Kim, Gwon-Sik;Kim, Kap-Choong;Kim, Beom-Su;Kim, Tae-Hwan;Yook, Heong-Hwan;Oh, Sung-Tae;Kim, Byung-Sik
Journal of Gastric Cancer
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v.10
no.3
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pp.111-117
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2010
Purpose: The aim of this study was to determine the prognostic factors and the significance of metastatectomy for Krukenberg's tumors of gastric origin.Materials and Methods: Among the patient who underwent gastric surgery from 1992 through 2005, 90 female patients with Krukenberg's tumors of gastric origin were identified. We retrospectively reviewed the clinicopathologic characteristics, prognostic factors, and treatments for primary gastric cancer. We also investigated the prognostic risk factors for the onset of metachronous Krukenberg's tumors and the survival time of patients who underwent an operation for metachronous Krukenberg's tumors. Results: The presence of a synchronous Krukenberg's tumor (mean survival time=17.6 months, P<0.01), peritoneal seeding (14.5 months, P<0.01), and non-curative resection (15.1 months, P<0.01), were statistically significant prognostic factors for survival time in female patients with gastric cancer. The stage of primary gastric cancer (P=0.049) and lymph node metastasis (P=0.011) were statistically significant risk factors for recurrence time of a metachronous Krukenberg's tumor. In the metachronous Krukenberg's tumor group (n=53), the mean survival time of the metastatectomy group (n=46, 43.2 months, P=0.012) was longer than that in the chemotherapy or conservative treatment groups (n=7 and 24 months, respectively). Metastatectomy, presense or abscence of residual tumor and extent of residual tumor were significant prognostic factors for survival time in female patients with metachronous Krukenberg's tumor of gastric origin. Conclusions: A close observation and evaluation with ultrasound or computed tomography is necessary in female patients with advanced gastric cancer to detect a metachronous Krukenberg's tumor as soon as possible. The surgeon must operate more aggressively in patients with metachronous Krukenberg's tumors.
Chu, Jinah;Bae, Hyunsik;Seo, Youjeong;Cho, Soo Youn;Kim, Seok-Hyung;Cho, Eun Yoon
Journal of Pathology and Translational Medicine
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v.52
no.6
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pp.396-403
/
2018
Background: In the current American Joint Committee on Cancer staging system of breast cancer, only tumor size determines T-category regardless of whether the tumor is single or multiple. This study evaluated if tumor multiplicity has prognostic value and can be used to subclassify breast cancer. Methods: We included 5,758 patients with invasive breast cancer who underwent surgery at Samsung Medical Center, Seoul, Korea, from 1995 to 2012. Results: Patients were divided into two groups according to multiplicity (single, n=4,744; multiple, n=1,014). Statistically significant differences in lymph node involvement and lymphatic invasion were found between the two groups (p<.001). Patients with multiple masses tended to have luminal A molecular subtype (p<.001). On Kaplan-Meier survival analysis, patients with multiple masses had significantly poorer disease-free survival (DFS) (p=.016). The prognostic significance of multiplicity was seen in patients with anatomic staging group I and prognostic staging group IA (p=.019 and p=.032, respectively). When targeting patients with T1-2 N0 M0, hormone receptor-positive, and human epidermal growth factor receptor 2 (HER2)-negative cancer, Kaplan-Meier survival analysis also revealed significantly reduced DFS with multiple cancer (p=.031). The multivariate analysis indicated that multiplicity was independently correlated with worse DFS (hazard ratio, 1.23; 95% confidence interval, 1.03 to 1.47; p=.025). The results of this study indicate that tumor multiplicity is frequently found in luminal A subtype, is associated with frequent lymph node metastasis, and is correlated with worse DFS. Conclusions: Tumor multiplicity has prognostic value and could be used to subclassify invasive breast cancer at early stages. Adjuvant chemotherapy would be necessary for multiple masses of T1-2 N0 M0, hormone-receptor-positive, and HER2-negative cancer.
