• Title/Summary/Keyword: effective factors.

검색결과 7,881건 처리시간 4.117초

Radiotherapy of Locally Recurrent Rectal Carcinoma (수술 후 국소재발된 직장암의 방사선치료 결과)

  • Jeong Hyeon Ju;Shin Young Ju;Mo Yang Kwang;Suh Hyun Suk;Chun Hachung;Lee Myung Za
    • Radiation Oncology Journal
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    • 제17권1호
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    • pp.36-41
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    • 1999
  • Purpose : We reviewed the treatment results for the patients with locally recurrent rectal carcinoma. The object was to evaluate the treatment outcome and to identify the prognostic factors influencing the survival. Methods and Materials: Twenty-eight patients with locally recurrent rectal carcinoma treated principally with external-beam radiation therapy between 1982 to 1996 in the Department of Radiation Oncology at Paik and Hanyang Hospital were reviewed retrospectively Of these, 17 patients had initially abdominoperineal resection, 9 had low anterior resection, and 2 had local excision. No patients had received adjuvant radiation therapy for the primary disease. There were 14 men and 14 women whose ages ranged from 31 to 72 years (median age:54.5). Median time from initial surgery to the start of radiation therapy for local recurrence was 11 months (4~47 months). Radiation therapy was given with total doses ranging from 27 to 64.8 Gy (median=51.2 Gy). Results : The median survival was 16.7 months. The 2-year and 5-year survival rates were 20.1%, 4.1% respectively. Upon multivariate analysis, overall survival was positively correlated with duration of intervals from initial surgery to local recurrence (P=0.039). Relief of pelvic symptoms was achieved in 17 of 28 patients (60.7%). Pain and bleeding responded in 40% and 100% of patients, respectively Conclusions : Patients with locally recurrent rectal carcinoma treated with radiotherapy have benefited symptomatically, and might have increased survivals with a small chance of cure. But, patient were rarely cured (median survival : 10 months, 5-year survival : less than 5%). Overall survival was positively correlated with long intervals from initial surgery to local recurrence. Future efforts should be directed to the use of effective therapy for patients with locally recurrent rectal carcinoma and adjuvant therapy for patients with rectal cancer to reduce the incidence of pelvic recurrence.

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Radiotherapy for Nasopharyngeal Carcinoma (비인강암의 방사선치료 성적)

  • Lee, Myung-Za;Chun, Ha-Chung
    • Radiation Oncology Journal
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    • 제21권4호
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    • pp.269-275
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    • 2003
  • Purpose: To evaluate the results of radiation management on recurrence, survival and prognostic factors of patients with nasopharyngeal cancer Materials and Methods: Forty-nine patients, treated for nasopharyngeal cancer by radiotherapy between January 1984 and June 2000, were retrospectively studied. All patients were followed up for at least 2.5 years. Their median age was 52 years (range 17$\~$78). The histological types were 21 squamous cell carcinoma, 25 undifferentiated carcinoma, and 3 adenoid cystic carcinoma. The tumor stages were as follows: T1 in 14 patients, T2 in 24, T3 in 3, and T4 in 8, and N0 in 17 patients, Nl in 15, N2 in 4 and N3 in 13. Stages I, IIa, IIb ,III, IV and IVb were 4, 7, 12, 5, 8, and 13 patients respectively. Radiation doses of 58$\~$70 Gy (median 68.7 Gy) were given to the nasopahryngeal and involved lymphatic areas and of 46 $\~$ 50 Gy to the uninvolved neck areas. Results: The overall 5 and 10-year actuarial and disease free survival rates were 54.53$\%$ and 47$\%$ and 55.7$\%$ and 45.3$\%$, respectively The overall five-year survival rates were 100$\%$ in stage I , 80$\%$ in stage IIa, 59.5$\%$ in stage IIIb, 40$\%$ in stage III, and 42.2$\%$ in stage IV tumors. Twenty-three patients fatted either loco-regionally or distantly. Incidences of local failure, regional failure and distant metastasis for the first failure were 20.4$\%$, 8.2$\%$ and 20.4$\%$, respectively. Local recurrences were 4.3$\%$ in T1, 12.5$\%$ in T2, 0$\%$ in T3, and 62.5$\%$ in T4 lesions. Distant metastasis was seen in 41.2$\%$ of N2-3 lesions. Fifty percent of local recurrence appeared within 2 years of treatment at the primary lesion, whereas 70$\%$ of distant metastasis appeared within 2 years following treatment. Young age, female, early T stage, N0 stage; and poorly differentiated carcinoma were all related with good survival. However only stage showed statistically significance. Conclusionn: Based on the results of this study, radiation therapy to nasopharyngeal cancer showed high local recurrence in T4 and increased metastasis in N2-3 lesions. To improve local failure, further radiation doses, such as stereotactic radiation or IMRT radiation, are necessary especially in T4 lesions. The high incidence of distant metastasis in positive lymph node patients, indicates that combined radiation and effective chemotherapeutic agents with appropriated schedule are necessary.

