4. In case of Triad of Buddha Carved on Rock in Seosan, total height in Bonjonbul, left Hyeopsi, and right Hyeopsi was 2.80m, 1.66m, and 1.70m, respectively. Height ratio in left-right Hyeopsibul was 0.60:0.62, thereby having been almost equal. On the other hand, the area ratio was 28.8:25.2, thereby having shown bigger difference. The area ratio on a plane was grasped to come closer to Samjae aesthetic proportion. 5. The axial angle of centering on Gwangbae was 84:46:50, thereby having been close to right angle. On the other hand, the axial angle ratio of centering on Yeonhwajwa(蓮華坐: lotus position) was measured to be 135:25:20, thereby having shown the form of inequilateral triangle close to obtuse angle. Accordingly, the upper part and the lower part of Triad of Buddha Carved on Rock in Susan are taking the stably proportional sense in the middle of maintaining the corresponding relationship through angular proportion of inequilateral triangle in right angle and obtuse angle. 6. The distance ratio in the upper half was 0.51:0.36:0.38. On the other hand, the distance ratio in the lower half was 0.53 : 0.33 : 0.27. Thus, the up-down and left-right symmetrical balance is being formed while showing the image closer to inequilateral triangle. 7. As a result of examining relationship of Samjae-mi(三才美) targeting Triad of Buddha Carved on Rock in Susan, the angular ratio was shown to be more notable that forms the area ratio or triangular form rather than length ratio. The inequilateral triangle, which is formed centering on Gwangbae(光背) in the upper part and Yeonhwajwa(lotus position) in the lower part, is becoming very importantly internal motive of doubling the constructive beauty among Samjae, no less than the mutually height and area ratio in Samjonbul.

Prognostic Relevance of WHO Classification and Masaoka Stage in Thymoma (흉선종양에서의 WHO 분류와 Masaoka 병기, 임상양상간의 상관관계연구)

  • Kang Seong Sik;Chun Mi Sun;Kim Yong Hee;Park Seung Il;Eeom Dae W.;Ro Jaee Y.;Kim Dong Kwan
    • Journal of Chest Surgery
    • /
    • v.38 no.1 s.246
    • /
    • pp.44-49
    • /
    • 2005
  • Although thymomas are relatively common mediastinal tumors, to date not only has a universal system of pathologic classification not been established but neither has a clearly defined predictable relationship between treatment and prognosis been made. Recently, a new guideline for classification was reported by WHO, and efforts, based on this work, have been made to better define the relationship between treatment and pro­gnostic outcome. In the present study a comparative analysis between the WHO classification and Masaoka stage system with the clinical disease pattern was conducted. Material and Method: A total of 98 patients undergoing complete resection for mediastinal thymoma between Juanuary 1993 and June 2003 were included in the present study. The male female ratio was 48 : 50 and the mean age at operation was $49.6{\pm}13.9\;years.$ A retrospective analytic comparison studying the relationship between the WHO classification and the Masaoka stage system with the clinical disease pattern of thymoma was conducted. Pathologic slide specimens were carefully examined, details of postoperative treatment were documented, and a relationship with the prognostic outcome and recurrence was studied. Result: There were 7 patients in type A according to the WHO system of classification, 14 in AB, 28 in B 1, 23 in B2, 18 in B3, and 9 in type C. The study of the relationship between the Masaoka stage and WHO classification system showed 4 patients to be in WHO system type A, 7 in type AB, 22 in B 1, 17 in B2, and 3 in type B3 among 53 $(54{\%})$ patients shown to be in Masaoka stage I. Among 28 $(28.5{\%})$ patients in Masaoka stage II system, there were 2 patients in type A, 7 in AB, 4 in B 1, 2 in B2, 8 in B3, and 5 in type C. Among 15 $(15.3{\%})$ in Masaoka stage III, there were 1 patient in type B1, 3 in B2, 7 in B3, and 4 in type C. Finally, among 2 $(2{\%})$ patients found to be in Masaoka stage IV there was 1 patient in type B1, and 1 in type B2. The mean follow up duration was $28{\pm}6.8$ months. There were 3 deaths in the entire series of which 2 were in type B2 (Masaoka stages III and IV), and 1 was in type C (Masaoka stage II). Of the patients that experienced relapse, 6 patients remain alive of which 2 were in type B2 (Masaoka III), 2 in type B3 (Masaoka I and III) and 2 in type C (Masaoka stage II). The 5 year survival rate by the Kaplan-Meier method was $90{\%}$ for those in type B2 WHO classification system, $87.5{\%}$ for type C. The 5 year freedom from recurrence rate was $80.7{\%}$ for those in WHO type B2, $81.6{\%}$ for those in type B3, and $50{\%}$ for those in type C. By the Log-Rank method, a statistically significant correlation between survival and recurrence was found with the WHO system of classification (p<0.05). An analysis of the relationship between the WHO classification and Masaoka stage system using the Spearman correction method, showed a slope=0.401 (p=0.023), showing a close correlation. Conclusion: As type C of the WHO classification system is associated with a high postoperative mortality and recurrence rate, aggressive treatment postoperatively and meticulous follow up are warranted. The WHO classification and Masaoka stage system were found to have a close relationship with each other and either the WHO classification method or the Masaoka stage system may be used as a predict prognostic outcome of Thymoma.