The purpose of the study is to analyze the impact of blended learning's external classroom formats and internal teaching strategies, which has been implemented in university classes due to COVID-19, on students' academic achievement and learners' perceptions, as well as to provide insights into the desirable direction of online education. The study was conducted during the 1st semester of 2022 at G University, targeting students taking Calculus I. The experimental group consisted of 117 students, while the control group consisted of 707 students. Blended learning, involving a combination of face-to-face classes, online classes, and mixed teaching methods, was implemented, and academic achievement and learner perceptions were assessed. The research findings indicate that compared to solely online classes, adopting a blended learning approach with online classes before the midterm and face-to-face classes afterwards resulted in a decline in academic achievement. The unprepared and simplistic external format of blended learning was found to be ineffective, however, a blended learning model consisting solely of online classes, incorporating a mix of asynchronous and synchronous instruction, demonstrated positive learner perceptions. Additionally, utilizing technology in the teaching strategies yielded positive outcome.
Purpose: To report the results of curative treatment for patients with tonsil cancer by retrospective analysis. Materials and Methods: From Jan. 1995 till Dec. 2000, 27 patients with squamous cell carcinoma of the tonsil received curative treatment at Samsung Medical Center. Therapeutic decision was made through multidisciplinary conference, and curative radiation therapy was favored when, (1) the patient's condition was not fit for general anesthesia and surgery, (2) the patient refused surgery, (3) complete resection was presumed impossible, or (4) too severe disability was expected after surgery. Surgery was the main local modality in 17 patients (S$\pm$RT group), and radiation therapy in 10 (RT$\pm$CT group). The median follow-up period was 41 months. Results: AJCC stages were I/II in four, III in two, and IV in 21 patients. The 5-year disease-free survival rate was 73.3$\%$ in all patients, 70.6$\%$ in the S$\pm$RT group, and 77.8$\%$ in the RT$\pm$CT group. Treatment failure occurred in seven patients, all with stage III/IV, and all the failures occurred within 24 months of the start of treatment. Five patients among the S$\pm$CT group developed treatment failures; 2 local, 2 regional, and 1 distant (crude rate=29.4$\%$). Two patients among the RT$\pm$CT group developed failures; 1 synchronous local and regional, and 1 distant (crude rate=20.0$\%$). The 5-year overall survival rate was 77.0$\%$ in all patients, 80.9$\%$ in the S$\pm$RT group, and 70.0$\%$ in the RT$\pm$CT group. Conclusion: We could achieve favorable results that were comparable to previously reported data with respect to both the rates of local control and of survival by applying S$\pm$RT and RT$\pm$CT. RT$\pm$CT is judged to be an alternative option that can avoid the functional disability after surgical resection.
Blood supply rather than nerve supply implies pulp vitality. To evaluate pulp vitality clinically, electric pulp test and thermal test which are based on sensory nerve response have been used in addition to many auxiliary data such as past dental history, visual inspection, radiographic examination, percussion, palpation and transillumination test. However, reactivity of the nerves to the stimulation is not synonymous with normalcy. Therefore measurement of pulpal blood flow using a laser Doppler flowmeter became a new trial to test the pulp vitality. The purpose of the present study was to evaluate normal pulpal blood flow level of maxillary teeth in adult to provide a guideline in determining the vitality of dental pulp. Pulpal blood flow was measured in maxillary central and lateral incisors, canines, first and second premolars and first molars of seventy nine adults of 22 - 30 years old using a laser Doppler flowmeter (PeriFlux 4001, Perimed Co., Stockholm, Sweden, 780 nm infrared laser, 1mW). For directly-made splints, silicone rubber impressions were taken directly from the mouth. For indirectly-made splints, alginate impressions were taken from the mouth and stone cast were made. After making depressions on the buccal surfaces of the cast teeth to indicate the hole positions, second impressions with vinyl polysyloxane putty were taken from the cast. Holes for the laser probes were made at the putty impressions 4mm above the gingival level. Laser probe (PF416 dental probe, 1.5mm) was inserted in the prepared hole and the splint was set in the mouth. After 10 minutes of patient relaxing, pulpal blood flow was recorded for 5 minutes on each tooth. The recorded flow was saved in the computer and calculated with a software 'Perisoft' version 5.1. Pulpal blood flow was also recorded in six teeth of five individuals with no response to electric pulp test and cold test, with periapical radiolucency, or with history of root canal treatment to compare with nonvital teeth. The difference between the mean flow values of each group of teeth were analyzed using one-way ANOVA and Duncan's Multiple Range test. The results were as follows: 1. The average pulpal blood flow values of all the tested teeth of each location were between 9 - 16 Perfusion Unit. Pulpal blood flow value was highest in maxillary lateral incisors, followed by first premolars, second premolars, canines, central incisors, and then first molars (p<0.01). 2. In six anterior teeth, indirectly-made splint group showed higher pulpal blood flow values than directly-made splint group (p<0.01). In posterior teeth, however, there was no significant flow value difference between directly-made splint group and indirectly-made splint one (p>0.05). 3. Teeth with vital pulps showed higher signal values than teeth with nonvital pulps (p<0.01), and the flow photographs showed heartbeat-synchronous fluctuations and vasomotions, while those were absent in non vital tooth.
