Moon, Kyoung Hwan;Ahn, Hee Kyung;Ahn, Hong Yup;Choi, Sun Young;Hwang, In Cheol;Choi, Youn Seon;Yeom, Chang Hwan
Journal of Hospice and Palliative Care
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v.17
no.1
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pp.27-33
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2014
Purpose: Although vitamin D deficiency is more commonly found in cancer patient than in non-cancer patients, there have been little data regarding the prevalence of vitamin D deficiency in cancer patients at the very end of life. We examined vitamin D deficiency in terminally ill cancer patients and related factors. Methods: This study was based on a retrospective chart review of 133 patients in a hospice ward. We collected data regarding age, sex, serum 25-hydroxyvitamin D level, cancer type, physical performance, current medications and various laboratory findings. We investigated factors related to serum vitamin D levels after multivariate adjustment for potential confounders. Serum 25-hydroxyvitamin D<20 ng/mL was considered deficient and <10 ng/mL severely deficient. Results: Ninety-five percent of the patients were serum vitamin D deficient. Severe vitamin D deficiency was more common in male patients, non-lung cancer patients, $H_2$ blocker users and non-anticonvulsant users. Elevated levels of serum alanine aminotransferase (ALT) were also associated with low serum vitamin D levels. Multiple regression analysis showed that severe vitamin D deficiency was associated with male gender (aOR 3.82, 95% CI: 1.50~9.72, P=0.005), $H_2$ blocker users (aOR 3.94, 95% CI: 1.61~9.65, P=0.003) and elevated serum ALT levels (aOR 4.52, 95% CI: 1.35~15.19, P=0.015). Conclusion: Vitamin D deficiency was highly prevalent among terminally ill cancer patients. Severe vitamin D deficiency was more common in male patients, $H_2$ blocker users, and patients with elevated ALT levels.
Sulawesi island, as a global producer of nickel resources, is leading the rapid growth of nickel industry of Indonesia. Nickel laterite deposits in Sulawesi was formed by lateritization of the world-scale East Sulawesi Ophiolite (ESO) under the active tectonic setting and tropical rainforest climate. In this paper, exploration cases for nickel laterite deposits in five regions of Sulawesi are reported. Regional characteristics on nickel laterite deposits in Sulawesi are understood based on various exploration activities such as outcrop, trench and pit survey, petrological observation, geochemical analysis, and interpretation of drilling data, etc.. In the northeastern part of 'Southeast-Arm', which is a strategic location for nickel industry of Indonesia, ESO is extensively exposed to the surface. In the Morombo and Morowali regions, typical high-grade saprolite-type orebodies with a thickness of 10 to 20 m occur. The cases showed that topographic relief tends to regulate Ni-grade distribution and orebody thickness, and that high grade intervals tend to occur in places where joints and garnierite veins are dense. In the Tinanggea and South Palangga regions in the southern part of the Southeast-Arm, overburden composed of Neogene to Quaternary deposits is a major factor affecting the preservation and profitability of nickel laterite deposits. Despite the overburden, high-grade saprolite-type orebodies composed of Ni-bearing serpentine with garnierite veins occur in a thickness of around 10 m to secure economic feasibility. In contrast, in the Ampana region in the northern part of 'East-Arm', low-grade nickel laterite deposits with immature laterite profile was identified, which is thought to be the result of active denudation due to tectonic uplift. Exploration cases in this paper will help to understand characteristics and controlling factors on nickel laterite deposits in Sulawesi, Indonesia.