Effect of Orthodontics Patients' Orthodontics Characteristics on the Living Quality Related to Oral Health (OHIP) (교정환자의 교정치료 특징이 구강건강관련 삶의 질(OHIP)에 미치는 영향)

  • Yoon, Sung-Uk;Oh, Na-Rae;Jeong, Mi-Ae
    • The Journal of the Korea Contents Association
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    • 제14권3호
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    • pp.250-258
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    • 2014
  • The purpose of this study was to promote effective health management of orthodontics patients by determining the effect that the factors related to orthodontics would have on the Oral Health Impact Profile (OHIP), and the subjects of this study was the local residents of Gangwon-do Province. The mean score of OHIP for the subjects was 2.97, while the mean score of physical factor was 3.01. The mean score of psychological factor was found to be 2.93. Thus, the orthodontics was found to have more influence on psychological factor. The item that had the greatest influence among the 10 items of Oral Health Impact Profile was found to be the question, "Have you ever felt shy due to your dental shape?" which had the mean score of 2.66. The characteristics that had significant effect on OHIP among general characteristics were found to be the age, religion, occupation, income, smoking or non-smoking status(p<0.05). In terms of the age, the age of 20 or less had the greatest effect with the mean score of 2.53. In relation to the occupation, the production/sales occupation had an influence with the mean score of 2.56 (p<0.05). Those with income exceeding KRW 4 million were found to have the mean score of 2.83 and 2.78. It turned out that the smokers had greater effect compared to the non-smokers in relation to the smoking/non-smoking status as the income was higher (p<0.05). The characteristics of orthodontics were manifested as the health perception in relation to Oral Health Impact Profile (OHIP) (p<0.05). Regarding the reason why they underwent the orthodontics, the 'uncomfortable feeling in chewing' was found to have the mean score of 2.69 and 2.67 (p<0.05). Regarding the orthodontics period, 1 to 2 years were found to have the mean score of 2.80 and 2.74, thus having an influence (p<0.05). In relation to the regret/non-regret over orthodontics, those who indicated that they regretted were found to have the mean score of 2.65 and 2.60 (p<0.05). Analysis of the relationship between Characteristics of orthodontic treatment and OHIP, orthodontic treatment reasons, oral health awareness, whether orthodontic treatment regret showed a statistically significant correlation. it is considered necessary to make constant efforts to help orthodontics patients, both physically and psychologically, in the course of treatment and improve their quality of lives.

Arthroscopic Adhesiolysis for Postoperative Arthrofibrosis of the Knee (수술후 발생한 슬관절 강직의 관절경적 유리술)

  • Kim Sung-Jae;Shin Sang-Jin;Lee Won-Yong;Kim Jin-Yong;Kim Sang-Gon
    • Journal of the Korean Arthroscopy Society
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    • 제4권1호
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    • pp.42-48
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    • 2000
  • We retrospectively reviewed the results of arthroscopic adhesiolysis on postoperative knee stiffness in order to observe the clinical improvement and to evaluate the prognostic factors. Arthroscopic adhesiolysis without extraarticular procedure was performed in 31 knees displaying persistent flexion or extension loss. The causes of arthrofobrosis were previous ligament surgeries in 17 knees, surgery for a fracture involving the articular surface of the knee in 10 cases and other causes in four cases. The average range of motion was $60^{\circ}(range,\;14^{\circ}-74^{\circ})$ preoperatively, and improved by $120^{\circ}(range,\;7^{\circ}-127^{\circ})$ immediately following the procedure. The range of motion at the final follow-up (average 34 months) was $129^{\circ}(range,\;3^{\circ}-132^{\circ})$. In the 17 patients with arthrofibrosis fellowing ligament surgery, the range of motion was improved from $65^{\circ}$ preoperatively to $135^{\circ}$ at final follow-up. The improvement in function and motion was achieved during the first postoperative year. In the 10 patients with arthrofibosis following intraarticular fractures, the range of motion was improved from $60^{\circ}$ preoperatively to $125^{\circ}$ at the final follow-up, and most of the increase in motion was achieved within the first 6 months. Patients who suffered from a limitation of motion for less than 7 months gained an average $70^{\circ}$ improvement in total range of motion following arthroscopic surgery. However, the total range of motion in patients with a duration of symptoms greater than 7 months improved by an average $49^{\circ}$ postoperatively. In conclusion, arthroscopic adhesiolysis without incisional procedure is an effective therapeutic modality in arthrofibrosis of intraarticular origin. Improved outcomes can be expected in stiffness after ligament surgery and a symptom duration of arthrofibrosis less than 7 months.

