Jo, Kwang-Wook;Kong, Doo-Sik;Lim, Do-Hoon;Ahn, Yong-Chan;Nam, Do-Hyun;Lee, Jung-Il
Journal of Korean Neurosurgical Society
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v.50
no.2
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pp.99-102
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2011
Objective : The purpose of this retrospective study was to evaluate the outcome of gamma knife radiosurgery (GKRS) and/or whole brain radiation therapy (WBRT) for the treatment of small cell lung carcinoma (SCLC) metastasis to the brain. Methods : From 2000 to 2010, 50 patients underwent GKRS for metastatic brain lesions originating from SCLC. Among these patients, 11 received prophylactic cranial irradiation (PCI) before the development of metastatic lesions (PCI group), and GKRS was performed as an initial treatment for newly diagnosed lesions in 12 patients who had not received PCI (primary GKRS group). In addition, GKRS was performed as a salvage treatment for progressive lesions after WBRT in 27 patients (salvage GKRS group). The medical records and imaging data of all patients were retrospectively analyzed. Results : The overall survival of the 50 patients was 20.8 months (range 1-53) after the diagnosis of primary tumor and 12.0 months (range 1-47) after the development of cerebral metastasis. Median survival after GKRS was 4.8 months (range 1-15) in the PCI group, 4.6 months (range 0-18) in the primary GKRS group, and 7.6 months (range 0-33) in the salvage GKRS group. Further treatment for progressive lesions after GKRS was necessary in 15 patients, after a mean interval of 3.8 months. Causes of death were systemic organ failure in 15 patients, deterioration of neurological state in 13 patients, and unknown or combined causes in 16 patients. The local control rate of the lesions treated with GKRS was 76.4% (decreased in 13 patients and stable in 16 patients at the final imaging follow-up (mean 5.60 months). Conclusion : GKRS is an effective local treatment for brain metastasis from SCLC both as an initial treatment for newly diagnosed lesions after PCI and as a salvage treatment for recurrent or progressive lesions. However, the survival benefit is not significant because most patients die of systemic multi-organ failure with a short life expectancy.
For the development of combustion technology of RDF(refuse derived fuel), combustion characteristics are examined in bubbling fluidized bed, circulating fluidized bed, continuos combustor and batch type combustor. The characteristics of combustion and exhaust gas has been compared and analyzed in many type of combustion facilities, which has been utilized as basic data for the advanced research of specified RDF combustion facility. Stable combustion has been observed in bubbling and circulating fluidized bed from controled operating condition like the proper feeding rate and superficial gas velocity. In circulating fluidized bed, concentration of NOx has been increased with the operating condition by the fuel-NO and oxygen reaction and $SO_2$ can be considered not to be produced in RDF fluidized bed from very low concentration in flue gas. HCl concentration is 36.4 ppm as average value and lower than standard emission value, but the counter plan is needed. Shaped RDF and fluff RDF have been compared in continuos combustor and batch type combustor and shaped RDF shows benefit for the stable heat recovery and gas emission shows similar value and characteristics.
Objectives Some plants were placed in indoor locations frequented by asthmatics in order to evaluate the quality of indoor air and examine the health benefits to asthmatics. Methods The present study classified the participants into two groups: households of continuation and households of withdrawal by a quasi-experimental design. The households of continuation spent the two observation terms with indoor plants, whereas the households of withdrawal passed the former observation terms with indoor plants and went through the latter observation term without any indoor plants. Results The household of continuation showed a continual decrease in the indoor concentrations of volatile organic compounds (VOCs) during the entire observation period, but the household of withdrawal performed an increase in the indoor concentrations of VOCs, except formaldehyde and toluene during the latter observation term after the decrease during the former observation term. Peak expiratory flow rate (PEFR) increased in the households of continuation with the value of 13.9 L/min in the morning and 20.6 L/min in the evening, but decreased in the households of withdrawal with the value of -24.7 L/min in the morning and -30.2 L/min in the evening in the first experimental season. All of the households exhibited a decrease in the value of PEFR in the second experimental season. Conclusions Limitations to the generalizability of findings regarding the presence of plants indoors can be seen as a more general expression of such a benefit of human-environment relations.
