• Title/Summary/Keyword: g-factor

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An Effect of the Selection of Excellent Design Product on the Business Performance in the Start-up: Focusing on 2013, 2014 and 2015 Design Awarded Companies (우수디자인제품 선정이 창업기업 경영성과에 미치는 영향: 2013년, 2014년, 2015년 우수디자인제품 선정기업들 중심으로)

  • Yoo, joung houn;Bae, byung Yun;Jeon, Ki suk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.13 no.4
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    • pp.211-216
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    • 2018
  • This study was intended to analyze the effects of the selection of excellent design product by the KIDP(Korea Institute of Design Promotion) on the business performance of the company focused on the start-up with relatively low competitiveness. According to the statistics of KIDP in 2013, a design accounted for 27.53% of the factors affecting the sales of products and a design was the most important factor among the factors affecting the sales of products for the small sized company in terms of the scale of company. In addition, looking at the trend by industry in the data collected for this study, the technology-based industry showed a relatively higher growth rate than the retail industry and other industries. In this study, the author surveyed 186 companies of the companies that recognized the importance of design in difficult management conditions and received excellent design product certificate from KIDP(2013, 2014 and 2015) and empirically verified whether there was any difference in business performance between the start-ups with a business history of less than 7 years and the ongoing firms with a business history of more than 7 years. To evaluate the value of design, we used analytical method of measuring related values by comparison between groups. In addition, we also analyzed the difference in business performance(sales) between manufacturing companies, where the role of design was relatively large, and non-manufacturing companies among companies that received the excellent design product certificate. We have established a study hypothesis that the selection of excellent design product by the KIDP would have more positive effect on the business performance(sales) of the start-up compared to the ongoing firm, and conducted an empirical analysis by comparing both the year before and the year after the selected year. As a result, we found that the selection of excellent design product by the KIDP has a positive effect on the business performance of the start-up, and the selection of excellent design product has a significant effect on the difference in business performance between manufacturing and non-manufacturing companies. This study was conducted in the hope that the government actively supports the design-related policies so that the selection of excellent design product become an important indicator of the business performance of the start-up, and thus the design management will be a way to enhance the competitiveness of the start-up.

Distribution and Antimicrobial Susceptibility of Bacteria in the Oral Cavity of Smokers or Non-Smokers (흡연자와 비흡연자간의 구강 내 세균 분포 및 항균제 감수성)

  • Jeong, Hyun-Ja;Kim, Su-Jung
    • Korean Journal of Microbiology
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    • v.46 no.4
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    • pp.334-340
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    • 2010
  • It is well known that smoking as well as drinking is a factor of stomatopathy, however there are few investigations about comparison of oral flora between smokers and non-smokers. In this study, we isolated the oral flora of 30 smokers and 30 non-smokers and cultured them on blood agar plates. The isolated pathogenic microorganisms were tested for antibiotic susceptibility and resistance using the Kirby-Bauer antibiotic testing method. Each colony was stained using the Gram staining method and was identified by an automatic identifier, known as the VITEK system. We isolated 41 colonies from smokers' oral cavity, and they were sorted as 63% of Gram-positive cocci, 29% of Gram-negative cocci, 3% of Gram-positive bacilli, and 5% of Gram-negative bacilli by gram staining, whereas 38 colonies were isolated from non-smoters' oral cavity, and their proportions were 55% of Gram-positive cocci, 26% of Gram-negative cocci, 3% of Gram-positive bacilli, and 16% of Gram-negative bacilli. The VITEK system revealed specific distribution of bacteria species that Streptococcus mutans (6/41), Gemella morillorum (6/41), Streptococcus oralis (2/41), Streptococcus pneumoniae (1/41), Staphylococcus aureus (3/41), Streptococcus anginosus (1/41), Streptococcus intermedius (1/41), Streptococcus uberis (1/41), and Streptococcus sanguinis (1/41) in smokers oral cavity whereas Streptococcus sanguinis (8/38), Staphylococcus aureus (1/38), Staphylococcus auricularis (1/38), Streptococcus uberis (1/38), Streptococcus intermedius (1/38), Streptococcus mutans (1/38), and Streptococcus oralis (1/38) in those of non-smokers'. Three cases of Staphylococcus aureus from smokers produced Beta-lactamase and were identified methicillin-resistance Staphylococcus aureus (MRSA). However one case of Staphylococcus aureus from non-smoker did not produce Beta-lactamase and was sensitive to methicillin. In conclusion, the distribution of oral flora was different between smokers' and non-smokers' oral cavity, especially Gemella morillorum and MRSA were predominantly found in smoker's oral cavity. These results are useful in the treatment and prevention of patients with stomatopathy caused by smoking.