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Surgical Treatment of Stage IIIA Non Small Cell Lung Cancer(NSCLC) (제 IIIA기 비소세포 폐암의 수술 성적)

  • 정경영;홍기표;김창수;김길동;김주항;신동환
    • Journal of Chest Surgery
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    • 제32권2호
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    • pp.144-150
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    • 1999
  • Background: Surgery has been considered the most effective and standard treatment modality in non-small cell lung cancer(NSCLC). However in stage IIIA lung cancer, the role of surgery is still controversial. To evaluate the role of surgery for stage IIIA NSCLC, we investigated the survival after surgery and the prognostic factors. Material and Method: We evaluated 158 consecutive cases of stage IIIA NSCLC patients operated on between 1990 and 1996. There were 130 male patients and 28 female patients, and the mean age was 58.5 years. All patients except one underwent lung resection beyond lobectomy and extended mediastinal dissection. Postoperative adjuvant therapy were undertaken in 145(94.8%) patients. All patients(153) were followed and the mean follow-up period was 21.4months. Result: Twenty nine cases of the postoperative complications developed in 25 patients (15.8%). There were 5 operative mortality cases(3.2%) and the main cause of death was acute respiratory distress syndrome (ARDS). Local or distant recurrences developed in 84 patients(54.9%). The 5-year survival of 153 patients was 29.6% and the median survival time was 18.0 months. The 5-year survival of non N2 disease group(36.8%) was better than that of N2 disease group(26.6%)(p=0.35) and the 5-year survival of squamous cell carcinoma (38.1%) was better than that of adenocarcinoma(25.7%)(p=0.39) however there were no significant differences. Regarding the postoperative adjuvant therapy, in combined therapy group(84 patients), radiotherapy group(37 patients) and chemotherapy group(24 patients), the 5-year survival were 31.3%, 32.4%, and 14.6% respectively. There was no difference of survival between radiotherapy and combined therapy group(p=0.31), however the survival of the combined therapy group was better than the chemotherapy group(p=0.005). The survival of the complete resection group(31.9%) was better than the incomplete resection group(16.6%) however there was no significant difference(p=0.19). Conclusion: These observations indicate that the good 5-year survival(29.6%) in patients with stage IIIA NSCLC result from the agressive surgical treatment including extensive mediastinal nodes dissection.

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Study on economic effects of outsourcing of food materials on the hotel kitchen - Focus on cooking Western food in the first class hotel - (식재료 아웃소싱이 경제적 주방에 미치는 영향에 관한 연구 - 특1급호텔 양식조리를 중심으로 -)