Kim, Ki-Hyung;Moon, Chul-Woo;Kim, Sang-kyun;Lee, Byung-Hee
Korean small business review
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v.39
no.1
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pp.1-39
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2017
The first generation of the business that had been founded in 1960~1970s faces the situation to consider the succession of the family business developed by devotion of their whole lives in the critical timing to the next generation. In the process of selecting the party of family business succession, it is required to consider a variety of succession types including smooth transfer to the other family member or the employee of the company, selling the company, or hiring external specialist. Foreign countries acknowledge the importance of the succession in the family owned company to perform multiple studies on the influential factors to the succession, distinction, and types of family business succession; and they utilize the results for the related policy development and the support of family owned business succession. However, few studies have been conducted on the succession of the domestic family owned business and majority of them are related to the types of succession. Considering its share and influential power in the domestic economy, it is necessary to develop the guideline and the policies to solve many issues on the succession of the family owned business by systemic studies. Hence, the impact of the main characteristics in the family owned business on the types of its succession was analyzed in this study focusing on five domains of Socioemtional Wealth (SEW) in view of Behavioral Agency Theory by Gomez-Mejia et al. (2007) using the data from 540 family owned small-to-medium sized businesses so as to analyze the issues on their business succession. Upon the empirical analysis results, it was confirmed that they were influenced to the selection of succession type by family succession > internal employee succession > external succession, for the variables of social contribution which were non-financial characteristics, internal employee succession > family succession > external succession for the intellectual properties, and family succession > external succession for the management participation of the family. The distinction of social contribution were influenced the most to the selection of the succession types. Financial factors, business performance, and R&D investment variables were not significantly influenced to their selection of the succession types. In case of simultaneous management, the family succession rate was high and it showed the control effect to strengthen selecting family owned business with R&D investment, social contribution, and company history variables. The behavioral agency theory used in this study was confirmed with high explanation power on the family owned business succession. The family owned business showed the tendency to maintain SEW, and non-financial factors such as accumulated know-how and social contribution based on the long term history were significantly affected to the succession in the small-to-medium sized family owned businesses, unlike general large sized listed companies. The results of this study are expected to be helpful practically for the succession of the family owned business and to suggest the guideline for the development of governmental policy.
Can money buy happiness? If not, what are the factors that influence happiness? What makes people happy? What are the factors that influence happiness among Korean adults? How can we better explain factors that influence happiness? These are the research questions that led to the analyses of psychological, relational, financial resources that influence happiness. To examine differences in socio-economic status, adults and elderly from three different districts that vary wealth and income were interviewed in their own home. A total of 313 respondents (male=133, female=180) between the ages of 20 through 80 completed a questionnaire that contained background information, emotional support scale and happiness scale developed by the present researcher and resiliency of efficacy developed by Bandura(1995). The results are as follows. First, monthly income influence happiness to some extent, but when the variable was excluded from the path analysis, the goodness-of-fit did not change significantly. Although those who have more money can be happier, those without much money can also be happy. These results indicate that financial resource has limited influence on happiness. In addition, monthly income did influence self-efficacy of respondents indicating that those with more money were not necessarily more confident about themselves. Second, an important factor influencing happiness is the relational resource. Emotional support was the most powerful predictor of happiness, four to five times more important than monthly income. Third, self-efficacy influenced happiness. Those respondents with higher resiliency of efficacy had higher happiness scores and the influence was two times greater than monthly income. Moreover, self-efficacy played a mediating role between emotional support and happiness. Fourth, those respondents with higher occupational achievement reported higher happiness score and the influence was two times greater than monthly income. Fifth, success of children influenced happiness score and the influence was 1.5 times greater than monthly income. Sixth, education did not directly influence happiness, but had an indirect influence through self-efficacy and occupational achievement. Seventh, age was not related to self-efficacy and happiness.
