• Title/Summary/Keyword: Regional factor

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Postoperative Adjuvant MVP Chemotherapy and Radiotherapy for Non-Small Cell Lung Cancer (비소세포성폐암의 수술후 MVP복합화학요법과 방사선병용치료 결과)

  • Kim, Jong-Hoon;Choi, Eun-Kyung;Chang, Hyesook;Kim, Sang-Wee;Suh, Chul-won;Lee, Kyoo-Hyung;Lee, Jung, Shin;Kim, Sang-Hee;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Park, Seung-Il;Sohn, Kwang-Hyun
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.149-156
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    • 1995
  • Purpose : Since February 1991 a Prospective study for non-small cell lung cancer patients who underwent radical resection and had a risk factor of positive resection margin or regional lymph node metastasis has been conducted to evaluate the effect of MVP chemotherapy and radiotherapy on the pattern of failure, disease free and overall survival. and tolerance of combined treatment. Materials and Methods: Twenty nine patients were registered to this study until Sep. 1993; of these 26 received planned therapy Within 3 weeks after radical resection, two cycles of MVP(Mitomycin C $6mg/m^2,$ Vinblastin $6mg/m^2,$ Cisplatin $60mg/m^2$) chemotherapy was given with 4 weeks intervals. Radiotherapy (5040cGy tumor bed dose and 900cGy boost to high risk area) was started 3 to 4 weeks after chemotherapy. Results: One and two year overall survival rates were $76.5\%\;and\;58.6\%$ respectively. Locoregional failure developed in 6 patients$(23.1\%)$ and distant failure in 9 patients$(34.6\%)$ Number of involved lymph nodes, resection margin positivity showed some correlation with failure pattern but T-stage and N-stage showed no statistical significance. The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70 days showed lower incidence of distant metastasis. Postoperative combined therapy were well tolerated without definite increase of complication rate, and compliance rate in this study was $90\%$. Conclusion: 1) MVP chemotherapy showed no effect on locoregional recurrence, but appeared to decrease the distant metastasis rate and 2) combined treatments were well tolerated in all patients. 3) The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70days showed lower incidence of distant metastasis. 4) Addition of chemotherapy to radiotherapy failed to increase the overall or disease free survival.

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학교도서관 발전의 저해요인에 관한 실증적 고찰 -일학교장의 학교도서관에대한 인식을 중심으로-

  • 김남석;김정소
    • Journal of Korean Library and Information Science Society
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    • v.7
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    • pp.1-55
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    • 1980
  • It has been observed that the purpose of education is poorly coordinated with the school library. Consequently a healthy growth of the library has been very rare, and educational process has been rather inefficient. Therefore this study attempts to define the role of a school library and the necessasity of its growth, examine principals' concepts of the library, find out the adverse causes for its growth, and make some suggestions to rectify them. A questionnaire was designed to get information on the principals' conceptions about the nature and the role of a school library, a librarian, and adverse causes for the growth of the library. This study is largely based on the analysis of this questionnaire. The results of this study may be summarized as. follows: 1) The school library is not generally considered as the center of educational activities. It is rather variously regarded as a subsidiary organization for education, a place where reading materials are offered, a place where books are kept, or a reading room. 2) This was largely due to the misconceptions of the principals as to the true nature and the role of the school library. 3) The degrees of their misconceptions varied depending on the amount of their exposure to the library science. Those principals who studied library science more hours had better understanding of the library. 4) Although the principals showed rather much concern for the library, the school library was not up to the expectation largely due to their misconception of it. 5) Most of the principals felt that they needed more knowledge on library science to carry out their job. This feeling was stronger for those who spent more hours in a library science course. 6) Most of the principals wanted to offer a position for a dual function: a librarian and a teacher. This was largely due to their lack of knowledge as to the duties of a librarian-which were considered as secondary to the duties of a teacher. 7) The majority of the principals thought the librarians were not paid well enough, but some of the principals o n.0, pposed their pay raise. The former generally took more courses in library science than the latter. 8) Many principals agreed that the adverse causes for the growth of the school library originated from the regional or governmental school authorities. This seemed to indicate that the legal requirements for the library were inadequate and that there was no administrative organization to take care of the library. 9) Most of the principals considered the insufficient funds as the major reason for the present poor condition of the library. But considering the fact that some libraries are better equi n.0, pped that others, financial matter cannot be the deciding factor. It rather seemed that there is some serious problems in the current educational system. For further studies in this field and for the libraries to function properly, the following suggestions are made here: 1) The major adverse cause for the healthy growth of the school library was found in the misconceptions on the school library by the principals, and these misconceptions were largely due to their lack of knowledge. Therefore they should be given more o n.0, pportunities to take courses in library science. 2) The librarian should not be overburdened with other duties than what his job duly calls for, and they should be properly compensated for their own job. They should also be encouraged to grow as librarians. 3) Education itself should be improved so that the library becomes the center of learning. 4) An administrative department should be created to oversee the school libraries, and legal measures should be enacted for better school libraries. 5) Financial su n.0, pport should be provided for a period of time in order to upgrade the school library to a certain level. Finally it is strongly felt that more detailed and inclusive studies in this field should be carried on and further experimental studies should be done.