  • 성태종
    • Journal of Applied Tourism Food and Beverage Management and Research
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    • 제13권2호
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    • pp.45-69
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    • 2002
  • This study is designed to examine feasibility and limitation of outsourcing in cooking Western food in a hotel, to interpret importance of outsourcing(eg. outside order, outside procurement, outside supply) in a broad sense in order to reinforce the core capacity in the cooking department, and to know whether the cooking human power is efficiently used and how much the chefs recognize outsourcing of food materials. As many companies conduct restructuring to cut down its size, the reduction of human power led the Western food cooking in the hotel to lower core capacities, lower quality, and lower efficiency. In addition, the sagging morale of chefs undermined creativity. To change from the traditional kitchen to an economic kitchen needs to look into importance of outsourcing, cognitive attitude of chefs, relation with outside suppliers. Here suggests performance of positive changes in the structure The study examined feasibility and limitation of outsourcing in the hotel kitchen as well as chefs' cognitive attitude toward outsourcing of food materials to reinforce core capabilities of the hotel kitchen. 1. Companies of outsourcing are selected according to variability of price conditions, flexibility of contract conditions, popularity of the outsourcing company, and reputation of the outsourcing company. 2. The importance of outsourcing in the Western food cooking is divided into 4 factors such as standard of selecting outsourcing companies, policies of cooking manu, quality of cooking, and quantity of cooking. 3. The most feasible section in outsourcing of food materials is a process of kneading flour for bread, which shows that many Western-food chefs expect to put higher possibility of outsourcing on the kneading. In other words, when it comes to confectionery and bakery, there are many outside expert processing companies supplying high quality products. In the order of outsourcing feasibility, sauce is followed by processed vegetable, garnish of main dish, and soup. The least feasible section in outsourcing of food materials is appetize. Appetize includes a concept of a improvised dish and needs speed. Due to its color, freshness, and sensibility of taste, the appetize plays a key role in the Western food cooking. 4. When outsourcing is taken in place, the highest risk is to lower the inner cooking skills. Therefore chefs in charge of the Western food sequently recognize both internal problems including storage of cooking skills, unstability of layoffs, and loss of cooperation between departments, and external problems including inferior goods, difficulty of differentiating manu, delay of delivery, and expiration date. It shows that most of the Western food chefs consider risks of the internal problems at first. 5. A effective outsourcing needs appropriate selection of outsourcing companies, maintenance of credibility, active communication, check and management of hygiene. However regardless of their position or career, chefs in charge of the Western food have the same cognitive attitude toward selecting successful outsourcing companies after the outsourcing system is enforced. The core of cooking, or a final stage in the full process of so-called artistic cooking, should be treated with insourcing. Reduction of several cooking processes resulted in shortened cooking time, increased efficiency, faster cooking, cutting the waiting-lines, and finally more room for customers. The outsourcing system can reduce or eliminate the following processes in cooking: buying various food materials, checking, storing, preparing, and processing. Especially in the Western food cooking department of a hotel, the outsourcing system should be enforced to make an economic kitchen and to efficiently manage it. Wow it's time to change from the traditional kitchen to an economic kitchen in the hotel cooking department. For that, the cooking department should become a small but strong organization by outsourcing except its core work.

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Concentration of E-cadherin Correlated with Pathologic Features in Gastric Cancer (위암에서 조직학적 특징에 따른 혈청 E-cadherin의 농도)

  • Hur, Hoon;Song-Gyo-Young;Kim, Jin-Jo;Chin-Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim-Keun-Woo;Park, Woo-Bae;Kim, Seung-Nam;Jeon, Hae-Myoung
    • Journal of Gastric Cancer
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    • 제4권3호
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    • pp.156-163
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    • 2004
  • Purpose: While E-cadherin in normal cells induces calciumdependent cell-cell adhesion, in malignant cell, it plays a role in invasion and metastasis with a reduction of adhesion. Serum soluble E-cadherin is a result of the reduction of the cellular E-cadherin molecule and is found in the circulation of normal individuals, but it is particularly known to be increased in patients with malignancies. Accordingly, through checking the level of serum soluble E-cadherin in patients with gastric cancer and analyzing it in the view of clinicopathology, we investigated whether serum soluble E-cadherin could be translated into a clinicopathologic esult and used as a tumor marker. Materials and Methods: The investigation targeted 88 patients who had been diagnosed as having gastric cancer by the Department of Surgery, St. Mary's Hospital, from October 1, 2002, to July 30, 2003, and who had under gone performed surgery. We measured the level of preoperative serum E-cadherin in the 88 patients by unsing ELISA. Among them, we collected gastric cancer tissues from 54 patients and executed immunohistochemistry for E-cadherin. The samples were compared with normal tissues in terms of both serum E-cadherin level and immunohistochemistry level, as well as with other clinicopathologic factors. Result: The mean serum E-cadherin level of the 88 patients was 4368.7 ng/ml and was significantly higher than the level in 12 normal control patients, 3335.5 ng/ml (P=0.016). In terms of clinicopathology, the serum level of E-cadherin was significantly correlated with increasing age (P=0.0006) and was higher in positive venous invasion patients (P=0.0005). When the E-cadherin immunohistochemical stain was compared with the serum E-cadherin level in 54 patients, no significant statistically meaningful result was obtained (P=0.2881). However, 4 patients with serum E-cadherin levels about 6000 ng/ml were classified into the lower expression group ($<80\%$ of E-cadherin immunohistochemicals stain. In the analysis for 36 patients who were early gastric cancer patients, the serum E-cadherin level in lymph-node-metastatic patients was higher than it was in the other patients (P=0.0442). Conclusion: The serum E-cadherin level in gastric cancer patients was higher than the level in normal control patients. In advanced gastric cancer patients, that the difference was increased. Also, since the E-cadherin level correlated with the serum E-cadherin level with venous invasion, it can be used as an effective tumor marker for gastric cancer. Particularly, in that the serum E-cadherin level correlated with lymph node metastasis in early gastic cancer, it can be used when a therapeutic method for early gastric cancer is selected.

