• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4603-4608
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• 2015

Background: To determine the potential value of serum tumor markers in predicting pCR (pathological complete response) during neoadjuvant chemotherapy. Materials and Methods: We retrospectively monitored the pro-, mid-, and post-neoadjuvant treatment serum tumor marker concentrations in patients with locally advanced breast cancer (stage II-III) who accepted pre-surgical chemotherapy or chemotherapy in combination with targeted therapy at Fudan University Shanghai Cancer Center between September 2011 and January 2014 and investigated the association of serum tumor marker levels with therapeutic effect. Core needle biopsy samples were assessed using immunohistochemistry (IHC) prior to neoadjuvant treatment to determine hormone receptor, human epidermal growth factor receptor 2(HER2), and proliferation index Ki67 values. In our study, therapeutic response was evaluated by pCR, defined as the disappearance of all invasive cancer cells from excised tissue (including primary lesion and axillary lymph nodes) after completion of chemotherapy. Analysis of variance of repeated measures and receiver operating characteristic (ROC) curves were employed for statistical analysis of the data. Results: A total of 348 patients were recruited in our study after excluding patients with incomplete clinical information. Of these, 106 patients were observed to have acquired pCR status after treatment completion, accounting for approximately 30.5% of study individuals. In addition, 147patients were determined to be Her-2 positive, among whom the pCR rate was 45.6% (69 patients). General linear model analysis (repeated measures analysis of variance) showed that the concentration of cancer antigen (CA) 15-3 increased after neoadjuvant chemotherapy in both pCR and non-pCR groups, and that there were significant differences between the two groups (P=0.008). The areas under the ROC curves (AUCs) of pre-, mid-, and post-treatment CA15-3 concentrations demonstrated low-level predictive value (AUC=0.594, 0.644, 0.621, respectively). No significant differences in carcinoembryonic antigen (CEA) or CA12-5 serum levels were observed between the pCR and non-pCR groups (P=0.196 and 0.693, respectively). No efficient AUC of CEA or CA12-5 concentrations were observed to predict patient response toward neoadjuvant treatment (both less than 0.7), nor were differences between the two groups observed at different time points. We then analyzed the Her-2 positive subset of our cohort. Significant differences in CEA concentrations were identified between the pCR and non-pCR groups (P=0.039), but not in CA15-3 or CA12-5 levels (p=0.092 and 0.89, respectively). None of the ROC curves showed underlying prognostic value, as the AUCs of these three markers were less than 0.7. The ROC-AUCs for the CA12-5 concentrations of inter-and post-neoadjuvant chemotherapy in the estrogen receptor negative HER2 positive subgroup were 0.735 and 0.767, respectively. However, the specificity and sensitivity values were at odds with each other which meant that improving either the sensitivity or specificity would impair the efficiency of the other. Conclusions: Serum tumor markers CA15-3, CA12-5, and CEA might have little clinical significance in predicting neoadjuvant treatment response in locally advanced breast cancer.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.76-83
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• 1995

Background: Despite advances in chemotherapy, the treatment of inoperable non-small cell carcinoma of the lung remains poor. According to the recent reports, the response rates of mitomycin, vinblastine, and cisplatin(MVP) chemotherapy are higher than those of other cisplatin based polychemotherapy and MVP chemotherapy can be used as neoadjuvant chemotherapeutic regimen. But the overall response rates of MVP chemotherapy range from 17 to 53 percent, so we studied the effect of MVP chemotherapy in advanced non-small cell lung cancer. Method: We treated forty patients with stage III or IV non-small cell lung cancer with two courses of MVP chemotherapy($8mg/m^2$ of mitomycin on day 1, $6mg/m^2$ of vinblastine on day 2 & day 14, and $100mg/m^2$ of cisplastin on day 1) at 4 weeks interval. Then all patients were evaluated the response of chemotherapy 4 weeks later, and received further chemotherapy, palliative radiotherapy or supportive therapy according to the patient's condition. We also determined the median survival time and prognostic factors. Results: 1) Nine patients(23%) had a partial reponse, 23 patients(57%) had a stable disease, and disease progressed in 8 patients(20%). There were no patients with complete response. 2) The overall median survival time was 36 weeks(range, 9 to 119+ weeks). The median survival time of responder(partial response) and non-responder(stable and progressed) groups were 60 weeks(range, 36 to 82+ weeks) and 31 weeks(range, 9 to 119+ weeks) respectively(p=0.03). 3) The median survival time of the female group was 71 weeks and significantly prolonged in comparision with 35 weeks of the male group(p=0.01). But, the other prognostic factors didn't affect the survival time and response rate. 4) The median survival times of chemotherapy group and chemotherapy with palliative radiotherapy group were not significantly different. Conclusion: MVP combined chemotherapy is unsatisfactory in improving survival in advanced non-small cell lung cancer. Therefore, further studies are needed to find more active new agents and to estabilish the efficacy of the combined treatment with radiotherapy and/or surgery.