Predicting the Nutritional Value of Seafood Proteins as Measured by Newer In Vitro Model 2. C-PER and DC-PER of Marine Crustacea (수산식품 단백질 품질평가를 위한 새로운 모델 설정 2. 해산 갑각류의 C-PER 및 DC-PER)

  • RYU Hong-Soo;LEE Keun-Woo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.19 no.3
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    • pp.219-226
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    • 1986
  • To confirm the application of a newer in vitro assays to determining the nutritional value of marine crustaceans (mainly shrimps and crabs), which have been considered to be highly nutritive depending on their levels of the essential amino acids and digestibility, their C-PERs and DC-PERs were determined and studied the factors influencing their in vitro results. Four species of seawater shrimps and 2 species of seawater crabs were used in this experiment. The in vitro digestibilities showed $83{\sim}86\%$ for raw shrimps and the trypsin indigestibile substrate content (TIS) was ranged from 1.32 to 3.33 mg/g solid expressed quantitatively as mg of purified soybean trypsin inhibitor. The smaller size of shrimps revealed a greater in vitro digestibility and a lower contents of TIS. It was noted that the in vitro digestibility of raw blue crab meat was around $85\%$ while boiled tenner crab meat showed $86\%$ or above, and the leg meat had the greatest in vitro digestibility in the various parts of crab meats. The poor in vitro digestibilities for shrimp's and crab's meat, compared with that of the other seafoods as noted in previous reports, suggest that the drop in pH, due to the change in their freshness during harvesting and frozen storage, resulted in underestimating their digestibilities using four-enzyme digestion technique. The lysine contents in all samples were higher than that of ANRC casein but they contained a slightly lower sulfur-containing amino acids than those in ANRC casein. But the other EAA, such as valine, tyrosine and phenylalanine, were found to be a half as little as that in casein and played a key-factor in calculation of C-PER or DC-PER. It was observed that the value of C-PER and DC-PER for all samples ranged from 2.1 to 2.4, and the predicted digestibilities showed $90\%$ or above in all samples. It was a different results from the fact that the animal proteins bear a higher values and predicted digestibilities than those of C-PER values. The lack of correlation between C-PER and DC-PER values is attributable to the fact that the lower content of valine, tyrosine and phenylalanine, and drop in pH owing to the changes of freshness in marine crustacea proteins. Therefore, if a newer in vitro digestion technique-which are taken into account the pH drop before digestion, TIS content and released free amino acids and/or peptides-developed, C-PER assays can provide more advantages in assessing the protein nutritional value of marine crustacea than any other in vitro assays.

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Reflecting Academic Symposia as a Trend at Animation Festivals, Media Art Festivals and Conferences on Computer Animation (학술회 반영 경향의 애니메이션 페스티벌과 미디어 아트 페스티벌 그리고 컴퓨터 애니메이션 학회)

  • Hagler, Juergen;Bruckner, Franziska
    • Cartoon and Animation Studies
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    • s.49
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    • pp.611-631
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    • 2017
  • At first there was practice, then festivals and theory followed. Compared to the animation production, which is older then the medium film itself, festivals and theory in this area started with a delay. While animation programs where shown in film festivals like Cannes since the mid 1940s, the first animation festival in Annecy, France was founded in 1960, followed by several short-lived events in Romania, Italy and Tokyo and finally in 1972 by the second oldest festival up to date, Animafest Zagreb. Animation theory evolved in the late 1980s in the Anglo-American area with associations like the Society for Animation Studies, following its 'big sister' film studies. Expanding ever since as a research area, European animation studies in e.g. France, German speaking countries, Poland or Croatia have been catching up in recent years by organizing theoretical conferences and publications. A vivid synergy between practice, festivals and theory has always been a key factor for establishing a platform for the art form and culture of animation. However, in the past few years a trend could be observed towards a more intense interaction between animation festivals and theory. Animation festivals are hosting theoretical and scientific symposia or conferences, which are open for artist positions and insights into the industry. At the beginning of the lecture a short reflection of the concept of Animafest Scanner itself is followed by an introduction of the Symposium Expanded Animation at the media festival Ars Electronica Linz. The talk will subsequently focus on the multilayered academic symposia at the Festival of Animated Film ITFS and the International Conference on Animation, Effects, VR, Games and Transmedia in Stuttgart. These case studies will reveal the blurring boundaries between art, science, theory and industry as well as the specificities of the interplay between artists, practitioners, scholars, curators and festival visitors in different formats.