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Analyses of Elementary School Homeroom Teachers' Role Percept ion and Performance as Counsellors and Children's Expectation for Teachers' Role as Counsellors (초등학교 담임교사의 상담자로서 역할지각 및 수행실태와 아동의 기대 분석)

  • Seo, Ju-Hee;Kim, Yang-Hyun
    • The Korean Journal of Elementary Counseling
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    • 제5권1호
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    • pp.65-92
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    • 2006
  • The objective of this study is to conduct survey analyses of the role perception and performance of homeroom teachers in elementary schools in Seoul as well as their students' expectations for teachers' role as counsellors. The study also aims to analyze the causes behind the lackluster performance, to provide assistance in teachers' counselling and guidance activities and collect basic data for providing a plausible orientation for elementary school counselling. Research topics for achieving these study objectives are as follows. First, what is the status quo of counselling between elementary school students and teachers? Second, what is the role perception of elementary school homeroom teachers as counsellors and their current level of performance? Third, what are the differences in students' expectations for homeroom teachers' role as counsellors according to students' environmental variables such as gender and grade? Fourth, what are the discrepancies between the roles perception and performance of elementary school homeroom teachers and role expectation of students for homeroom teachers' role as counsellors? In order to answer these questions, surveys were conducted for 229 teachers and 385 students in grades 4, 5 and 6 in 11 elementary schools in Seoul, and the results were analyzed. The questionnaires used for this study were modified and supplemented according to the research objectives based on survey questions released by Gyung-Beom Lee(1989), Hak-Soo Lee(2001) and Gi-Nam Gwon(2005). Statistical analyses were peformed using the SPSS for Windows 10.0 program. The results of the study can be summarized as follows. First, most elementary school homeroom teachers were involved in counselling activities, and about half of them were providing counselling once a month or less. The classroom was the primary location of counselling, and more than half of the surveyed teachers were dissatisfied with their counselling activities. The teachers cited overwhelming teaching hours and excessive work as the factors that made counselling difficult. Second, it was revealed that most elementary school students have had experiences of anguish and most have had some form of counselling. They mostly sought counselling from their parents and friends, and the reasons behind such choices were that they were very understanding. Third, most students responded that they have had no experience of receiving counselling from their homeroom teachers. Among those with counselling experience with their homeroom teachers, most said that the counselling was helpful. The most significant reason for not receiving counselling from their homeroom teachers was that the students had no worries to talk about with their teachers. Fourth, as a result of categorizing the role of elementary school homeroom teachers as counsellors according to the areas of counselling, role perception for each area turned out to be generally high, while performance was substantially lacking. Fifth, in terms of the causes for the lackluster counselling performance, overwhelming teaching hours and excessive work were indicated for counselling areas of academic and personality issues. Sixth, the analysis of students' expectations for elementary school homeroom teachers as counsellors for counselling areas according to gender and grade revealed that there was no overall statistical significance. Seventh, from the general perspective, the level of role perception of the homeroom teachers were higher than the level of students' expectations. In conclusion, in order to enhance the teacher's role as a counsellor, there has to be a concrete perception of roles as a primary premise, calling for training sessions and programs dedicated to counseling for the teachers to take part in. Moreover, in order to alleviate the most significant causes for undermining teachers' counselling activities - overwhelming teaching hours and excessive work - there must be administrative consideration as well as provisions for effective counselling centers and dedicated school counsellors.