• Journal of Korean Academy of Nursing
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• v.4 no.1
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• pp.1-21
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• 1974

A considerable change of the Korean nursing system has been made during the last decade not only in its philosophy but also in its function and structure to meet political and scientific need of the modern society. The main purpose of this study is to develope the new concept of comprehensive nursing care, both its Philosophy and ethics, as the basic of modern clinical nursing theory and practice. Comprehensive nursing care is the concept of human centered nursing care, and it helps a man to meet the basic physical, psychological, environmental, socioeconomic and teaching needs. It also helps him to help himself to meet these needs. This concept starts from the individualized nursing care and its ultimate goal is to improve a man to have a better position in his own community so that he may able to have a meaningful life. To accomplish this goal, an individualized nursing care plan as a nursing diagnosis and problem solving method should be set up for different patients with similar diagnosis to meet their needs, because each patient has a different social background. from this viewpoint, nursing is a science as well as abstruse humanity. The performance of comprehensive nursing care is a goal and issue of modern clinical nursing care. If nursing is a science and a profession for man, it should have ethics which recognize the dignity of man and offers infinite service voluntarily, and should be able to show leadership in carrying out the nursing responsibility. This leadership finds a person's potential and encourages him to utilize it. Such concepts should develop into a nursing ideology and this ideology should become a priority in comprehensive nursing care. The following statements are the conclusion of this study. 1) Modern nursing has been developed from disease centered nursing care to comprehensive nursing care based on humanity. The primary principle of nursing was to assist in the treatment of disease, but it has been changed to the professional nursing system independently. 2) The concept of nursing is one of continuous or endless scope of dispersion. It proves that nursing is grasping the professional responsibility to be able to coordinate scientific principles Patient health problems are according to scientific principles rather than adhering to nursing technical discipline as a daily work. 3) In chapter I and Ⅱ, the philosophy and ideology of nursing have been discussed and the flow of concept of clinical nursing and the rate of progress which emerges from naturalizing performance of the concept of comprehensive nursing in clinical nursing studied. The discussion developed the theory that a nurse should be to embody nursing ideas and objectives by establishing definite conviction of professions and study. 4) In chapter lil, nursing planning based on nursing diagnosis as a method to attain ideal nursing care for humanity with a definite idea of establishing philosophy of nursing was presented. 5) From the result of survey on patient needs about treatment and nursing, it was observed that all patient had emotional stress from unknown factors. Therefore it was concluded that nurses should not only educate the patient but also give them the opportunity to communicate freely their needs and anxieties. Furthermore complaints and doubts of the patient should be carefully noted and must be considered to meet these needs. 6) Patient teaching is the most important part of comprehensive nursing care. In chapter, Ⅲ, the important of patient teaching was emphasized by demonstrating the effect of patient teaching for diabetic patient. 7) In Chapter Ⅳ, from the result of the study on nurses attitudes to comprehensive nursing care, it was pointed that the evolution of nursing education and the establishment of a complete concept and value of comprehensive nursing was necessary.

• KDI Journal of Economic Policy
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• v.13 no.2
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• pp.97-127
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• 1991