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Clinical observations of juvenile rheumatoid arthritis (연소성 류마티스 관절염의 임상적 고찰)

  • Lee, Joo Hoon;Ryu, Jeong Min;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.424-430
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    • 2006
  • Purpose : Juvenile rheumatoid arthritis(JRA) is one of the most common rheumatic diseases of childhood and is an important cause of short- and long-term disability. The purpose of this study was to determine the disease course and outcome in childhood patients with JRA. Methods : Fifty nine patients with JRA who were diagnosed and treated in the Department of Pediatrics, Asan Medical Center from August 1990 to November 2004 were enrolled in this study. Sex, age, type, affected joints, extra-articular manifestations, laboratory and radiologic findings, treatments, and outcomes of JRA patients were reviewed retrospectively. Results : Among JRA patients, 32.2 percent had pauciarticular type, 30.5 percent had polyarticular type and 37.3 percent had systemic type. The ratio of boys to girls was 1.7 : 1 and the mean age at onset was $9.3{\pm}3.7$(1.3-15.9) years. The most commonly affected joints were knee, ankle and wrist. The extra-articular manifestations observed were fever, rash, myalgia and lymph node enlargement, etc. The main laboratory findings observed were leukocytosis, anemia, thrombocytosis, elevated ESR, and elevated CRP. Rheumatoid factor and antinuclear antibody(ANA) were positive in 5.3 percent and 18.0 percent. Nonsteroid anti-inflammatory drugs(NSAID) were used most frequently and methotrexate with or without steroids was added in 27.1 percent of patients unresponsive to NSAID. 88.1 percent of patients were cured without functional disability and only one patient was in functional status IV. One patient, who had pulmonary involvement, died. Conclusion : Our results showed an even distribution in type of onset, male predominance, older age of onset, low incidence of iridocyclitis, and low positivity of ANA in JRA patients; this differs from occidental data. This study may suggest regional differences and variability in disease groups of JRA among different racies, but further multi-center trials and large scale epidemiological studies are needed to confirm our conclusion.

Results of Breast Conserving Surgery and Subsequent Postoperative Radiotherapy for Cases of Breast Cancer (유방암에서 유방보존수술 및 수술 후 방사선치료의 결과)

  • Chie, Eui-Kyu;Kim, Kyu-Bo;Choi, Jin-Hwa;Jang, Na-Young;Han, Won-Shik;Noh, Dong-Young;Im, Seock-Ah;Kim, Tae-You;Bang, Yung-Jue;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.26 no.3
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    • pp.142-148
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    • 2008
  • Purpose: We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by postoperative radiotherapy.Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months. Results: The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival. Conclusion: This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.

A Study on the Strategies of Growth in Small & Medium Construction Firms (강원지방 중소건설업의 성장전략에 관한 연구)

  • Kim, Beom-Jin;Cho, Chang-Jin
    • Korean Business Review
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    • v.19 no.1
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    • pp.53-80
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    • 2006
  • This research has been accomplished to build up the growth strategies of Kangwon district's small & medium-sized construction firms. For this purpose, we made an investigation of the present situation and status for existing regional small & medium construction firms by analyzing data. Based on the results from this study, the following growth strategies are suggested to gain their competitive advantages. Firstly, most of all, the role of the top manager is the most important factor since most of the top manager for the small & medium-sized construction firms coincide with the owner the firms. Secondly, the specialization strategy is to establish. Above all they concentrate their business capacities on core business. Then, this growth strategy should be based on the selective escalation of functions in order to maintain an appropriate level of construction works. Thirdly, the specialized skills and skilled workers are ensured for competitive advantages. For human resource development, they should train workers to be multi-functioned on the assumption the they could stay at firm until they wish to retire. Finally, the government must also spare no effort to encourage the small & medium-sized construction firms to build up it's competitive power and cultivate it's spontaneous generation power though the reformation of system related whit the small and medium construction industry.