Purpose : This is a retrospective analysis for pattern of failure, survival rate and prognostic factors of 114 patients with histologically proven invasive cancer of the uterine cervix treated with definitive irradiation. Materials and Methods : One hundred fourteen patients with invasive carcinoma of the cervix were treated with a combination of intracavitary irradiation using Fletcher-Suit applicator and external beam irradiation by 6MV X-ray at the Ewha Womans University Hospital between March 1982 and Mar 1990. The median age was 53 years(range:30-77 years). FIGO stage distribution was 19 for IB, 23 for IIA, 42 for IIB, 12 for IIIA and 18 for IIIB. Summation dose of external beam and intracavitary irradiation to point A was 80-90 Gy(median:8580 cGy) in early stage(IB-IIA) and 85-100 Gy(median:8850 cGy) in advanced stage(IIB-IIIB). Kaplan-Meier method was used to estimate the survival rate and multivariate analysis for progrostic factors was performed using the Log likelihood for Weibull Results : The pelvic failure rates by stage were $10.5{\%}$ for IB. $8.7{\%}$ for IIA, $23.8{\%}$ for IIB, $50.0{\%}$ for IIIA and $38.9{\%}$ for IIIB. The rate of distant metastasis by stage were $0{\%}$ for IB, $8.7{\%}$ for IIA, $4.8{\%}$ for IIB. $0{\%}$ for IIIA and $11.1{\%}$ for IIIB. The time of failure was from 3 to 50 months and with median of 15 months after completion of radiation therapy. There was no significant coorelation between dose to point A($\leq$90 Gy vs >90 Gy) and pelvic tumor control(P>0.05). Incidence rates of grade 2 rectal and bladder complications were $3.5{\%}$(4/114) and $7{\%}$(8/114), respectively and 1 patient had sigmoid colon obstruction and 1 patient had severe cystitis. Overall 5-year survival rate was $70.5{\%}$ and disease-free survival rate was $53.6{\%}$. Overall 5-year survival rate by stage was $100{\%}$ for IB, $76.9{\%}$ for IIA, $77.6{\%}$ for IIB $87.5{\%}$ for IIIA and $69.1{\%}$ for IIIB. Five-rear disease-free survival rate by stage was $81.3{\%}$ for IB, $67.9{\%}$ for IIA, $46.8{\%}$ for IIB, $45.4{\%}$ for IIIA and $34.4{\%}$ for IIIB. The prognostic factors for disease-free survival rate by multivariate analysis was performance status(p= 0.0063) and response rate after completion of radiation therapy(p= 0.0026) but stage, age and radiation dose to point A were not siginificant. Conclusion : The result of radiation therapy for early stage of the uterine cervix cancer was relatively good but local control rate and survival rate in advanced stage were poor inspite of high dose irradiation to point A above 90 Gy. Prospective randomized studies are recommended to establish optimal tumor doses for various stages and volume of carcinoma of uterine cervix, And ajuvant chemotherapy or radiation-sensitizing agents must be considered to increase the pelvic control and survival rate in advanced cancer of uterine cervix.
Lee Kyung-Ja;Moon Hye Seong;Kim Seung Cheol;Kim Chong Il;Ahn Jung Ja
Radiation Oncology Journal
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v.21
no.3
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pp.199-206
/
2003
Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.
The site categorization and corresponding site amplification factors in the current Korean seismic design guideline are based on provisions for the western United States (US), although the site effects resulting in the amplification of earthquake ground motions are directly dependent on the regional and local site characteristic conditions. In these seismic codes, two amplification factors called site coefficients, $F_a$ and $F_v$, for the short-period band and midperiod band, respectively, are listed according to a criterion, mean shear wave velocity ($V_S$) to a depth of 30 m, into five classes composed of A to E. To suggest a site classification system reflecting Korean site conditions, in this study, systematic site characterization was carried out at four regional areas, Gyeongju, Hongsung, Haemi and Sacheon, to obtain the $V_S$ profiles from surface to bedrock in field and the non-linear soil properties in laboratory. The soil deposits in Korea, which were shallower and stiffer than those in the western US, were examined, and thus the site period in Korea was distributed in the low and narrow band comparing with those in western US. Based on the geotechnical characteristic properties obtained in the field and laboratory, various site-specific seismic response analyses were conducted for total 75 sites by adopting both equivalent-linear and non-linear methods. The analysis results showed that the site coefficients specified in the current Korean provision underestimate the ground motion in the short-period range and overestimate in the mid-period range. These differences can be explained by the differences in the local site characteristics including the depth to bedrock between Korea and western US. Based on the analysis results in this study and the prior research results for the Korean peninsula, new site classification system was developed by introducing the site period as representative criterion and the mean $V_S$ to a depth of shallower than 30 m as additional criterion, to reliably determine the ground motions and the corresponding design spectra taking into account the regional site characteristics in Korea.
