• Korean Journal of Radiology
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• v.21 no.7
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• pp.812-828
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• 2020

Objective: To provide an evidence-based guide for the MRI interpretation of complete tumor response after neoadjuvant chemoradiation therapy (CRT) for rectal cancer using visual assessment on T2-weighted imaging (T2) and diffusion-weighted imaging (DWI). Materials and Methods: PubMed MEDLINE, EMBASE, and Cochrane Library were searched on November 28, 2019 to identify articles on the following issues: 1) sensitivity and specificity of T2 or DWI for diagnosing pathologic complete response (pCR) and the criteria for MRI diagnosis; 2) MRI alone vs. MRI combined with other test(s) in sensitivity and specificity for pCR; and 3) tests to select patients for the watch-and-wait management. Eligible articles were selected according to meticulous criteria and were synthesized. Results: Of 1615 article candidates, 55 eligible articles (for all three issues combined) were identified. Combined T2 and DWI performed better than T2 alone, with a meta-analytic summary sensitivity of 0.62 (95% confidence interval [CI], 0.43-0.77; I² = 80.60) and summary specificity of 0.89 (95% CI, 0.80-0.94; I² = 92.61) for diagnosing pCR. The criteria for the complete response on T2 in most studies had the commonality of remarkable tumor decrease to the absence of mass-like or nodular intermediate signal, although somewhat varied, as follows: (near) normalization of the wall; regular, thin, hypointense scar in the luminal side with (near) normal-appearance or homogeneous intermediate signal in the underlying wall; and hypointense thickening of the wall. The criteria on DWI were the absence of a hyperintense signal at high b-value (≥ 800 sec/mm²) in most studies. The specific algorithm to combine T2 and DWI was obscure in half of the studies. MRI combined with endoscopy was the most utilized means to select patients for the watch-and-wait management despite a lack of strong evidence to guide and support a multi-test approach. Conclusion: This systematic review and meta-analysis provide an evidence-based practical guide for MRI assessment of complete tumor response after CRT for rectal cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.215-217
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• 2016

Background: Chronic lymphocytic leukemia (CLL) is the most frequent form of leukemia in Europe and North America, and it mainly affects older individuals. Many approaches are implemented in the management of CLL from a watch and wait (W&W) strategy to chemotherapeutic regimens. We here reviewed our clinical practice for the relevance of the W&W strategy in Lebanese CLL patients. Materials and Methods: A total of 95 patients with CLL diagnosed in four institutions in Lebanon, between 1992 and 2013, were selected and their files were reviewed. Characteristics of these patients were noted including age, sex, RAI and Binet scores, CBC values, presence of hepatomegaly or splenomegaly, performance of bone marrow biopsy or peripheral blood flux cytometry for diagnosis, adoption of W&W strategy, different chemotherapeutic regimens and the indications for treatment. Results: Some 38 patients (40%) diagnosed with CLL were women and 57 (60%) were men with a mean age of 65.1 years [36-89]. Of the total, 50.5%, 17.2%, 14%, 7.5% and 10.8% had an RAI score at diagnosis of 0, 1, 2, 3 and 4, respectively, while 65.6%, 17.2% and 17.2% had Binet scores of I, II and III. The mean lymphocyte count at diagnosis was $39885/mm^3$ [1596-290000], the mean hemoglobin level was 12.7 g/dl [6.2-17] and the mean platelet count was $191255/mm^3$ [14000-458000]. While 26.3% of patients with CLL had splenomegaly, only 7.4% had hepatomegaly. Some 33.7% had undergone a bone marrow biopsy, 66.3% flow cytometry of circulating blood and 5.3% a lymph node biopsy. Overall, the W&W was adopted in 62.4% (58) of patients with a mean duration of 37.7 months [3-216]. The W&W was used in 82.6%, 73.3%, 46.2%, 14.3% and 0% of patients having RAI scores of 0, 1, 2, 3 and 4, respectively, and, it was used in 80%, 46.7% and 6.25% with Binet scores of I, II and III. The most frequent indication for treatment was anemia and thrombocytopenia, accounting for 32.7% of cases. The most frequently used chemotherapeutical regimens were chlorambucil until the end of the last century and flufarabine-cyclophosphamide-rituximab during the last decade. Conclusions: This retrospective review of CLL clinical practice showed an important implementation of the W&W strategy with a long duration, especially in early stage cases with low RAI or Binet scores.

• The Journal of the Korea Contents Association
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• v.10 no.5
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• pp.107-114
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• 2010

A nonlinear story is generated through the interactivity with users using the interactive storytelling system. In a play or movie, audiences can watch one scene at a time, and in order to watch next scene, they should wait for the end of current scene. In the real world, however, various events can simultaneously happen at different places, and even those events performed by characters may dramatically affect the flow of the story. This paper suggests Constraint Based narrative structure to create such story, known as "Simultaneous Story Arcs", and "Multi Viewpoint" to simultaneously lead the direction of the stories in each place.

