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Tertiary Cytoreduction for Recurrent Epithelial Ovarian Cancer: a Multicenter Study in Turkey

  • Arvas, Macit;Salihoglu, Yavuz;Sal, Veysel;Gungor, Tayfun;Sozen, Hamdullah;Kahramanoglu, Ilker;Topuz, Samet;Demirkiran, Fuat;Iyibozkurt, Cem;Bese, Tugan;Ozgu, Burcin Salman;Vatansever, Dogan;Tokgozoglu, Nedim;Berkman, Sinan;Turan, Hasan;Bengisu, Ergin;Sofiyeva, Nigar;Demiral, Irem;Meydanli, Mutlu
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1909-1915
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    • 2016
  • Background: The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. Materials and Methods: Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. Results: Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery. Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. Conclusions: Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.

GROWTH OF SOUTH AND WEST COAST PACIFIC OYSTER SPATS(CRASSOSTREA GIGAS) AFTER CROSS-TRANSPLANTATION (남해산 및 서해산 참굴(Crassostrea gigas)종패의 상호 이식 후의 성장)

  • CHUNG Jong Rak;KWAK Hi-Sang
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.3 no.2
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    • pp.129-136
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    • 1970
  • As an attempt to determine if the morphological differences between the southern and western oysters are due simply to the local ecological factors or are based on their fundamental genetic nature, oyster seeds produced in 1968 at Tong-Young, Ye-Chun, and Ko-Hung on the south coast and at Kan-Wol-Do on the west coast were cross-transplanted during May of 1969 to compare their growth. The spats were placed in plastic baskets which permitted free water flow through and the baskets hung from a wooden rack located at a tidal zone of less than I hour exposure at a depth chosen to keep the baskets submerged in water at all times. Twice a month the growth of the spats were measured along with the air and water temperature and salinity. The early summer spats, which were $17-240\%$ larger, in size, than the late summer spats at the time of cross-transplantation, grew more slowly than the late summer spats when exposed to identical environmental conditions, shortening the initial gap to a $5-20\%$ level as the first year of the growth phase came to an end in December. The growth of the Kan-Wol-Do spats lagged considerably behind the southern spats at all localities tested, whereas there were no significant differences among the latter groups. This suggests that the morphological differences between southern and western Pacific oysters in Korea are a manifestation of genetic variety and that Pacific oysters cultured along the south coast are of an identical variety as they are commonly believed to be. The seasonal changes in temperature and salinity even during rainy season in both the southern and western coastal areas are well within the range suitable for successful spawning, and spat fall. However, since the results were based on twice-a-month measurements with no data covering the critical period before and after spawning, they can only serve to indicate at best the general pattern of changes in the environmental conditions of each growing area.

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The Effects of Structural Factors of Administered Channels on the Retailer's Trust in the Supplier and Long-Term Orientation: Focusing on the Moderating Effect of Relationship Lifecycle (관리형 유통경로의 구조적 요인이 소매상의 공급자 신뢰와 장기지향성에 미치는 영향: 관계수명주기의 조절효과)

  • Park, Jong-Hee;Kim, Do-Yle;Kim, Seon-Hee
    • Journal of Distribution Research
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    • v.16 no.1
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    • pp.65-93
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    • 2011
  • This paper aims to explore how relational constructs(supplier's idiosyncratic investment, retailer's dependence, and dyadic communication) impact the buyer's trust across the relationship lifecycle. Companies make great efforts to create trust and maintain long-term relationship with buyers. Buyer and supplier relationships evolve through distinct lifecycles. In each phase, buyers and suppliers exhibit different patterns of behaviour. Also, they have different attitudes toward, and expectation of, one another. In this study, the final outcome investigated is long-term orientation from the buyer's perspective. Data were collected from 296 survey questionnaires of retailers engaging in Crops Protected Material industry in Korea. Exploratory factor analysis and confirmatory factor analysis were used to purify the measurement scales. And structural equation analysis and Chow test were used to test the hypotheses. The result indicates that the effect of retailer's dependence on the trust is greatest. Especially, the effect of dependence is growing as the relationship has developed. Supplier's idiosyncratic investment increases trust in the early phase, while it is not found to affect trust in the maturity phase. In the early phase, the determination of trust begins to be increasingly influenced by partner's relationship investment only because other clues are not observed yet. Reciprocal communication has a positive effect on trust, and long-term orientation is directly influenced by retailer's trust. Communication's effect is greater in the build-up phase than in the maturity phase. A limitation of this study is the unequal sample size in each of the relationship phases. Literature has suggested that the effects of relational constructs on outcomes are different across relationship phases. This study shows that different relational constructs have different effects on trust depending upon the relationship phase.

