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Evaluating the usefulness of BinkieRTTM (oral positioning stent) for Head and Neck Radiotherapy (두경부암 환자 방사선 치료 시 BinkieRTTM(구강용 고정장치)에 대한 유용성 평가)

  • GyeongJin Lee;SangJun Son;GyeongDal Lim;ChanYong Kim;JeHee Lee
    • The Journal of Korean Society for Radiation Therapy
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    • v.34
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    • pp.21-30
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    • 2022
  • Purpose: The purpose of this study is to evaluate the effectiveness of oral positioning stent, the BinkieRTTM in radiation treatment for head and neck cancer patients in terms of tongue positions reproducibility, tongue doses and material properties. Materials and Methods: 24 cases using BinkieRTTM during radiation treatments were enrolled. The tongue was contoured on planning CT and CBCT images taken every 3 days during treatment, and then the DSC and center of tongue shift values were analyzed to evaluate the reproducibility of the tongue. The tongue dose was compared in terms of dose distribution when using BinkieRTTM and different type of oral stents (mouthpiece, paraffin wax). Randomly selected respective 10 patients were measured tongue doses of initial treatment plan for nasal cavity and unilateral parotid cancer. Finally, In terms of material evaluation, HU and relative electron density were identified in RTPS. Results: As a result of DSC analysis, it was 0.8 ± 0.07, skewness -0.8, kurtosis 0.61, and 95% CI was 0.79~0.82. To analyze the deviation of the central tongue shift during the treatment period, a 95% confidence interval for shift in the LR, SI, and AP directions were indicated, and a one-sample t-test for 0, which is an ideal value in the deviation(n=144). As a result of the t-test, the mean and SD in the LR and SI directions were 0.01 ± 0.14 cm (p→.05), 0.03 ± 0.25 cm (p→.05), and -0.08 ± 0.25 cm (p ←.05) in the AP direction. In the case of unilateral parotid cancer patients, the Dmean to the tongue of patients using BinkieRTTM was 16.92% ± 3.58% compared to the prescribed dose, and 23.99% ± 10.86% of patients with Paraffin Wax, indicating that the tongue dose was relatively lower when using BinkieRTTM (p←.05). On the other hand, among nasal cavity cancer patients, the Dmean of tongue dose for patients who used BinkieRTTM was 4.4% ± 5.6%, and for those who used mouthpiece, 5.9% ± 6.8%, but it was not statistically significant (p→.05). The relative electron density of Paraffin Wax, BinkieRTTM and Putty is 0.94, 0.99, 1.26 and the mass density is 0.95, 0.99 and 1.32 (g/cc), Transmission Factor is 0.99, 0.98, 0.96 respectively. Conclusion: The result of the tongue DSC analysis over the treatment period was about 0.8 and Deviation of the center of tongue shifts were within 0.2 cm, the reproducibility was more likely excellent. In the case of unilateral head and neck cancer patients, it was found that the use of BinkieRTTM rather than Paraffin Wax or Putty can reduce the unnecessary dose irradiated to the tongue. This study might be useful to understand of BinkieRTTM's properties and advantages. And also it could be another considered option as oral stent to keep the reproducibility of tongue and reducing dose during head and neck radiation treatments.

Developing a Scale for Measuring the Corporate Social Responsibility Activities of Korea Corporation: Focusing on the Consumers' Awareness (한국형 기업의 사회적 책임활동 측정을 위한 척도 개발 연구: 소비자 인식을 중심으로)