Clinical Experiences for Cardiac Myxomas (심장 점액종의 임상적 고찰)

  • Lee, Geun-Dong;Lee, Jae-Won;Jung, Jae-Seung;Jung, Sung-Ho;Je, Hyoung-Gon;Choo, Suk-Jung;Song, Hyun;Chung, Cheol-Hyun
    • Journal of Chest Surgery
    • /
    • v.41 no.6
    • /
    • pp.703-709
    • /
    • 2008
  • Background: Diagnosis and treatment are often successful in the setting of cardiac myxomas. However, cardiac myxomas can lead to catastrophic complications, due to intracardiac obstruction and embolism preoperatively, and can recur postoperatively. Material and Method: We retrospectively reviewed the clinical characteristics, surgical treatment, and recurrence data of 85 patients who underwent cardiac myxoma surgery at Asan Medical Center between November 1994 and June 2007. We analyzed the morphologic characteristics of 58 patients with left atrial myxomas and determined the development of functional mitral valve stenosis and systemic embolism through reviewing the results of preoperative echo-cardiograms to find potential preoperative risk factors. Result: Twenty-seven (31.8%) patients were men, and 58 (68.2%) were women. The mean patient age was $54.5{\pm}14.3$ years. Preoperative symptoms included obstructive symptoms in 41 (48.2%) patients, signs of embolism in 19 (22.4%), constitutional symptoms in 8 (9.4%), and no symptoms in 19 (20.0%). Among the 58 patients with left atrial myxomas, the mean maximal tumor diameter was $4.3{\pm}1.8$ (range $1.1{\sim}8\;cm$)cm. Twenty-six (44.8%) patients had a prolapsing type, defined as a tumor mobile enough to move down. to the mitral. annular plane during diastole, and 32 (55.2%) had villous type, defined as a tumor consisting of multiple fine villous extensions on the surface. Twelve (20.7%) patients had severe functional mitral valve stenosis, and 15 (25.9%) had systemic embolism preoperatively. The incidence of severe functional mitral valve stenosis was significantly higher in patients with the prolapsing type than in those with the non-prolapsing type (p=0.001). The mean maximal tumor diameter in patients with severe functional mitral valve stenosis was $5.1{\pm}1.0\;cm$, significantly larger than that seen in patients without severe functional mitral valve stenosis (p=0.041). The incidence of systemic embolism was significantly higher in patients with the villous type than in those with the smooth type (p=0.006). Postoperative complications were noted in 6 (7.1%) patients, and early mortality was noted in 1 (1.2%). The mean postoperative follow-up duration was $36.2{\pm}37.5$ months, with recurrence reported in 2(2.4%) patients during the follow-up period. The disease free interval were 48, 12 months, respectively. Conclusion: Surgical treatment for cardiac myxomas was performed safely, and long-term prognosis was good. In patients with left atrial myxoma, close attention should be maintained and surgery should be performed promptly in those of prolapsing type, those with large maximal diameter in order to prevent severe functional mitral valve stenosis, and those of villous type in order to prevent systemic embolism. Echocardiography should be followed serially in order to detect recurrence.