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A Survey on the Actual State of Laboratory Facilities and Equipments at Nursing Schools (간호교육기관의 실험실습설비 보유실태 조사)

  • Lim, N.Y.;Lee, S.O.;Suh, M.J.;Kim, H.S.;Kim, M.S.;Oh, K.O.
    • The Korean Nurse
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    • v.36 no.1
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    • pp.108-117
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    • 1997
  • This study was carried out to examine the standards for evaluation of laboratory facilities and equipment. These constitute the most important yet vulnerable area of our system of higher education among the six school evaluation categories provided by the Korean Council for University Education. To obtain data on the present situation of holdings and management of laboratory facilities and equipment at nursing schools in Korea, questionnaires were prepared by members of a special committee of the Korea Nursing Education Society on the basis of the Standards for University Laboratory Facilities and Equipment issued by the Ministry of Education. The questionnaires were sent to nursing schools across the nation by mail on October 4, 1995. 39 institutions completed and returned the questionnaires by mail by December 31 of the same year. The results of the analysis of the survey were as follows: 1. The Physical Environment of Laboratories According to the results of investigation of 14 nursing departments at four-year colleges, laboratories vary in size ranging from 24 to 274.91 pyeong ($1{\;}pyeong{\;}={\;}3.3m^2).$. The average number of students in a laboratory class was 46.93 at four-year colleges, while the number ranged from 40 to 240 in junior colleges. The average floor space of laboratories at junior colleges, however, was almost the same as those, of laboratories at four-year colleges. 2. The Actual State of Laboratory Facilities and Equipment Laboratory equipment possessed by nursing schools at colleges and universities showed a very wide distribution by type, but most of it does not meet government standards according to applicable regulations while some types of equipment are in excess supply. The same is true of junior colleges. where laboratory equipment should meet a different set of government standards specifically established for junior colleges. Closer investigation is called for with regard to those types of equipment which are in short supply in more than 80 percent of colleges and universities. As for the types of equipment in excess supply, investigation should be carried out to determine whether they are really needed in large quantities or should be installed. In many cases, it would appear that unnecessary equipment is procured, even if it is already obsolete, merely for the sake of holding a seemingly impressive armamentarium. 3. Basic Science Laboratory Equipment Among the 39 institutions, five four-year colleges were found to possess equipment for basic science. Only one type of essential equipment, tele-thermometers, and only two types of recommended equipment, rotators and dip chambers, were installed in sufficient numbers to meet the standards. All junior colleges failed to meet the standards in all of equipment categories. Overall, nursing schools at all of the various institutions were found to be below per in terms of laboratory equipment. 4. Required Equipment In response to the question concerning which type of equipment was most needed and not currently in possession, cardiopulmonary resuscitation (CPR) machines and electrocardiogram (ECG) monitors topped the list with four respondents each, followed by measuring equipment. 5. Management of Laboratory Equipment According to the survey, the professors in charge of clinical training and teaching assistants are responsible for management of the laboratory at nursing schools at all colleges and universities, whereas the chief of the general affairs section or chairman of the nursing department manages the laboratory at junior colleges. This suggests that the administrative systems are more or less different. According to the above results, laboratory training could be defined as a process by which nursing students pick up many of the nursing skills necessary to become fully qualified nurses. Laboratory training should therefore be carefully planned to provide students with high levels of hands-on experience so that they can effectively handle problems and emergencies in actual situations. All nursing students should therefore be thoroughly drilled and given as much on-the-job experience as possible. In this regard, there is clearly a need to update the equipment criteria as demanded by society's present situation rather than just filling laboratory equipment quotas according to the current criteria.