Park, Yong-hwa;Shim, In-tae;Kim, Hyun-jin;Jang, Am
Journal of Korean Society of Environmental Engineers
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v.39
no.7
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pp.377-384
/
2017
This study examined the possibility of solving the water shortage problem through the water reuse of buildings through the Suwon water reuse (greywater) facility installation project conducted as a pilot project of Ministry of Environment. Water reuse of individual building units can reduce city water demand by up to 25%. This is a level that can solve the water shortage problem in Korea. However, in order to revitalize the water reuse facilities of individual buildings, it is necessary to solve the problem of the user's rejection of the greywater and the economical problems. The resolution of the user's rejection can be solved by linking the MBR process with the AOP process. When the MBR process and the AOP process are operated in conjunction with each other, it is found that the users do not feel the water quality difference with the tap water. Economical problems can be solved at the water rate levels when the facility capacity is over 100 ton/day considering the construction cost and the operation cost, and when the operation cost alone is over 15 ton/day. Furthermore, when considering the social benefit cost, it is found that profit is generated from 150 ton/day.
Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.
This study was conducted to evaluate the effectiveness of a combination of gemcitabine and nedaplatin therapy among patients with metastatic urothelial carcinoma previously treated with two lines of chemotherapy. Between February 2009 and August 2013, 30 patients were treated with gemcitabine and paclitaxel as a second-line chemotherapy. All had received a first-line chemotherapy consisting of methotrexate, vinblastine, doxorubicin and cisplatin. Ten patients who had measurable histologically proven advanced or metastatic urothelial carcinoma of the urinary bladder and upper urinary tract received gemcitabine $1,000mg/m^2$ on days 1, 8 and 15 and nedaplatin $70mg/m^2$ on day 2 as a third-line chemotherapy. Tumors were assessed by imaging every two cycles. The median number of treatment cycles was 3.5. One patient had partial response and three had stable disease. The disease-control rate was 40%, the median overall survival was 8.8 months and the median progression-free survival was 5.0 months. The median overall survival times for the first-line and second-line therapies were 29.1 and 13.9 months, respectively. Among disease-controlled patients (n=4), median overall survival was 14.2 months. Myelosuppression was the most common toxicity. There were no therapy-related deaths. Gemcitabine and nedaplatin chemotherapy is a favorable third-line chemotherapeutic option for patients with metastatic urothelial carcinoma. Given the safety and benefit profile seen in this study, further prospective trials are warranted given the implications of our results with regard to strategic chemotherapy for patients with advanced or metastatic urothelial carcinoma.
Purpose: To evaluate the prognostic value of the expression of excision repair cross-complementation group l (ERCC1), MutS protein homolog 2 (MSH2) and poly ADP-ribose polymerase 1 (PARP1) in non-small-cell lung cancer patients receiving platinum-based postoperative adjuvant chemotherapy. Methods: Immunohistochemistry was applied to detect the expression of ERCC1, MSH2 and PARP1 in 111 cases of non-small cell lung cancer paraffin embedded surgical specimens. Through og-rank survival analysis, we evaluated the prognostic value of the ERCC1, MSH2, PARP1 and the related clinicopathological factors. COX regression analysis was used to determine whether ERCC1, MSH2 and PARP1 were independent prognostic factors. Results: In the enrolled 111 non-small cell lung cancer patients, the positive expression rate of ERCC1, MSH2 and RARP1 was 33.3%, 36.9% and 55.9%, respectively. ERCC1 (P<0.001) and PARP1 (P=0.033) were found to be correlated with the survival time while there was no correlation for MSH2 (P=0.298). Patients with both ERCC1 and PARP1 negative cancer had significantly longer survival time than those with ERCC1 (P=0.042) or PARP1 (P=0.027) positive alone. Similalry, the survival time of patients with both ERCC1 and PARP1 positive cancer was shorter than those with ERCC1 (P=0.048) or PARP1 (P=0.01) positive alone. Conclusion: Patients with ERCC1 or PARP1 negative non-small cell lung cancer appear to benefit from platinum-based postoperative adjuvant chemotherapy.