The task network which is formed of different individuals can be recognized as a social network. Therefore, the way to communicate with people inside or outside the network has considerable influence on their outcome. Moreover, the position on which a member stands in a network shows the different effects of the information systems supporting communication with others. In this paper, it is to be studied how personal CMC (computer-mediated communication) tools affect the mission that those who work for a network perform through diverse task networks. Especially, we focused on synchronicity of CMC. On this score, the perspective of Media Synchronicity Theory was taken that had been suggested by criticizing Media Richness Theory. It is the objective, from this perspective, to find which characteristics of networks make the value of IT supporting synchronicity high. In the research trends of social networks, there have been two traditional perspectives to explain the effect of network: embeddedness and diversity ones. These differ from the aspect which type of social network can provide much more economic benefits. As similar studies have been reported by various researchers, these are also divided into the bonding and bridging views which are based on internal and external tie, respectively, Size, density, and centrality were measured as the characteristics of personal task networks. Size means the level of relationship between members. It is the total number of other colleagues who work with a specific member for a certain project. It means, the larger the size of task network, the more the number of coworkers who interact each other through the job. Density is the ratio of the number of relationships arranged actually to the total number of available ones. In an ego-centered network, it is defined as the ratio of the number of relationship made really to the total number of possible ones between members who are actually involved each other. The higher the level of density, the larger the number of projects on which the members collaborate. Centrality means that his/her position is on the exact center of whole network. There are several methods to measure it. In this research, betweenness centrality was adopted among them. It is measured by the position on which one member stands between others in a network. The determinant to raise its level is the shortest geodesic that represents the shortest distance between members. Centrality also indicates the level of role as a broker among others. To verify the hypotheses, we interviewed and surveyed a group of employees of a nationwide financial organization in which a groupware system is used. They were questioned about two CMC applications: MSN with a higher level of synchronicity and email with a lower one. As a result, the larger the size of his/her own task network, the smaller its density and the higher the level of his/her centrality, the higher the level of the effect using the task network with CMC tools. Above all, this positive effect is verified to be much more produced while using CMC applications with higher-level synchronicity. Among the a variety of situations under which the use of CMC gives more benefits, this research is considered as one of rare cases regarding the characteristics of task network as moderators by focusing ITs for the operation of his/her own task network. It is another contribution of this research to prove empirically that the values of information system depend on the social, or comparative, characteristic of time. Though the same amount of time is shared, the social characteristics of users change its value. In addition, it is significant to examine empirically that the ITs with higher-level synchronicity have the positive effect on productivity. Many businesses are worried about the negative effect of synchronous ITs, for their employees are likely to use them for personal social activities. However. this research can help to dismiss the concern against CMC tools.