• Nuclear Engineering and Technology
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• v.40 no.1
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• pp.9-20
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• 2008

Since plutonium accounts for 40-50% of the power produced by uranium fuels, spent fuel contains only residual plutonium. Management of this plutonium is one of the aspects influencing the choice of a fuel cycle back-end option: reprocessing, direct disposal or wait-and-see. Different grades and qualities of plutonium exist depending from their specific generation conditions; all are valuable fissile material. Safeguard authorities watch the inventories of civil plutonium, but access to those data is restricted. Independent evaluations have led to an estimated current inventory of 220t plutonium in total (spent fuel, separated civil plutonium and military plutonium). If used as MOX fuel, it would be sufficient to feed all the PWRs and BWRs worldwide during 7 years or to deploy a FBR park corresponding to 150% of today' s installed nuclear capacity worldwide, which could then be exploited for centuries with the current stockpile of depleted and spent uranium. The energy potential of plutonium deteriorates with storage time of spent fuel and of separated plutonium, due to the decay of $^{241}Pu$, the best fissile isotope, into americium, a neutron absorber. The loss of fissile value of plutonium is more pronounced for usage in LWRs than in FBR. However, keeping the current plutonium inventory for an expected future deployment of FBRs is counterproductive. Recycling plutonium reduce the required volume for final disposal in an underground repository and the cost of final disposal. However, the benefits of utilizing an energy resource and of reducing final disposal liabilities are not the only aspects that determine the choice of a back-end policy.

• Journal of the Korean Institute of Landscape Architecture International Edition
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• no.2
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• pp.114-119
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• 2004

By Article two of a Japanese urban park low, it prescribes park facilities strictly, and one of the classifications includes 'path and plaza'. In addition, it is assumed that we divide several kinds different paths of width by size of the park in a path design of a park with a textbook of park design in a trunk line path, the main path, a vice-path or a branch path and design it. From such a thing, in the path of an urban park, a line consists straight of fixed width, and it is most that one pattern is considered to be. Therefore, in modem urban park, a path and division of a plaza are lucid explanation. It is rare that the historical parks which generally former daimyo gardens are shown later, and is used as a kind of an urban park width of the path where was particularly posted in a strolling garden in that is fixed, and width waits straight for even a line and waits, and, for this, there is. As a result, it is a path and the situation that are hard to be distinguished of a plaza. Although there are a difference of design and a difference of pavement materials in modem landscape space when We watch road surface constitution of the path that We did that will let you wait, in gross We are uniform, and it is it with a result to be poor in change nature. From such an observation, this consideration compared traditional landscape space and modem landscape space with path width about two points of road surface constitution through the trial that a graph analyzed the actual place data which measured into and lectured on an ideal method of a park path from this.

• The Korean journal of helicobacter and upper gastrointestinal research
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• v.18 no.4
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• pp.258-263
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• 2018

Follicular lymphoma is the most common form of low-grade B cell lymphoma. Follicular lymphoma occurs predominantly at lymph node sites and rarely in the gastrointestinal tract. Rare gastrointestinal follicular lymphoma is most commonly found in the small intestine, especially in the duodenum, and appears as multiple granules. However, gastric follicular lymphoma mostly appears as a subepithelial tumor. We observed two primary gastric follicular lymphomas that resembled subepithelial tumors located in the body of the stomach. Endoscopic ultrasound revealed hypoechoic lesions located in the submucosa layer. Since endoscopic forceps biopsies were inconclusive, we performed endoscopic submucosal dissection, which resulted in a final pathologic diagnosis of follicular lymphoma. Because of the indolent nature of gastrointestinal follicular lymphoma, the "watch and wait" strategy can be applied in the early phase. The identification of endoscopic characteristics of gastric follicular lymphoma can be helpful for differential diagnosis and decision of treatment strategy. Therefore, we report two cases of primary gastrointestinal follicular lymphoma diagnosed following endoscopic submucosal dissection.

• Journal of the Korean Institute of Telematics and Electronics C
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• v.35C no.11
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• pp.21-30
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• 1998

In this paper, a digital current control system using a FPGA(Field Programmable Gate Array) was implemented, and the system was applied to an induction motor widely used as an industrial driving machine. The FPGA designed by VHDL(VHSIC Hardware Description Language) consists of a PWM(Pulse Width Modulation) generation block, a PWM protection block, a speed measuring block, a watch dog timer block, an interrupt control block, a decoder logic block, a wait control block and digital input and output blocks respectively. Dedicated clock inputs on the FPGA were used for high-speed execution, and an up-down counter and a latch block were designed in parallel, in order that the triangle wave could be operated at 40 MHz clock. When triangle wave is compared with many registers respectively, gate delay occurs from excessive fan-outs. To reduce the delay, two triangle wave registers were implemented in parallel. Amplitude and frequency of the triangle wave, and dead time of PWM could be changed by software. This FPGA was synthesized by pASIC 2SpDE and Synplify-Lite synthesis tool of Quick Logic company. The final simulation for worst cases was successfully performed under a Verilog HDL simulation environment. And the FPGA programmed for an 84 pin PLCC package was applied to digital current control system for 3-phase induction motor. The digital current control system of the 3 phase induction motor was configured using the DSP(TMS320C31-40 MHz), FPGA, A/D converter and Hall CT etc., and experimental results showed the effectiveness of the digital current control system.