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Present Use of Trails and Influential Factors on Trail Selection -in Mudeung-san Provincial Park- (무등산(無等山) 도립공원(道立公園)의 등산로(登山路) 이용현황(利用現況)과 등산로(登山路) 선정요인(選定要因))

  • Kim, Sang-Oh;Oh, Kwang-In
    • Journal of Korean Society of Forest Science
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    • v.87 no.2
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    • pp.131-144
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    • 1998
  • Understanding of the reasons why users in recreation settings select particular trails may provide useful information for effective recreation resources management. This study investigated the present use of the major trails in Mudeung-san Provincial Park and the major influential factors on trail selection. This study was conducted in Mudeung-san Provincial Park stretching over Hwasun-gun and Damyang-gun of Chonnam Province and Kwang-ju city during August in 1996. Data were collected through on-site survey and mail-back questionnaire. 519(44.2%) out of 1173 survey samples were used for analysis. Reasons for selecting a particular trail were classified into 8 major factors. In overall, the order of the importance degree of the factors was 1) aesthetics of landscape, 2) safety(from physical and crime), 3) conditions for health, 4) quietness, 5) familiarity, 6) on the way to the destination, 7) convenience/social, 8) others' intention. There were differences in the degree of importance of each factor depending on trails, users' characteristics(eg., gender, age, group size, visit experience, etc.) and users' behavioral patterns. Recreation motivations were classified into 5 major factors. The order of the importance degree of the factors was 1) contacting with nature, 2) self-training, 3) solitude, 4) social interaction, 5) appreciating cultural properties. Regardless of trails, 'contacting with nature' was the most important factor, and the degree of importance in the other 4 motivational factors showed only a little differences in order according to the trails. There were correlations between major factors for trail selection and recreation motivations. The results of this study may provide foundational information for establishing effective management strategies through better understanding of the present use of trails and influential factors on trail selection. It can be used for reducing the present social and ecological problems caused by use concentration on certain trails and providing users with better quality of diverse recreational experiences. This study discussed the findings, and suggested some management strategies based on these information.

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The Moderating Effect of Social Capital between Organizational Slack and Managerial Practices for Open Innovation in Venture SMEs (벤처중소기업의 조직여유와 개방형 경영혁신 간의 관계에서 사회적 자본의 조절효과 연구)

  • Bae, Hoyoung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.10 no.5
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    • pp.73-81
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    • 2015
  • This research is designed to analyze the moderating effect of social capital between organizational slack and managerial practices for open innovation. After controlling the firm size, firm age, and environmental uncertainty, we test two hypotheses. First, we test the hypothesis that organizational slack has a positive effect on managerial practices for open innovation. Especially we focus on the managerial innovation and open innovation because recently managerial innovation and open innovation are more and more important. Second, we test the moderating role of social capital between organizational slack and managerial practices for open innovation. Because social capital is a kind of networking activity, we assume that social capital can contribute to managerial practices for open innovation through the networking activity. For this research, we administered the questionnaire surveys, and got the 250 effective data (companies) in Korea. Then we used the validity, reliability, correlation and multiple regression analysis by means of SPSS 18.0. As a result, we can find the two meaningful results. First, organizational slack, especially not absorbed slack but unabsorbed slack, has positive effect on managerial practices for open innovation. It is because absorbed slack such as excessive facilities, machines, or employees is not useful in managerial practices for open innovation. On the other hand, unabsorbed slack is useful in managerial practices for open innovation because unabsorbed slack such as excessive money or securities is very flexible and active. Taken together, the relationship between managerial practices for open innovation and unabsorbed slack is proven in terms of flexibility. Second, social capital has a moderating effect positively between organizational slack, especially not absorbed slack but unabsorbed slack, and managerial practices for open innovation. A prior study related to the relationship between managerial practices for open innovation and social capital doesn't exist yet, so this analysis result is very meaningful in academic respect. But this research has some limitations. First, this research is analyzed by limited region (Korea) and samples (250 companies), so more global regions and samples are recommended in the future. Second, we focus on managerial practices for open innovation in this paper, so the studies about technological practices for open innovation are recommended in the future.

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The Impact on the Business Effectiveness of the Educational Satisfaction in Elderly Employment Program: The Mediating Effect of Job Satisfaction (노인일자리 사업의 교육 만족도가 사업효과성에 미치는 영향 : 일자리 만족도의 매개효과)