Proceedings of the Korean Society of Propulsion Engineers Conference
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2011.04a
/
pp.1-2
/
2011
Hybrid rockets have lately attracted attention as a strong candidate of small, low cost, safe and reliable launch vehicles. A significant topic is that the first commercially sponsored space ship, SpaceShipOne vehicle chose a hybrid rocket. The main factors for the choice were safety of operation, system cost, quick turnaround, and thrust termination. In Japan, five universities including Hokkaido University and three private companies organized "Hybrid Rocket Research Group" from 1998 to 2002. Their main purpose was to downsize the cost and scale of rocket experiments. In 2002, UNISEC (University Space Engineering Consortium) and HASTIC (Hokkaido Aerospace Science and Technology Incubation Center) took over the educational and R&D rocket activities respectively and the research group dissolved. In 2008, JAXA/ISAS and eleven universities formed "Hybrid Rocket Research Working Group" as a subcommittee of the Steering Committee for Space Engineering in ISAS. Their goal is to demonstrate technical feasibility of lowcost and high frequency launches of nano/micro satellites into sun-synchronous orbits. Hybrid rockets use a combination of solid and liquid propellants. Usually the fuel is in a solid phase. A serious problem of hybrid rockets is the low regression rate of the solid fuel. In single port hybrids the low regression rate below 1 mm/s causes large L/D exceeding a hundred and small fuel loading ratio falling below 0.3. Multi-port hybrids are a typical solution to solve this problem. However, this solution is not the mainstream in Japan. Another approach is to use high regression rate fuels. For example, a fuel regression rate of 4 mm/s decreases L/D to around 10 and increases the loading ratio to around 0.75. Liquefying fuels such as paraffins are strong candidates for high regression fuels and subject of active research in Japan too. Nakagawa et al. in Tokai University employed EVA (Ethylene Vinyl Acetate) to modify viscosity of paraffin based fuels and investigated the effect of viscosity on regression rates. Wada et al. in Akita University employed LTP (Low melting ThermoPlastic) as another candidate of liquefying fuels and demonstrated high regression rates comparable to paraffin fuels. Hori et al. in JAXA/ISAS employed glycidylazide-poly(ethylene glycol) (GAP-PEG) copolymers as high regression rate fuels and modified the combustion characteristics by changing the PEG mixing ratio. Regression rate improvement by changing internal ballistics is another stream of research. The author proposed a new fuel configuration named "CAMUI" in 1998. CAMUI comes from an abbreviation of "cascaded multistage impinging-jet" meaning the distinctive flow field. A CAMUI type fuel grain consists of several cylindrical fuel blocks with two ports in axial direction. The port alignment shifts 90 degrees with each other to make jets out of ports impinge on the upstream end face of the downstream fuel block, resulting in intense heat transfer to the fuel. Yuasa et al. in Tokyo Metropolitan University employed swirling injection method and improved regression rates more than three times higher. However, regression rate distribution along the axis is not uniform due to the decay of the swirl strength. Aso et al. in Kyushu University employed multi-swirl injection to solve this problem. Combinations of swirling injection and paraffin based fuel have been tried and some results show very high regression rates exceeding ten times of conventional one. High fuel regression rates by new fuel, new internal ballistics, or combination of them require faster fuel-oxidizer mixing to maintain combustion efficiency. Nakagawa et al. succeeded to improve combustion efficiency of a paraffin-based fuel from 77% to 96% by a baffle plate. Another effective approach some researchers are trying is to use an aft-chamber to increase residence time. Better understanding of the new flow fields is necessary to reveal basic mechanisms of regression enhancement. Yuasa et al. visualized the combustion field in a swirling injection type motor. Nakagawa et al. observed boundary layer combustion of wax-based fuels. To understand detailed flow structures in swirling flow type hybrids, Sawada et al. (Tohoku Univ.), Teramoto et al. (Univ. of Tokyo), Shimada et al. (ISAS), and Tsuboi et al. (Kyushu Inst. Tech.) are trying to simulate the flow field numerically. Main challenges are turbulent reaction, stiffness due to low Mach number flow, fuel regression model, and other non-steady phenomena. Oshima et al. in Hokkaido University simulated CAMUI type flow fields and discussed correspondence relation between regression distribution of a burning surface and the vortex structure over the surface.