Patterns of Pulsatile and Surge Modes of Follicle-Stimulating Hormone Treated with Different Progesterone Levels in Ovariectomized Goats (난소제거된 Shiba 염소에서 다른 농도의 Progesterone 처치에 의한 FSH Surge 및 Pulse 분비에 미치는 영향)

  • Kim, Seung-Joon;Tanaka, Tomomi;Kamomae, Hideo
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.225-231
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    • 2011
  • The objective of the present study was to determine the progesterone levels that effects on the pulsatile and surge modes of FSH secretion. In previous studies we have shown that LH surge occurred in the follicular levels of progesterone, whereas there was no surge mode secretion of LH in either the sub luteal or luteal levels of progesterone. LH pulsatile frequencies were high in two groups such as follicular level and sub luteal level. But in the luteal level of progesterone the pulsatile pattern of LH were strongly suppressed. Namely, sub luteal levels of progesterone, around 1 ng/ml, completely suppressed the LH surge but did not affect the pulsatile frequency of LH secretion. Because of this we hypothesized that the two secretory patterns of FSH are similar to that of LH. Long-term ovariectomized Shiba goats that had received implants of estradiol capsules and three different progesterone silastic packet inducing follicular, subluteal and luteal levels of progesterone were divided into three groups such as non-P, low-P and high-P group. Blood samples were collected daily throughout the experiment for the analysis of gonadal steroid hormone levels and at 10-min intervals for 8 h on Days 0, 3, and 7 (Day 0: just before progesterone treatment) for analysis of the pulsatile frequency of FSH secretion. Then estradiol was infused into the jugular vein of all animals at a rate of 3 ${\mu}/h$ for 16 h on Day 8 to determine whether an FSH surge was induced. Blood samples were collected every 2 h from 4 h before the start of the estradiol infusion until 48 h after the start of the infusion. In each group, the mean ${\pm}$ SEM concentration after progesterone implant treatment was 3.3 ${\pm}$ 0.1 ng/ml for the high P group, 1.1 ${\pm}$ 0.1 ng/ml for the low P group, and < 0.1 ng/ml for the non-P group, concentrations similar to the luteal levels, subluteal levels, and follicular phase levels of the normal estrous cycle, respectively. The FSH pulse frequency was maintained highly in all groups on Day 0, Day 3 and Day 7. An FSH surge was induced in all 4 cases of the Non-P group. In the High P and Low P groups, the plasma concentrations of FSH remained low until 48 h after the start of estradiol infusion, and no occurrence of FSH surge was found in any of the animals. The results of this study not only confirm that the pulsatile patterns of FSH were not inhibited strongly relative to LH, they also suggest that some other mechanism and factor may be controlling the FSH secretion.

Using Trophic State Index (TSI) Values to Draw Inferences Regarding Phytoplankton Limiting Factors and Seston Composition from Routine Water Quality Monitoring Data (영양상태지수 (trophic state index)를 이용한 수체 내 식물플랑크톤 제한요인 및 seston조성의 유추)