This paper investigates the roles and the limitations of the Korean antitrust agencies-the Office of Fair Trade (OFT) and the Fair Trade Commission (FTC) during the making of the major industrial policies of the 1980's. The Korean antitrust agencies played only a minimal role in three major industrial policy-making issues in the 1980's- the enactment of the Industrial Development Act (IDA), the Industrial Rationalization Measures according to the IDA, and the Industrial Readjustment Measures on Consolidation of Large Insolvent Enterprises based on the revised Tax Exemption and Reduction Control Act. As causes for this performance bias in the Korean antitrust system, this paper considers five factors according to the current literature on implementation failure: ambiguous and insufficient statutory provisions of the Monopoly Regulation and Fair Trade Act (MRFTA); lack of resources; biased attitudes and motivations of the staff of the OFT and the FTC; bureaucratic incapability; and widespread misunderstanding about the roles and functions of the antitrust system in Korea. Among these five factors, bureaucratic incompetence and lack of understanding in various policy implementation environments about the roles and functions of the antitrust system have been regarded as the most important ones. Most staff members did not have enough educational training during their school years to engage in antitrust and fair trade policy-making. Furthermore, the high rate of staff turnover due to a mandatory personnel transfer system has prohibited the accumulation of knowledge and skills required for pursuing complicated structural antitrust enforcement. The limited capability of the OFT has put the agency in a disadvantaged position in negotiating with other economic ministries. The OFT has not provided plausible counter-arguments based on sound economic theories against other economic ministries' intensive market interventions in the name of rationalization and readjustment of industries. If the staff members of antitrust agencies have lacked substantive understanding of the antitrust and fair trade policy, the rest of government agencies must have had serious problems in understanding the correst roles and functions of the antitrust system. The policy environment of the Korean antitrust system, including other economic ministries, the Deputy Prime Minister, and President Chun, have tended to conceptualize the OFT more as an agency aiming only at fair trade policy and less as an agency that should enforce structural monopoly regulation as well. Based on this assessment of the performance of the Korean antitrust system, this paper evaluate current reform proposals for the MRFT A. The inclusion of the regulation of conglomerate mergers and of business divestiture orders may be a desirable revision, giving the MRFTA more complete provisions. However, given deficient staff experties and the unfavorable policy environments, it would be too optimistic and naive to expect that the inclusion of these provisions alone could improve the performance of the Korean antitrust system. In its conclusion, this paper suggests several policy recommendations for the Korean antitrust system, which would secure the stable development and accumulation of antitrust expertise for its staff members and enough understanding and conformity from its environments about its antitrust goals and functions.

• Parasites, Hosts and Diseases
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• v.28 no.3
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• pp.183-194
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• 1990

In an attempt to develop prophylactic and therapeutic measures of the intestinal giant-cystic disease caused by Thelohanellus kitauei in the Israel carp, Cyprinus carpio nodus, pathological observations were conducted upon the carps which were hatched in May 1988 and raised in a net cage fish farm at the Soyang lake, managed by Horim Fisheries for the period of 21 months with 1~2 months interval. After a gross inspection of the carps, necropsy was carried out periodically in order to clarify the pathological changes in various internal organs and muscular tissues. Also. the prevalence of the disease was checked during the period from 1988 to 1990. Gross inspections revealed that the infected carps showed some degree of fading in body and gill color, back-emaciation symptoms, reddish anus accompanying erosion and relaxation and pot-belly, as well as discharge of yellowish white mucoid material from the anus. However, most carps died eventually of intestinal obstruction. Other significant necropsy fadings included cyst formation of various size in the intestinal mucosa, ascites, anemic condition through internal organs and muscular tissues, hyperemia and dilation of intestines with decreased tension, thinness and fragility, and full contents of semi-fluid or yellowish white mucoid material in the intestinal canals. Based on the morphological characteristics of the spores found in the cysts, parasitic location in the intestines, macro- and microscopic findings of the lesions, the parasites were identised as Thelohanellus kitauei Egusa os Nakajima, 1981. Although monthly changes of water temperature were distinct, the extrusion rates of the polar filaments of the spores stayed constant throughout the year with an exception of a lower rate in July, The lesions initiated from mucosa and submucosa in early July became large swellings and then complete mature (orms following the peracute course. From late August the upper cysts were gradually opened and most of the spores were dispersed from anus into the surrounding water through December but only a few lasted until next April. The cysts were completely recovered until next September. Comparing the incidence and prevalence of the disease by year tremendous infection and death rates were checked in the first prevalent year, 1988, but the rates were significantly decreased in the second year, and showed an almost normal status in the third year, 1990. As the above summarized results showed, the disease entity might come to an end in three years after the first prevalent year, however, the spores must be strictly prevented because they could be infective in the water for one year.

• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.156-168
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• 2010

Purpose : To compare immunogenicity and reactogenicity of a combined diphtheria-tetanus-acellular pertussis-inactivated poliovirus vaccine (DTPa-IPV, $Infanrix^{TM}$ IPV, GlaxoSmithKline Biologicals) with co-administration of commercially available DTPa and IPV vaccines at separate injection sites (DTPa+IPV). Methods : A total of 458 infants aged 8-12 weeks were randomized to receive three-ose primary vaccination at 2, 4 and 6 months with DTPa-IPV or DTPa+IPV. Blood samples were collected pre and post vaccination for measurement of immune responses. Reactogenicity was assessed following each dose using diary cards. Results : One month post-dose 3, seroprotection rates for anti-diphtheria, anti-tetanus and anti-poliovirus types 1, 2 and 3 were ${\geq}99.5%$ and vaccine response rates to pertussis antigens were at least 98.6% in both DTPa-IPV and DTPa + IPV groups. Non-inferiority between the groups was demonstrated based on pre-defined statistical criteria. Incidences of both local and systemic symptoms were within the same range across both groups with grade 3 symptoms reported following no more than 4.3% of DTPa-IPV doses and 4.5% of DTPa + IPV doses. Two serious adverse events (both pyrexia) after DTPa-IPV administration were considered vaccine-related. Both infants recovered fully. Conclusion : Combined DTPa-IPV vaccine was immunogenic and well tolerated when used as a three-dose primary vaccination course in Korean infants. DTPa-IPV could be incorporated into the Korean vaccination schedule, reducing the number of injections required to complete primary immunization.

• Pediatric Infection and Vaccine
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• v.15 no.2
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• pp.180-187
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• 2008

Purpose : We wanted to determine the characteristics of patients with Kawasaki disease (KD) who were unresponsive to intravenous immunoglobulin (IVIG). Methods : The patients with KD were divided into two groups: the IVIG responsive group (25 cases) and the IVIG unresponsive group (14 cases). We analyzed various parameters before and after the administration of IVIG, including the complete blood cell count with the differential count (%), the erythrocyte segmentation rate (ESR), the C-reactive protein (CRP) level and the protein and lipid profiles. Results : The IVIG unresponsive group had a prolonged duration of fever and a higher incidence of CAL compared to the IVIG responsive group (P<0.001, respectively). Before IVIG infusion, the neutrophil differential, the ESR and the CRP values were higher (P<0.001), and the total protein and albumin values were lower in the IVIG unresponsive group (P=0.01) compared to the IVIG responsive group. After IVIG infusion, there were no significant changes in the WBC count and CRP levels in the IVIG unresponsive group. The reduction of the HDL-cholesterol levels by IVIG was more significant in the unresponsive group (P=0.02). Conclusion : A more severe and prolonged inflammatory response occurred in the IVIG unresponsive group at an early stage, and this finding can be detected by such inflammatory parameters as the neutrophil count and the CRP and HDL-cholesterol levels after IVIG infusion.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.213-221
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• 2005

Purpose: Hemophagocytic syndrome (HPS) is characterized by persistent high fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, and/or hypofibrinogenemia. Hepatic manifestations including overt hepatic failure and fulminant hepatitis are common in HPS. Liver transplantation (LT) should be considered in a case of fulminant hepatitis by other than HPS, but LT is contraindicated and complete cure is possible by chemotherapy in HPS. Therefore, we conducted this study to define the characteristics of HPS presenting as severe acute hepatitis. Methods: Among the total of 23 patients diagnosed as HPS by bone marrow examination between 1994 and 2005 in Asan Medical Center, 11 cases presented as severe acute hepatitis were enrolled in this study. We analyzed the clinical features, laboratory findings and outcome retrospectively. Results: Seven (64%) of the 11 children with HPS and hepatitis were referred to pediatric gastroenterologist at first. The mean age of onset was 50 months. There was no case with family history of primary HPS. Epstein-Barr virus was positive in 4, and herpes Simplex virus was positive simultaneously in 1 case. As the presenting symptoms and signs, fever was present in 10, hepatosplenomagaly was noted in all and jaundice in 10. Anemia was observed in 10, thrombocytopenia in 10, leukopenia in 8, hypertriglyceridemia in 9, hypofibrinogenemia in 8 and hyperferritinemia in 7 cases, respectively. Nine children received chemotherapy including etopside. The overall mortality rate was 72% (8/11). Conclusion: HPS, which needs chemotherapy, should be considered as a cause of severe acute hepatitis especially when accompanied with prolonged high fever and cytopenias.