Purpose: Generally, aspirin is used as a protective agent against thrombogenic phenomenon after pulmonary valve replacement (PVR) using a bioprosthetic valve. However, the appropriate duration of aspirin use is unclear. We analyzed the impact of postoperative duration of aspirin use on the longevity of bioprosthetic pulmonary valves in patients who underwent repair for congenital heart diseases. Methods: We retrospectively reviewed the clinical data of 137 patients who underwent PVR using a bioprosthetic valve between January 2000 and December 2003. Among these patients, 89 were included in our study and divided into groups I (${\leq}12$ months) and II (>12 months) according to duration of aspirin use. We analyzed echocardiographic data from 9 to 11 years after PVR. Pulmonary vale stenosis and regurgitation were classified as mild, moderate, or severe. Results: The 89 patients consisted of 53 males and 36 females. Their mean age was $14.3{\pm}8.9$ years (range, 2.6-48 years) and body weight was $37.6{\pm}14.7kg$ (range, 14-72 kg). The postoperative duration of aspirin use was $7.3{\pm}2.9$ months in group I and $32.8{\pm}28.4$ months in group II. However, no significant difference in sex ratio, age, body weight, type of bioprosthetic valve, and number of early redo-PVRs. In the comparison of echocardiographic data about 10 years later, no significant difference in pulmonary valve function was found. The overall freedom rate from redo-PVR at 10 years showed no significant difference (P=0.498). Conclusion: Our results indicated no benefit from long-term aspirin medication (>6 months) in patients who underwent PVR with a bioprosthetic valve.
Lee, Ji Sun;Oh, Eui Geum;Lee, Hyang Kyu;Kim, Sang Hee
The Journal of the Korea Contents Association
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v.17
no.12
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pp.357-367
/
2017
The study investigated information about the effects of message framing on colorectal cancer(CRC) screening related health beliefs and compliance with the CRC screening test within the theoretical framework of the prospect theory and the Health belief model (HBM). This study was using a non-randomized controlled quasi-experimental design. One hundred and sixty-four in the industrial workers who were currently nonadherent to guidelines for receiving screening were assigned to one of three experimental conditions: (a) gain-framed message, (b) loss-framed message, and (c) general-framed message. CRC screening-related health beliefs was self-reported after the intervention. And the immunoassay Fecal Occult Blood Test (iFOBT) kit was collected at 1 week. The research finding were analyzed by $x^2$ test and one-way ANOVA using SPSS 21.0. The loss-framed message group had higher perceived susceptibility, severity and benefit than the gain-framed message and general message. The participation rate for the immunoassay Fecal Occult Blood Test(iFOBT) was highest in the loss-framed message group. The loss framed messages more effective to enhance screening behavior. The present results provide a theoretical basis for developing educational guidelines for CRC testing and could be used for performing comprehensive approach by predicting and suggesting the practical effects according to message type in advance.
Standards boost technological innovation by promoting information sharing, compatibility, stability and quality. Identifying groups of companies that particularly benefit from these functions of standards in their technological innovation and commercialization helps to customize planning and implementation of standards-related policies for demand groups. For this purpose, this study engages in profiling of SMEs whose R&D objective is to respond to standards as well as those who need to implement standards system for technological commercialization. Then it suggests a prediction model that can distinguish such companies from others. To this end, decision tree analysis is conducted for profiling of characteristics of subject SMEs through data mining. Subject SMEs include (1) those that engage in R&D to respond to standards (Group1) or (2) those in need of product standard or technological certification policies for commercialization purposes (Group 2). Then the study proposes a prediction model that can distinguish Groups 1 and 2 from others based on several variables by adopting discriminant analysis. The practicality of discriminant formula is statistically verified. The study suggests that Group 1 companies are distinguished in variables such as time spent on R&D planning, KoreanStandardIndustryClassification (KSIC) category, number of employees and novelty of technologies. Profiling result of Group 2 companies suggests that they are differentiated in variables such as KSIC category, major clients of the companies, time spent on R&D and ability to test and verify their technologies. The prediction model proposed herein is designed based on the outcomes of profiling and discriminant analysis. Its purpose is to serve in the planning or implementation processes of standards-related policies through providing objective information on companies in need of relevant support and thereby to enhance overall success rate of standards-related projects.
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