  • Havens, Karl E
    • Korean Journal of Ecology and Environment
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    • v.33 no.3 s.91
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    • pp.187-196
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    • 2000
  • This paper describes a simple method that uses differences among Carlson's (1977) trophic state index (TSI) values based on total phosphorus (TP), chlorophyll a (CHL) and Secchi depth (SD) to draw inferences regarding the factors that are limiting to phytoplankton growth and the composition of lake seston. Examples are provided regarding seasonal and spatial patterns in a large subtropical lake (Lake Okeechobee, Florida, USA) and inter- and intra-lake variations from a multilake data set developed from published studies. Once an investigator has collected routine water quality data and established TSI values based on TP, CHL, and SD, a number of inferences can be made. Additional information can be provided where it also is possible to calculate a TSI based on total nitrogen (TN). Where TSI (CHL)<>TSI (SD), light attenuating particles are large (large filaments or colonies of algae), and the phytoplankton may be limited by zooplankton grazing. Other limiting conditions are inferred by different relationships between the TSI values. Results of this study indicate that the analysis is quite robust, and that it generally gives good agreement with conclusions based on more direct methods (e.g., nutrientaddition bioassays, zooplankton size data, zooplankton removal experiments). The TSI approach, when validated periodically with these more costly and time-intensive methods, provides an effective, low cost method for tracking long-term changes in pelagic structure and function with potential value in monitoring lake ecology and responses to management.

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Extrauterine Growth Restriction in Very Low Birth Weight Infants (극소 저체중 출생아의 자궁 외 성장 지연)

  • Kim, Eun-Sun;Sohn, Jin-A;Lee, Eun-Hee;Choi, Eun-Jin;Lee, Hyun-Ju;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.53-63
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    • 2010
  • Purpose : Extrauterine growth restriction (EUGR) in preterm infants is a major problem in neonatal intensive care units (NICUs) and it has been related to long-term growth deficit and neurodevelopmental issues. The aim of this study was to investigate the frequency of and risk factors for EUGR. Methods : The study subjects consisted of very low birth weight (VLBW) infants with a gestational age $\leq$32 weeks that were born at the Seoul National University Children's Hospital between November 2005 and April 2009. EUGR was defined as weight for gestation, lower than the 10th percentile on discharge. Results : The frequency of EUGR was 67% (n=111/166). By multiple logistic regression, the presence of small for gestational age (SGA) was the greatest predictor of EUGR, birth weight and daily weight gain during the first 28 days were independent predictors of EUGR. Risk factors for EUGR in non-SGA infants were evaluated because 56% (64/114) of non-SGA infants developed EUGR at discharge. Daily weight gain in the first 28 days was also decreased in EUGR group and independently predicted the risk of EUGR in the non-SGA group. Conclusion : EUGR was a common problem in the NICU. SGA was the most significant predictive factor of the EUGR. Half of the non-SGA infants also developed EUGR, revealing poor weight gain in the early days was as an important predictor. These results support the importance of early nutritional intervention for weight gain which have lagged behind other modern therapeutic interventions when the infant is clinically unstable.

New Approaches for Overcoming Current Issues of Plasma Sputtering Process During Organic-electronics Device Fabrication: Plasma Damage Free and Room Temperature Process for High Quality Metal Oxide Thin Film