Postoperative Radiation Therapy in the Soft-tissue Sarcoma (연부 조직 육종의 수술 후 방사선 치료 결과)

  • Kim Yeon Shil;Jang Hong Seok;Yoon Sei Chul;Ryu Mi Ryeong;Kay Chul Seung;Chung Su Mi;Kim Hoon Kyo;Kang Yong Koo
    • Radiation Oncology Journal
    • /
    • v.16 no.4
    • /
    • pp.485-495
    • /
    • 1998
  • Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 50 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patients with median follow up duration 50 months (range 6-162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58$\%$) was the most frequent site of occurrence followed by trunk (20$\%$) and head and neck (12$\%$). Histologically malignant fibrous histiocytoma (23$\%$), liposarcoma (17$\%$), malignant schwannoma (12$\%$) constitute 52$\%$ of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42$\%$) received chemotherapy with various regimen in the postoperative period. Results : Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48$\%$) of local recurrence. Four patients (7$\%$) developed simultaneous local recurrence and distant metastasis and 8 patients (13$\%$) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck Primary This feature is likely explanation for the decreased local control rate. Five of 29 Patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 $\%$, 30.6$\%$ respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

  • PDF

A Brief Review of Backgrounds behind "Multi-Purpose Performance Halls" in South Korea (우리나라 다목적 공연장의 탄생배경에 관한 소고)

  • Kim, Kyoung-A
    • (The) Research of the performance art and culture
    • /
    • no.41
    • /
    • pp.5-38
    • /
    • 2020
  • The current state of performance halls in South Korea is closely related to the performance art and culture of the nation as the culture of putting on and enjoying a performance is deeply rooted in public culture and arts halls representing each area at the local government level. Today, public culture and arts halls have multiple management purposes, and the subjects of their management are in the public domain including the central and local governments or investment and donation foundations in overwhelming cases. Public culture and arts halls thus have close correlations with the institutional aspect of cultural policies as the objects of culture and art policies at the central and local government level. The full-blown era of public culture and arts halls opened up in the 1980s~1990s, during which multi-purpose performance halls of a similar structure became universal around the nation. Public culture and arts halls of the uniform shape were distributed around the nation with no premise of genre characteristics or local environments for arts, and this was attributed to the cultural policies of the military regime. The Park Chung-hee regime proclaimed Yusin that was beyond the Constitution and enacted the Culture and Arts Promotion Act(September, 1972), which was the first culture and arts act in the nation. Based on the act, a five-year plan for the promotion of culture and arts(1973) was made and led to the construction of cultural facilities. "Public culture and arts" halls or "culture" halls were built to serve multiple purposes around the nation because the Culture and Arts Promotion Act, which is called the starting point of the nation's legal system for culture and arts, defined "culture and arts" as "matters regarding literature, art, music, entertainment, and publications." The definition became a ground for the current "multi-purpose" concept. The organization of Ministry of Culture and Public Information set up a culture and administration system to state its supervision of "culture and arts" and distinguish popular culture from the promotion of arts. During the period, former President Park exhibited his perception of "culture=arts=culture and arts" in his speeches. Arts belonged to the category of culture, but it was considered as "culture and arts." There was no department devoted to arts policies when the act was enacted with a broad scope of culture accepted. This ambiguity worked as a mechanism to mobilize arts in ideological utilizations as a policy. Against this backdrop, the Sejong Center for the Performing Arts, a multi-purpose performance hall, was established in 1978 based on the Culture and Arts Promotion Act under the supervision of Ministry of Culture and Public Information. There were, however, conflicts of value over the issue of accepting the popular music among the "culture and arts = multiple purposes" of the system, "culture ≠ arts" of the cultural organization that pushed forward its establishment, and "culture and arts = arts" perceived by the powerful class. The new military regime seized power after Coup d'état of December 12, 1979 and failed at its culture policy of bringing the resistance force within the system. It tried to differentiate itself from the Park regime by converting the perception into "expansion of opportunities for the people to enjoy culture" to gain people's supports both from the side of resistance and that of support. For the Chun Doo-hwan regime, differentiating itself from the previous regime was to secure legitimacy. Expansion of opportunities to enjoy culture was pushed forward at the level of national distribution. This approach thus failed to settle down as a long-term policy of arts development, and the military regime tried to secure its legitimacy through the symbolism of hardware. During the period, the institutional ground for public culture and arts halls was based on the definition of "culture and arts" in the Culture and Arts Promotion Act enacted under the Yusin system of the Park regime. The "multi-purpose" concept, which was the management goal of public performance halls, was born based on this. In this context of the times, proscenium performance halls of a similar structure and public culture and arts halls with a similar management goal were established around the nation, leading to today's performance art and culture in the nation.