Purpose : The aims of this study were to investigate the long-term outcomes in children with infantile spasms (IS) and to identify the prognostic factors influencing their neurodevelopment. Methods : We retrospectively evaluated seventy two children over five years old who were treated for IS at Asan Medical Center, Seoul, Korea, between 1994 and 2007. Forty-three children were contacted by telephone or medical follow-up to assess their current neurodevelopmental status. Multiple logistic regression was used to calculate odds ratios (ORs) and 95% confidence interval (95% CIs) of risk factors for unfavorable outcomes.Results : The mean follow-up duration for these 43 children was $7.2{\pm}1.5$ years (range, 4.5 to 13.0 years). Of these, 13 (30.2%) had cryptogenic and 30 (69.8%) had symptomatic IS. Eleven (25.6%) children were initially treated with adrenocorticotrophic hormone (ACTH) therapy, with a mean treatment lag of $1.3{\pm}1.9$ months (range; 0.1 to 7.0 months). Eighteen (41.8%) children clinically responded to initial treatment, as shown by EEG response. Overall, 22 (51.2%) children had at least moderate neurodevelopmental disorders and 2 (4.8%) died. In univariate analysis, etiology (symptomatic) and poor electroclinical response to initial treatment were related to long-term unfavorable outcomes. In multivariate analysis, response to primary treatment was the sole significant independent risk factor with a high OR. Conclusion : Overall prognosis of children with IS was poor. Electroclinical non-responsiveness to initial treatment was related to unfavorable long-term outcomes, indicating that initial control of seizures may be important in reducing the likelihood of poor neurodevelopment.
Purpose: Biallelic germline variants of the 8-hydroxyguanine (8-OG) repair gene MYH have been associated with colorectal neoplasms that display somatic $G:C{\rightarrow}T:A$ transversions. However, the effect of single germline variants has not been widely studied, prompting the present investigation of monoallelic MYH variants and susceptibility to sporadic colorectal cancer (CRC) in a Chinese population. Patients and Methods: Between January 2006 and December 2012, 400 cases of sporadic CRC and 600 age- and sex-matched normal blood donors were screened randomly for 7 potentially pathogenic germline MYH exons using genetic testing technology. Variants of heterozygosity at the MYH locus were assessed in both sporadic cancer patients and healthy controls. Univariate and multivariate analyses were performed to determine risk factors for cancer onset. Results: Five monoallelic single nucleotide polymorphisms (SNPs) were identified in the 7 exon regions of MYH, which were detected in 75 (18.75%) of 400 CRC patients as well as 42 (7%) of 600 normal controls. The region of exon 1 proved to be a linked polymorphic region for the first time, a triple linked variant including exon 1-316 $G{\rightarrow}A$, exon 1-292 $G{\rightarrow}A$ and intron 1+11 $C{\rightarrow}T$, being identified in 13 CRC patients and 2 normal blood donors. A variant of base replacement, intron 10-2 $A{\rightarrow}G$, was identified in the exon 10 region in 21 cases and 7 controls, while a similar type of variant in the exon 13 region, intron 13+12 $C{\rightarrow}T$, was identified in 8 cases and 6 controls. Not the only but a newly missense variant in the present study, p. V463E (Exon 14+74 $T{\rightarrow}A$), was identified in exon 14 in 6 patients and 1 normal control. In exon 16, nt. 1678-80 del GTT with loss of heterozygosity (LOH) was identified in 27 CRC cases and 26 controls. There was no Y165C in exon 7 or G382D in exon 14, the hot-spot variants which have been reported most frequently in Caucasian studies. After univariate analysis and multivariate analysis, the linked variant in exon 1 region (p=0.002), intron 10-2 $A{\rightarrow}G$ (p=0.004) and p. V463E (p=0.036) in the MYH gene were selected as 3 independent risk factors for CRC. Conclusions: According to these results, the linked variant in Exon 1 region, Intron 10-2 $A{\rightarrow}G$ of base replacement and p. V463E of missense variant, the 3 heterozygosity variants of MYH gene in a Chinese population, may relate to the susceptibility to sporadic CRC. Lack of the hot-spot variants of Caucasians in the present study may due to the ethnic difference in MYH gene.
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.2
/
pp.560-569
/
2016
Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.
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