  • Hong, Mun-Pyo
    • Proceedings of the Korean Vacuum Society Conference
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    • 2012.02a
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    • pp.100-101
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    • 2012
  • The plasma damage free and room temperature processedthin film deposition technology is essential for realization of various next generation organic microelectronic devices such as flexible AMOLED display, flexible OLED lighting, and organic photovoltaic cells because characteristics of fragile organic materials in the plasma process and low glass transition temperatures (Tg) of polymer substrate. In case of directly deposition of metal oxide thin films (including transparent conductive oxide (TCO) and amorphous oxide semiconductor (AOS)) on the organic layers, plasma damages against to the organic materials is fatal. This damage is believed to be originated mainly from high energy energetic particles during the sputtering process such as negative oxygen ions, reflected neutrals by reflection of plasma background gas at the target surface, sputtered atoms, bulk plasma ions, and secondary electrons. To solve this problem, we developed the NBAS (Neutral Beam Assisted Sputtering) process as a plasma damage free and room temperature processed sputtering technology. As a result, electro-optical properties of NBAS processed ITO thin film showed resistivity of $4.0{\times}10^{-4}{\Omega}{\cdot}m$ and high transmittance (>90% at 550 nm) with nano- crystalline structure at room temperature process. Furthermore, in the experiment result of directly deposition of TCO top anode on the inverted structure OLED cell, it is verified that NBAS TCO deposition process does not damages to the underlying organic layers. In case of deposition of transparent conductive oxide (TCO) thin film on the plastic polymer substrate, the room temperature processed sputtering coating of high quality TCO thin film is required. During the sputtering process with higher density plasma, the energetic particles contribute self supplying of activation & crystallization energy without any additional heating and post-annealing and forminga high quality TCO thin film. However, negative oxygen ions which generated from sputteringtarget surface by electron attachment are accelerated to high energy by induced cathode self-bias. Thus the high energy negative oxygen ions can lead to critical physical bombardment damages to forming oxide thin film and this effect does not recover in room temperature process without post thermal annealing. To salve the inherent limitation of plasma sputtering, we have been developed the Magnetic Field Shielded Sputtering (MFSS) process as the high quality oxide thin film deposition process at room temperature. The MFSS process is effectively eliminate or suppress the negative oxygen ions bombardment damage by the plasma limiter which composed permanent magnet array. As a result, electro-optical properties of MFSS processed ITO thin film (resistivity $3.9{\times}10^{-4}{\Omega}{\cdot}cm$, transmittance 95% at 550 nm) have approachedthose of a high temperature DC magnetron sputtering (DMS) ITO thin film were. Also, AOS (a-IGZO) TFTs fabricated by MFSS process without higher temperature post annealing showed very comparable electrical performance with those by DMS process with $400^{\circ}C$ post annealing. They are important to note that the bombardment of a negative oxygen ion which is accelerated by dc self-bias during rf sputtering could degrade the electrical performance of ITO electrodes and a-IGZO TFTs. Finally, we found that reduction of damage from the high energy negative oxygen ions bombardment drives improvement of crystalline structure in the ITO thin film and suppression of the sub-gab states in a-IGZO semiconductor thin film. For realization of organic flexible electronic devices based on plastic substrates, gas barrier coatings are required to prevent the permeation of water and oxygen because organic materials are highly susceptible to water and oxygen. In particular, high efficiency flexible AMOLEDs needs an extremely low water vapor transition rate (WVTR) of $1{\times}10^{-6}gm^{-2}day^{-1}$. The key factor in high quality inorganic gas barrier formation for achieving the very low WVTR required (under ${\sim}10^{-6}gm^{-2}day^{-1}$) is the suppression of nano-sized defect sites and gas diffusion pathways among the grain boundaries. For formation of high quality single inorganic gas barrier layer, we developed high density nano-structured Al2O3 single gas barrier layer usinga NBAS process. The NBAS process can continuously change crystalline structures from an amorphous phase to a nano- crystalline phase with various grain sizes in a single inorganic thin film. As a result, the water vapor transmission rates (WVTR) of the NBAS processed $Al_2O_3$ gas barrier film have improved order of magnitude compared with that of conventional $Al_2O_3$ layers made by the RF magnetron sputteringprocess under the same sputtering conditions; the WVTR of the NBAS processed $Al_2O_3$ gas barrier film was about $5{\times}10^{-6}g/m^2/day$ by just single layer.

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Effects of Flavonoid from Rhus verniciflua on Testosterone Secretion by Rat Leydig Cells In Vitro (옻나무 유래 Flavonoid 처리가 흰쥐 Leydig 세포의 체외배양에서 Testosterone 분비에 미치는 영향)

  • 성환후;최선호;장유민;민관식;우제현;장원경;정남철;나천수;정일정
    • Korean Journal of Animal Reproduction
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    • v.25 no.2
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    • pp.125-130
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    • 2001
  • This study was performed to report a direct dose dependent stimulatory effect of the Flavonoid(F) on basal testosterone secretion and a dose dependent effect on LH induced testosterone production by Leydig cell of matured rats in vitro culture. F was obtained kom the Rhus vernicifua through aceton extraction and silica gel adsorption column chromatography. Leydig cells (1$\times$10$^{6}$ cells/well) from 12 weeks old rats were incubated with or without F(0, 20, 40, 80, 160 ng) or insulin-like growth factor-I(IGF-I) in the presence or absence of LH(10, 100ng). 1. The maximal stimulatory concentrations of testosterone in culture media were showed at 24hr of culture. but these testosterone level were decreased at 36 hr of culture. 2. Flavonoid(80ng) were significantly(P < 0.05) increased testosterone production compared with control groups for 12 hr culture. 3. Testosterone secretion by Leydig cells stimulated with LH(10, 100ng) for 6 hr and 12hr culture compared with 3 hr culture. 4. LH 10 ng augmented testosterone were increased by addition of F 40 ng for 12 hr culture. 5. F(0 and 40 ng) also enhanced LH 10 ng stimulated testosterone for 3 hr Leydig cells culture. 6. Addition of IGF-I 100 ng to the culture medium for 6 hr were increased the concentration of testosterone by Leydig cells stimulated with 100 ng LH. These results indicate that Flavonoid has a direct stimulatory effect on basal testosterone secretion in rat Leydig cells, and also modulates LH mediated testosterone. Therefore, Flavonoid may act as a modulator on gonadal development or gonadal steroidogenesis in direct or indirect.