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Laparoscopic Assisted Total Gastrectomy (LATG) with Extracorporeal Anastomosis and using Circular Stapler for Middle or Upper Early Gastric Carcinoma: Reviews of Single Surgeon's Experience of 48 Consecutive Patients (원형 자동문합기를 이용한 체외문합을 시행한 복강경 보조 위전절제술: 한 술자에 의한 연속적인 48명 환자의 수술성적분석)

  • Cheong, Oh;Kim, Byung-Sik;Yook, Jeong-Hwan;Oh, Sung-Tae;Lim, Jeong-Taek;Kim, Kab-Jung;Choi, Ji-Eun;Park, Gun-Chun
    • Journal of Gastric Cancer
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    • v.8 no.1
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    • pp.27-34
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    • 2008
  • Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

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The Korean Cough Guideline: Recommendation and Summary Statement

  • Rhee, Chin Kook;Jung, Ji Ye;Lee, Sei Won;Kim, Joo-Hee;Park, So Young;Yoo, Kwang Ha;Park, Dong Ah;Koo, Hyeon-Kyoung;Kim, Yee Hyung;Jeong, Ina;Kim, Je Hyeong;Kim, Deog Kyeom;Kim, Sung-Kyoung;Kim, Yong Hyun;Park, Jinkyeong;Choi, Eun Young;Jung, Ki-Suck;Kim, Hui Jung
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.1
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    • pp.14-21
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    • 2016
  • Cough is one of the most common symptom of many respiratory diseases. The Korean Academy of Tuberculosis and Respiratory Diseases organized cough guideline committee and cough guideline was developed by this committee. The purpose of this guideline is to help clinicians to diagnose correctly and treat efficiently patients with cough. In this article, we have stated recommendation and summary of Korean cough guideline. We also provided algorithm for acute, subacute, and chronic cough. For chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered. If UACS is suspicious, first generation anti-histamine and nasal decongestant can be used empirically. In CVA, inhaled corticosteroid is recommended in order to improve cough. In GERD, proton pump inhibitor is recommended in order to improve cough. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, angiotensin converting enzyme inhibitor, habit, psychogenic cough, interstitial lung disease, environmental and occupational factor, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and idiopathic cough can be also considered as cause of chronic cough. Level of evidence for treatment is mostly low. Thus, in this guideline, many recommendations are based on expert opinion. Further study regarding treatment for cough is mandatory.

Regional Differences of Proteins Expressing in Adipose Depots Isolated from Cows, Steers and Bulls as Identified by a Proteomic Approach

  • Cho, Jin Hyoung;Jeong, Jin Young;Lee, Ra Ham;Park, Mi Na;Kim, Seok-Ho;Park, Seon-Min;Shin, Jae-Cheon;Jeon, Young-Joo;Shim, Jung-Hyun;Choi, Nag-Jin;Seo, Kang Seok;Cho, Young Sik;Kim, MinSeok S.;Ko, Sungho;Seo, Jae-Min;Lee, Seung-Youp;Chae, Jung-Il;Lee, Hyun-Jeong
    • Asian-Australasian Journal of Animal Sciences
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    • v.29 no.8
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    • pp.1197-1206
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    • 2016
  • Adipose tissue in the loin muscle area of beef cattle as a marbling factor is directly associated with beef quality. To elucidate whether properties of proteins involved in depot specific adipose tissue were sex-dependent, we analyzed protein expression of intramuscular adipose tissue (IMAT) and omental adipose tissue (OMAT) from Hanwoo cows, steers, and bulls of Korean native beef cattle by liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based proteomic analysis, quantitative polymerase chain reaction (PCR) and western blot analysis. Two different adipose depots (i.e. intramuscular and omental) were collected from cows (n = 7), steers (n = 7), or bulls (n = 7). LC-MS/MS revealed a total of 55 and 35 proteins in IMAT and OMAT, respectively. Of the 55 proteins identified, 44, 40, and 42 proteins were confirmed to be differentially expressed in IMAT of cows, steers, and bulls, respectively. In OMAT of cows, steers, and bulls, 33, 33, and 22 were confirmed to be differentially expressed, respectively. Tropomyosin (TPM) 1, TPM 2, and TPM3 were subjected to verification by quantitative PCR and western blot analysis in IMAT and OMAT of Hanwoo cows, steers, and bulls as key factors closely associated with muscle development. Both mRNA levels and protein levels of TPM1, TPM2, and TPM3 in IMAT were lower in bulls compared to in cows or steers suggesting that they were positively correlated with marbling score and quality grade. Our results may aid the regulation of marbling development and improvement of meat quality grades in beef cattle.