Our experience with Internet-based scientific collaboratories indicates that they need to be user-extensible, allow users to add tools and objects dynamically to workspaces, per mit users to move work dynamically between private and shared workspaces, and be easily accessible on the Internet. We present the software architecture of a development environment, called Collaboratory Builder's Environment(CBE), for building collaboratories to meet such needs. CBE provides user extensibility by allowing a collaboratory to be constructed as a collection of collaborative applets. To support dynamic reconfiguration of shared workspaces, CBE uses the metaphor of room that can contain applets, users, and arbitrary data objects. Rooms can be used not only for synchronous collaboration but also for asynchronous collaboration by supporting persistence. For the access over the Internet room participants are given different roles with appropriate access rights. A prototype of the model has been implemented in Java and can be run from a Java-enabled Web browser. The implemented system had been used by 95 users including 79 space scientists around the world in a scientific campaign that ran for 4 days. The usage evaluation of the campaign is also presented.
Kim, Hyool;Jung, Tae-Young;Kim, In-Young;Jung, Shin;Moon, Kyung-Sub;Park, Seung-Jin
Journal of Korean Neurosurgical Society
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v.54
no.2
/
pp.107-111
/
2013
Objective : We investigated the effectiveness of stereotactic gamma knife Radiosurgery (GKR) for radioresistant brain metastases with the impact upon histology. Methods : Between April 2004 and May 2011, a total of 23 patients underwent GKR for 67 metastatic brain tumors from 12 renal cell cancers, 5 sarcomas and 6 melanomas. The mean age was 56 years (range, 18 to 79 years). Most of the patients were classified as the Radiation Therapy Oncology Group recursive partitioning analysis class II (91.3%). The synchronous metastasis was found in 6 patients (26.1%) and metachronous metastasis in 17 patients (73.9%). We analyzed the local control rate, intracranial progression-free survival (PFS) and overall survival (OS). Results : The mean tumor volume for GKR was 2.24 cc and the mean prescription dose was 19.4 Gy (range, 10 to 24) to the tumor margin. Out of metachronous metastases, the median duration to intracranial metastasis was 3.3 years in renal cell cancer (RCC), 2.4 years in melanoma and 1.1 years in sarcoma (p=0.012). The total local control rate was 89.6% during the mean 12.4 months follow-up. The six-month and one-year local control rate was 90.2% and 83% respectively. Depending on the pathology, the control rate of RCC was 95.7%, sarcoma 91.3% and melanoma 80.5% during the follow-up. The common cause of local failure was the tumor bleeding in melanoma. The median PFS and OS were 5.2 and 8.4 months in RCC patients, 6.5 and 9.8 months in sarcoma, and 3.8 and 5.1 months in melanoma. Conclusion : The GKR can be one of the effective management options for the intracranial metastatic tumors from the radioresistant tumors. The melanoma showed a poor local control rate compared to other pathologies because of the hemorrhage.
The spectroscopic characteristics and chemical oxygen demand (COD) oxidation efficiencies were investigated for dissolved organic matters (DOM) from diverse sources, which may indirectly affect the concentrations and the quality of DOM found in watersheds. The DOM investigated for this study showed a wide range of the percent distributions of refractory organic matter (R-OM) from 8 to 100%. Relatively high R-OM distributions were observed for the DOM with the source of head water, sediments, paddy soils, field soils, and treated sewage whereas the DOM from livestock waste, reed, weeds, algae, and attached algae exhibited lower R-OM percent distributions. The percent distribution of R-OM had positive correlations with specific UV absorbance (SUVA) and humidification indices (HIX) of DOM. The investigated DOM was classified into four different source groups (i.e., biota, vegetables, soils, sediments) by comparing the synchronous fluorescence spectra. The DOM group from biota source was characterized by a prominent presence of protein-like fluorescence (PLF) whereas fulvic-like fluorescence (FLF) was additionally observed for vegetable-source DOM. FLF became significant for the DOM from both soils and sediments although no PLF was found for soil-derived DOM. A range of COD oxidation efficiency was observed for the various DOM, ranging from 36 to 94% and from 65 to 125% for $COD_{Mn}$ and $COD_{Cr}$, respectively. The results indicate that $COD_{Cr}$ reflects the higher OM concentration than $COD_{Mn}$. However, 95% confidence intervals of the COD oxidation efficiencies were similar for the two types of COD, suggesting that $COD_{Cr}$ may not be the superior OM index to $COD_{Mn}$ in terms of the variability of the oxidation efficiency. No significant correlations were obtained between COD oxidation efficiencies and the spectroscopic characteristics of DOM for this study.
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