• Journal of Sericultural and Entomological Science
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• v.2
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• pp.49-61
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• 1962

The insect Diplosis mori Yokoyama is causing extensive destruction of mulberry trees in Korea with a resultant loss in silk production. This study was made to determine an effective method of control. Methods and Materials Used Preliminary studies were made to determine more exactly the life cycle of the insect. Based on this information, various control measures were tested, including the use of spray methods with BHC and control of larvae by tilling. Results Obtained 1. Life cycle studies (a) In the Suwon area, this-insect has 5 generations per year. The first starts in the later part of June and the final cycle ends in the later part of September. (b) The adult insects appear about 7: 00-8: 00 P.M. and live for 2-5 days. Females live in longer periods than the male. (c) Larvae lives inside the second and third stipules (A. B.) before mulberry leaf development. They cause extensive damage to the leaves at the point where they are attached to the stem. (d) Weather conditions considerably affect the life cycle. The pupa particularly are affected and not be able to change into the moth stage when there is a long period of no rain. (e) Larvae are large......0.3 to 2.0mm......and are milky-white immediately after hatching but turn to pinkish as the worm matures. The matured worm has a jumping ability up to 15-20cm. The worm burrows into the ground 1.5 to 3.0 cm before changing into the pupal stage. (f) The pupal stage usually lasts 7-8 days, in summer weather conditions and the pupa is surrounded with a coarse cocoon. (g) These insects, as a general rule, overwinter as pupae but sometimes as larvae. 2. Control measures (a) BHC dust applied on the ground seem most effective. It should be done 4-5 days after the worm has burrowed into the ground. For this control, it is recommended that 6kg of a 2% formation Tanbo(l0ares) be used. (b) For the effective spraying against the fly, it is recommended that a formulation of liquid BHC spray terials be used at the rate of 400-600 liters per Tanbo. (c) Tillage methods which provide a cover of soil 5cm or more in depth above infested areas will effect-maively prevent the emergence of the fly from the pupal stage. 3. Conclusions Methods of control against Diplosis mori Yokoyama can be tied more closely to the life cycle of the insect with more effective results. Further studies are needed to complete information on possible controls during or after hibernation. Economic studies on the cost of these control measures are also needed.

• Asian-Australasian Journal of Animal Sciences
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• v.24 no.8
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• pp.1164-1172
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• 2011

Two experiments were conducted to evaluate the efficacy of Trichoderma reesei derived phytase for pigs fed diets with fixed calcium to total phosphorus ratios (1.5:1). In Exp. 1, 280 weaned pigs (initial BW of $10.32{\pm}1.94$ kg) were allocated to one of five dietary treatments on the basis of weight and gender in a randomized complete block design. Treatments were the low phosphorus (0.6% Ca, 0.4% total P and 0.23% available P) diets supplemented with 0, 250, 1,000, or 2,000 FTU phytase/kg of diet and a positive control diet (PC; 0.85% Ca, 0.58% total P and 0.37% available P). The treatments were applied to seven pens with eight pigs per pen, half male and half female. In Exp. 2, six barrows fitted with ileal T-cannula (initial BW = $35.1{\pm}1.6$ kg) were assigned to three dietary treatments with a double $3{\times}3$ Latin square design. The dietary treatments were the low-phosphorus diet (0.53% Ca, 0.34% total P and 0.14% available P), the low phosphorus diet plus 1,000 FTU phytase/kg and a positive control diet (0.77% Ca, 0.50% total P and 0.30% available P). In Exp. 1, there were linear increases (p<0.01) in weight gain, phosphorus absorption, bone strength, calcium and phosphorus content of fat-free dried bone and plasma phosphorus concentrations with increasing dose rate of phytase. The performance of pigs fed the diets with 250, 1,000, or 2,000 FTU of phytase/kg did not differ from pigs fed the PC diet. Pigs fed diets with 1,000 or 2,000 FTU of phytase/kg did not differ from pigs fed the PC diet in bone characteristics. The apparent digestibility of dry matter, crude protein, ash and energy was not affected by dietary treatment. However, pigs fed the PC diet excreted more fecal phosphorus (g/d, p<0.01) and fecal phosphorus per BW gain (g/kg) than pigs fed the diets with phytase. Phytase linearly decreased (p<0.01) fecal phosphorus excreted per BW gain (g/kg), plasma calcium concentration as well as plasma and bone alkaline phosphatase activity. In Exp. 2, phytase supplementation in the low-P diet increased (p<0.05) the apparent ileal digestibility (AID) of Ca, P, leucine, lysine, phenylalanine, alanine and cysteine, tended to AID of crude protein, isoleucine, threonine, asparagine and serine. In conclusion, the novel phytase originated from Trichoderma reesei is effective in releasing Ca, P, and amino acids from corn soy based diet for pigs.