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Effects of Some Environmental Factors on Japanese Yew (Taxus cuspidata Sieb. et Zucc.) (몇 발근환경인자(發根環境因子)가 주목삽수(揷穗) 발근(發根)에 미치는 효과(効果))

  • Kim, Chang Ho;Nam, Jung Chil
    • Journal of Korean Society of Forest Science
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    • 제70권1호
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    • pp.1-6
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    • 1985
  • The purpose of this experiment lies in finding the most appropriate cutting condition of Taxus cuspidata Sieb. et Zucc. which has been considered valuable tree species in gardening. Statistical analysis was focused on the comparison of the average ratios of rooting between greenhouses and fields, based on the observation rooted autogenis. To conduct this survey, hardwood cutting of Taxus cuspidata Sieb. et Zucc. were performed at both places of experiment above on April 20, 1982 with rooting results calculated on October 31, 1982. After formation of cuttings, it was soaked in IBA 200 ppm for 12 hours and than put in a bed. A summary of the result is presented as follows; 1) Cutting at the greenhouse showed higher average rate of rooting than at fields. Same tendency was found regardless of the differences in treatment. 2) It was clear that IBA-treatment contributed remarkably to causing higher average rooting rate. As an evidence, when twenty centimeter cuttings were inserted sandy media, IBA-treated area resulted in eighty six percent of average rooting rate, as compared with only twenty three percent in nontreatment case. In case of field cutting, IBA-treatment brought about fifty three percent of rooting in comparison with eleven percent nontreatment. 3) When sandy soil, loam and brown soil were separately used as cutting media, the highest rooting rate was found in case of sandy soil, without any difference between the two experimental places above. 4) As a result of the analysis to seek the impact of the length of cuttings on rooting, the range of length form fifteen to twenty centimeter was apparently most appropriate. It was also found that the rate of rooting declined beyond twenty five centimeter. 5) Two kinds of rooting pattern were observed. One was the case that callus cell lump was created on the lower cut side of cuttings. Importantly, root radical were formed inside the lump to influence the germination of root system. The other relates to the case that adventitious root which look like lateral roots appeared at the stem region. In abstract, first, sandy soil was effectively recommended in case of hardwood cutting in April. Second, the most appropriate length of cuttings ranged between fifteen and twenty centimeters. Third, high density IBA treatment was clearly effective. Forth, for proper environmental management, both pre-disinfection of sail by sterilizer and maintenance of high relative humidity were essentially required.

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CLINICAL ANALYSIS OF GONIAL ANGLE CHANGE AFTER ORTHOGNATHIC SUGERY IN PATIENTS WITH THE MANDIBULAR PROGNATHISM (하악전돌증환자의 악교정수술후 하악각변화에 관한 임상적 분석)

  • Kwon, Yeong-Ho;Jang, Hyun-Jung;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권2호
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    • pp.206-216
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    • 2000
  • Predictional study for lateral change between pre- and post-orthognathic surgery has been emphasized mainly on anterior area of lateral profile; upper lip, lower lip and chin et al. So interest for lateral profile change has been less in posterior area of lateral profile and literature analyzing gonial angle change is rare. The purpose of this study is to make prediction for gonial angle change possible and to offer somewhat treatment guidance for gonial angle to be improved by investigating overall gonial angle change between pre- and post-orthognathic surgery and inquiring into factors influencing on pattern of genial angle change. For this study 35 patients were selected retrospectively. Lateral cephalometric radiographs were taken in just pre-op time, pod 1 day, pod 1 year. They were analyzed and genial angles were measured. The results were as follows : 1. Gonial angle at pod 1 day was decreased about $9.3^{\circ}$ than pre-op and gonial angle at pod 1 year was increased about $4.0^{\circ}$ than pod 1 day. So genial angle at pod 1 year was decreased about $5.3^{\circ}$ than pre-op genial angle(p<0.01). 2. Mean pre-op gonial angle was $129.4^{\circ}$, showing significantly high value than normal and mean gonial angle at pod 1 year was $124.1^{\circ}$, showing value near to normal. 3. Mean gonial angle change between pre-op and pod 1 year was decreased about $5.4^{\circ}$ in female and $5.3^{\circ}$ in male. There was no statistically significant difference between male and female(p>0.05). 4. Principal factor influencing on decreased gonial angle in gonial angle change between pre-op and pod 1 year was amount of mandibular setback. 5. Principal factor influencing on increased gonial angle in gonial angle change between pod 1 day and pod 1 year was % horizontal relapse, and it was thought that resorption and bone remodelling on posterior area in mandibular distal segment also were related to increased gonial angle. 6. It is thought that sagittal split ramus osteotomy in mandibular prognathic patients with high value of gonial angle is effective to improvement of gonial angle, and In patients who have normal range of gonial angle and are required with excessive mandibular setback, short lingual cut method, additional resection of posterior margin of distal segment, Obwegeser II method will be considerd. 7. More prudent operation and careful post-op management will be responsible for maintenance of postoperative stable gonial angle.

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