  • Shin, Gye Soo;Kwon, Seung Sug
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.10 no.5
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    • pp.105-115
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    • 2015
  • This study examined what effect the educational satisfaction level in the grey job project had on the business effectiveness and verified the effect the participant education satisfaction level had on the project business effectiveness ultimately by influencing the job satisfaction. This study utilized the source data of the senior job project old participant status survey of the Korea senior manpower development center which was conducted in 2013, and the non-proportional stratification sample extracting method was used which considered the project type, regional size, and cities/provinces. Sejong City was excluded from the survey target and the survey targeted 2,005 persons except for non-response or response-irrelevant persons concerning this study question. The collected material was analyzed by using SPSS WIN 21.0 program. The frequency and percentage were calculated to apprehend the general characteristic of the study target. Also, the regression analysis was conducted to examine the effect the educational satisfaction level had on the business effectiveness of the senior job project, and the hierarchical regression analysis was conducted in order to examine the mediated effect of the job satisfaction level in the effect the educational satisfaction level had on the business effectiveness of the senior job project. The main result of this study is as follows. First, among the effects the educational satisfaction level had on the business effectiveness, both interest level of educational contents and the job utilization of education had a significant effect on the psychological effect, and the interest level of the educational contents had a significant level on the physical/social effect, and the job utilization of education had a significant effect on the economic effect. Second, in the effect the educational satisfaction level had on the business effectiveness, the job satisfaction level was confirmed the job satisfaction level had a partial mediated effect in the effect the educational satisfaction level had on the psychological/physical/social effect. The job satisfaction level was confirmed the job satisfaction level had a complete mediated effect in the effect the educational satisfaction level had on the economic effect. Also, The job satisfaction level was confirmed the job satisfaction level had a partial mediated effect in the effect the educational satisfaction level had on the business effectiveness. Consequently, the educational contents according with the demand of job participants will have to be developed and the exclusive manpower must be arranged to conduct the education effectively. Also, making participants feel a pride on the job fully will largely contribute to raising the business effectiveness because the job satisfaction level has a positive effect on the business effectiveness.

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Development of Automated Region of Interest for the Evaluation of Renal Scintigraphy : Study on the Inter-operator Variability (신장 핵의학 영상의 정량적 분석을 위한 관심영역 자동설정 기능 개발 및 사용자별 분석결과의 변화도 감소효과 분석)

  • 이형구;송주영;서태석;최보영;신경섭
    • Progress in Medical Physics
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    • v.12 no.1
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    • pp.41-50
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    • 2001
  • The quantification analysis of renal scintigraphy is strongly affected by the location, shape and size of region of interest(ROI). When ROIs are drawn manually, these ROIs are not reproducible due to the operators' subjective point of view, and may lead to inconsistent results even if the same data were analyzed. In this study, the effect of the ROI variation on the analysis of renal scintigraphy when the ROIs are drawn manually was investigated, and in order to obtain more consistent results, methods for automated ROI definition were developed and the results from the application of the developed methods were analyzed. Relative renal function, glomerular filtration rate and mean transit time were selected as clinical parameters for the analysis of the effect of ROI and the analysis tools were designed with the programming language of IDL5.2. To obtain renal scintigraphy, $^{99m}$Tc-DTPA was injected to the 11 adults of normal condition and to study the inter-operator variability, 9 researchers executed the analyses. The calculation of threshold using the gradient value of pixels and border tracing technique were used to define renal ROI and then the background ROI and aorta ROI were defined automatically considering anatomical information and pixel value. The automatic methods to define renal ROI were classified to 4 groups according to the exclusion of operator's subjectiveness. These automatic methods reduced the inter-operator variability remarkably in comparison with manual method and proved the effective tool to obtain reasonable and consistent results in analyzing the renal scintigraphy quantitatively.

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Intergrowth and Interlayering of Muscovite, Chlorite, and Biotite in a Garnet Zone Metamorphic Rock of the Ogcheon Belt, South Korea (옥천대의 석류석데 변성암에서 산출되는 백운모, 녹니석 및 흑운모의 Intergrowth와 Interlayering)