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Frameless Fractionated Stereotactic Radiaton Therapy in Recurrent Head & Neck Cancers (국소재발된 두경부종양의 무고정틀 정위적 분할방사선치료)

  • Kim In-Ah;Choi Ihl-Bhong;Jang Ji-Young;Kang Ki-Mun;Jho Seung-Ho;Kim Hyung-Tae;Lee Kyung-Jin;Choi Chang-Rak
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.156-163
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    • 1998
  • Background & Objectives: Frameless fractionated stereotactic radiotherapy(FFSRT) is a modification of stereotactic radiosurgery(SRS) with radiobiologic advantage of fractionation without losing mechanical accuracy of SRS. Local recurrence of head and neck cancer at or near skull base benefit from reirradiation. Main barrier to successful palliation is dose limitation secondary to normal tissue tolerance. We try to evaluate the efficacy and safety of FFSRT as a new modality of reirradaton in these challenging patients. Materials & Methods: Seven patients with recurrent head & neck cancer involving at or near skull base received FFSRT from September 1995 to November 1997. Six patients with nasopharyngeal cancer had received induction chemotherapy and curative radiation therapy. One patient with maxillary sinus cancer had received total maxillectomy and postoperative radiation therapy as a initial treatment. Follow-up ranged from 11 to 32 months with median of 24 months. Three of 7 patients received hyperfractionated radiation therapy(1.1-1.2Gy/fraction, bid, total 19.8-24Gy) just before FFSRT. All patients received FFSRT(3-5Gy/fraction, total 15-30Gy/5-10fractions). Chemotherapy(cis-platin $100mg/m^2$) were given concurrently with FFSRT in four patients. Second course of FFSRT were given in 4 patients with progression or recurrence after initial FFSRT. Because IF(irregularity factor; ratio of surface area of target to the surface area of sphere with same volume as a target) is too big to use conventional stereotactic RT using multiple arc method for protection of radiation damage to critical normal tissue, all patients received FFSRT with conformal method using irregular static ports. Results: Five of 7 patients showed complete remission in follow-up CT &/or MRI. Three of these five patients who developed marginal, in-field, and out-field recurrences, respectively. Another one of complete responders has been dead of G-I bleeding without evidence of local recurrence. One partial responder who showed progressive disease 15 months after initial FFSRT has received additional FFSRT, and then he is well-being with symptomatic improvement. One minmal responder who showed progression of locoregional disease 9 months after $1^{st}$ FFSRT has received 2nd FFSRT, and then he is alive with stable disease. Five of 7 case had showed direct invasion to skull base and had complaint headache and various symptoms of cranial nerve involvement. Four of these five case showed improvement of neurologic symptoms after FFSRT. No significant neurologic complicaltion related to FFSRT was observed during follow-up periods. Tumor volumes were ranged from 3.9 to 50.7 cc and surface area ranged from 16.1 to $114.9cm^2$. IF ranged from 1.21 to 1.74. The average ratio of volume of prescription isodose shell to target volume was 1.02 that indicated the improvement of target coverage and dose distribution with FFSRT with conformal method compared to target coverage with FFSRT with multiple arc method. Conclusion: Our initial experience suggests that FFSRT with conformal method was relatively effective and safe modality in the treatment of recurrent head and neck cancer involving at or near skull base. Treatment benefit included good palliation of symptoms and reasonable radiographic response. However, more experience and additional follow-up are needed to better assess its ultimate role in treating these challenging patients.

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