An Analysis of Process-oriented Design in the Invited Entries of International Competition for the Master Plan of the Yongsan Park, Korea (용산공원 설계 국제공모 출품작에 나타난 프로세스적 설계 분석)

  • So, Jin;Sung, Jong-Sang;Pae, Jeong-Hann
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.2
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    • pp.11-26
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    • 2013
  • Designing large parks such as Yongsan Park requires the open-ended process-oriented design approach in complex layers rather than the conventional self-completed master plan method. This study aims to examine the characteristics of process-oriented design in the eight invited entries of "International Competition for the Master Plan of the Yongsan Park, Korea"(2012). For this purpose, it analyzed each entry according to three criteria: objects of process-oriented approach, time factor and its features of phasing plan, and presentation method of the process. This analysis can not only critically review the current level of the process-centered design methodology but also suggest strategic future directions for Yongsan Park. The objects of process-oriented design in the eight works were order of physical space development, restoration process of ecosystem, recovering process of publicity, and economic operation and management. Main considerations in the objects were connections to adjacent urban fabrics, links to regional green and water system, reuse of existing buildings and infrastructures in the site. The temporal criteria of the phasing plan had two aspects. One was planning a certain time and period, and the other was just establishing an order of phases. Most of the presentation method of process was the phasing plan, but some of the entries suggested a scenario plan. The eight works of "International Competition for the Master Plan of Yongsan Park" did not attempt process-oriented designs entirely and completely. Rather, they tried to introduce the phasing plan as part of a process-centered design. Also, they took an eclectic approach between master plan and process-oriented design instead of rejecting the conventional master plan approach.

The Infertility Characteristics of Patients in the Obstetrics and Gynecology Specialized Hospital and Effect of Pregnancy on the Type of Assisted Reproductive Technology (산부인과 전문병원 내원환자의 난임 특성과 보조생식술 유형이 임신에 미치는 영향)

  • Kim, Yun-Jeong;Hwang, Byung-Deog
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.318-326
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    • 2016
  • This study was conducted to identify characteristics observed by staff during infertility treatment, and to analyze the relationship between the result of the treatment according to the ART infertility characteristics. In cooperation with an Obstetrics and Gynecology Hospital in Ulsan, data were collected from 344 people receiving infertility treatment from 2012-1013 and evaluated by cross-analysis, logistic regression analysis, and the ${\chi}^2$ test. Age 30 subjects (72.1%), no disease (70.9%), and no birth children (77.0%) were most common among patients. Causes of infertility factor is the higher the age, followed by uterine factors, ovarian factors were the lower the age.Were assisted reproduction are IUI (51.5%), IVF (23.0%), IUI + IVF (25.6%), assisted reproduction were age (p<.013) infertility period (p<.014), abortion Experience (p<.008) it was not statistically significant. ART pregnancies result was 34.9%, IUI was 49.2%, IVF was 50.8%. The average number of successful IVF treatment was 1.64, while it was 1.36 for IVF. IVF is 0.28 times lower than the IUI. Thus, low in order to increase the success rate of pregnancy according to the assisted reproduction age, nanim period is short, and if you do not have birth children choose artificial fertilization, and high age, IVF If there are nanim period is longer and birth child treatment and you must choose. This study analyzed all subjects who underwent fertility treatment to have research significance. However, it is difficult to generalize, locally called Sun City limits. If this one based on regional and national follow-up study of infertility therapist made it will help to prepare the way of effective treatment for infertility causes.