  • Yeong Boo Lee;Jung Hoo Lee;Chang Whan Oh
    • Journal of the Mineralogical Society of Korea
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    • v.15 no.2
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    • pp.122-131
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    • 2002
  • Muscovite, chlorite and biotite in metapelites of the Ogcheon Hetamorphic Belt are studied using electron probe microanalysis (EPMA), backscattered electron images (BEI) of scanning electron microscopy (SEM) and lattice fringe images of transmission electron microscopy (TEM). These minerals are observed to be intergrown under a polarized light microscope and are apparently interlayered below EPMA resolution; EPMA data often indicate mixtures of phyllosilicates such as muscovite/chlorite (M/C), biotite/chlorite (B/C), muscovite/pyrophyllite/chlorite (M/P/C). biotite/pyrophyllite/chlorite (B/P/C) or biotite/muscovite/chlorite (B/M/C). BEI observations show that the three minerals (muscovite, chlorite and biotite) are mixed at various scales in a grain through the garnet zone, and the interlayering of the three minerals are observed from TEM lattice fringe images and selected area electron diffraction patterns. The result of TEM observations reveals that 7-$\AA$ layers (serpentine, precursor of chlorite) are interlayered within 10-$\AA$ layers (muscovite) at 100~200 $\AA$ scale as well as M/C in the chlorite zone. The 7-$\AA$ layers become smaller in size and less frequent in the biotite tone, and 10-$\AA$ layers are interlayered with chlorite (14 $\AA$) at an individual layer scale. The 7-$\AA$ layers are no longer observed in the garnet zone, and 10-$\AA$ layers (biotite) are interlayered with chlorite (B/C) at 50~100 $\AA$ scale. Relatively large scale (1000~2000 $\AA$) of intergrowth is also frequently observed from the garnet zone samples. However, rocks from all three metamorphic zones show interlayering of a few units of 7-, 10- and 14-$\AA$ layers with each other at TEM observations. The result of this study implies that metamorphic minerals such as muscovite, chlorite and biotite form through disequilibrum mineral reactions resulting in inhomogenious phases.

Strategy for Bio-Diversity and Genetic Conservation of Forest Resources in Korea (생물종(生物種) 다양성(多樣性) 및 삼림유전자원(森林遺傳資源) 보존(保存) 전략(戰略))

  • Park, Young Goo
    • Journal of Korean Society of Forest Science
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    • v.83 no.2
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    • pp.191-204
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    • 1994
  • Due to its topographic complexities and various climatical condition, Korea exhibits diverse forest types. Dominant tree species in this zone are Quercus spp., Betula spp., Zelkova spp., Fraxinus spp., Pinus densiflora, Pinus koraiensis, and Pinus thunbergii ete. Genetic conservation in forest species in Korea there are three ways ; one is in situ, other is ex situ and third is in-facility conservation. In situ conservation include that are the present status of conservation of rare and endangered flora and ecosystem, the reserved forest, the national and provincial park, and the gene pool of natural forests. Ex situ conservation means to be established the new forest from in situ forest stands, progeny and provenance test populations, seed orchard and clone banks, and gene conservation in-facility. As a tool for low temperature storage, several aspects on in vitro system were studied ; (1) establishment of in vitro cultures from juvenile and/or rejuvenated tissues, (2) induction of multiple shoots from the individual micropropagules, (3) elongation of the proliferated shoots. Studies on cold storage for short-and long-term maintenance of in vitro cultures under $4^{\circ}C$ in the refrigerator were conducted. For the cryopreservation at $-196^{\circ}C$, various factors affecting survivability of the plant materials are being examined. The necessity of gene conservation of forest trees is enlarged not only to increase the adaptability for various environments but also to gain the breeding materials in the future. For effective gene conservation of forest trees, I would like to suggest followings ; 1. Forest stands reserved for other than the gene conservation purposes such as national parks should be investigated by botanical and gene-ecological studies for selecting bio-diversity and gene conservation stands. 2. Reserved forest for gene pool should be extented both economically important tree spp. and non-economical species. 3. Reserved forest for progeny test and clone bank should be systematically investigated for the use of Ex situ forest gene conservation. 4. We have to find out a new methodology of genetic analysis determining the proper and effective size of subpopulation for in situ gene conservation. 5. We should develop a new tree breeding systems for successful gene conservation and utilization of the genetic resources. 6. New method of in-facility gene conservation using advanced genetic engineering should be developed to save time and economic resources. 7. For the conservation of species with short-life span of seed or shortage of knowledge of seed physiology, tissue culture techniques will be played a great role for gene conservation of those species. 8. It is are very useful conservation not only of genes but of genotypes which were selected already by breeding program. 9. Institutional and administrative arrangements including legistlation must be necessarily taken for gene conservation of forest trees. 10. It is national problems for conservation of forest resources which have been rapidly destroyed because of degenerating environmental condition and of inexperienced management system of bio-diversity and gene conservation. 11. In order to international cooperation for exchanging data of bio-diversity and gene conservation, we should connect to international net works as soon as possible.

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