  • Park, Jongchul;Kim, Kyungjin;Lee, Hanjoon
    • Asia Marketing Journal
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    • v.12 no.2
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    • pp.27-52
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    • 2010
  • It is not new that today's business organizations are expected to exhibit ethical and moral management and to carry out social responsibility as a good corporate citizen. Since South Korea emerged as a newly industrialized country during the 1980s, Korean corporations have become active in carrying out their social responsibility as a good corporate citizen to society. In spite of the short history of corporate social responsibility, Korean companies have actively participated in corporate philanthropy. Corporations' significant donations to various social causes, no-lay-off policies, corporate volunteerism and green marketing are evidences of their commitment to corporate citizenship. Corporate social responsibility is now an essential management practice whereby corporation can strengthen its sustainable value creation processes by enhancing the trust assets underlying the relationships between the business and the stakeholders. Much of the conceptual work in the area of corporate social responsibility(CSR) has originated from researches conducted in the management field. Carroll(1979) proposed that corporations have four types of social responsibilities: economic, legal, ethical and philanthropic responsibility. Most past research has investigated CSR and its impact on consumers' attitudes toward the corporations and corporate performances. Although there exists a large body of literature on how consumers perceive and respond to CSR, the majority of past studies were conducted in the United States. The stability and applicability of past findings need to be tested across different national/cultural settings, especially since corporate social responsibility is a reflection of implicit conformation with the expectations and criticism that society may have toward a corporation(Matten and Moon, 2004). In this study, we explored whether people in Korea perceive CSR of Korean corporations in the same four dimensions as done in the United States and what were the measurement items tapping each of these four dimensions. In order to investigate the dimensions of CSR and the measurement items for CSR perceived by Korean people, nine focus group interviews were conducted with several stakeholder groups(two with undergraduate students, two with graduate students, three with general consumers, and two with NGO groups). Scripts from the interviews revealed that the Korean stakeholders perceived four types of CSR which are the same as those proposed by Carroll(1979). However we found CSR issues unique to Korean corporations. For example for the economic responsibility, Korean people mentioned that the corporation needed to contribute to the economic development of the country by generating corporate profits. For the legal responsibility, Koreans included the "corporation need to follow the consumer protection law." For the ethical responsibility, they considered that the corporation needed to not promote false advertisement. In addition, Koreans thought that an ethical company should do transparent management. For the philanthropic responsibility, people in Korea thought that a corporation needed to return parts of its profits to the society for the betterment of society. The 28 items were developed based on the results of the nine focus group interviews, while considering the scale developed by Maignan and Ferrell(2001). Following the procedure proposed by Churchill(1979), we started by developing an item poll consisting of 28 items and purified the initial pool of items through exploratory, confirmatory factor analyses. 176 samples were sued for this analysis. Confirmatory factor analysis was performed on the 28 items in order to verify the underlying four factor structure. Study 1 provided new measurement items for tapping the Korean CSR dimensions, which can be useful for the future studies exploring the effects of CSR on Korean consumers' attitudes toward the corporations and corporate performances. And we found the CSR scale(17 items) has good reliability, discriminant validity and nomological validity. Economic Responsibility: "XYZ company continuously improves the quality of our products", "XYZ company has a procedure in place to respond to customer complaint", "XYZ company contributes to the economic development of our country by generating profits", "XYZ company is eager to hire people". Legal Responsibility: "XYZ company's products meet legal standards", "XYZ company seeks to comply with all laws regulating hiring and employee benefits", "XYZ company honors contractual obligations to its suppliers", "XYZ company's managers try to comply with the law related to the business operation". Ethical Responsibility: "XYZ company has a comprehensive code of conduct", "XYZ company does not promote a false or misleading advertisement", "XYZ company seems to conduct a transparent business", "XYZ company does a fair business with its suppliers or sub-contractors". Philanthropic Responsibility: "XYZ company encourages partnerships with local businesses and schools", "XYZ company supports sports and cultural activities", "XYZ company gives adequate contributions to charities considering its business size", "XYZ company encourages employees to support our community". Study 2 was condusted for comprehensive validity. 655 samples were used for this anlysis. Collected samples were tested by factor analysis and Crnbach's Alpha coefficiednts and were found to be satisfactory in terms of validity and reliability. Furthermore, fitness of the measurement model was tested by using conformatory factor analysis. χ2=880.73(df=160), GFI=0.891, AGFI=0.854, NFI=0.908, NNFI=0.913, RMR=0.059, RMESA=0.070. We hope that CSR scale could greatly facilitate research on Corporate social resposibility, it is by no means the final answer.

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Application and Analysis of Ocean Remote-Sensing Reflectance Quality Assurance Algorithm for GOCI-II (천리안해양위성 2호(GOCI-II) 원격반사도 품질 검증 시스템 적용 및 결과)

  • Sujung Bae;Eunkyung Lee;Jianwei Wei;Kyeong-sang Lee;Minsang Kim;Jong-kuk Choi;Jae Hyun Ahn
    • Korean Journal of Remote Sensing
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    • v.39 no.6_2
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    • pp.1565-1576
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    • 2023
  • An atmospheric correction algorithm based on the radiative transfer model is required to obtain remote-sensing reflectance (Rrs) from the Geostationary Ocean Color Imager-II (GOCI-II) observed at the top-of-atmosphere. This Rrs derived from the atmospheric correction is utilized to estimate various marine environmental parameters such as chlorophyll-a concentration, total suspended materials concentration, and absorption of dissolved organic matter. Therefore, an atmospheric correction is a fundamental algorithm as it significantly impacts the reliability of all other color products. However, in clear waters, for example, atmospheric path radiance exceeds more than ten times higher than the water-leaving radiance in the blue wavelengths. This implies atmospheric correction is a highly error-sensitive process with a 1% error in estimating atmospheric radiance in the atmospheric correction process can cause more than 10% errors. Therefore, the quality assessment of Rrs after the atmospheric correction is essential for ensuring reliable ocean environment analysis using ocean color satellite data. In this study, a Quality Assurance (QA) algorithm based on in-situ Rrs data, which has been archived into a database using Sea-viewing Wide Field-of-view Sensor (SeaWiFS) Bio-optical Archive and Storage System (SeaBASS), was applied and modified to consider the different spectral characteristics of GOCI-II. This method is officially employed in the National Oceanic and Atmospheric Administration (NOAA)'s ocean color satellite data processing system. It provides quality analysis scores for Rrs ranging from 0 to 1 and classifies the water types into 23 categories. When the QA algorithm is applied to the initial phase of GOCI-II data with less calibration, it shows the highest frequency at a relatively low score of 0.625. However, when the algorithm is applied to the improved GOCI-II atmospheric correction results with updated calibrations, it shows the highest frequency at a higher score of 0.875 compared to the previous results. The water types analysis using the QA algorithm indicated that parts of the East Sea, South Sea, and the Northwest Pacific Ocean are primarily characterized as relatively clear case-I waters, while the coastal areas of the Yellow Sea and the East China Sea are mainly classified as highly turbid case-II waters. We expect that the QA algorithm will support GOCI-II users in terms of not only statistically identifying Rrs resulted with significant errors but also more reliable calibration with quality assured data. The algorithm will be included in the level-2 flag data provided with GOCI-II atmospheric correction.

A Study on the Phase Change of Cubic Bi1.5Zn1.0Nb1.5O7(c-BZN) and the Corresponding Change in Dielectric Properties According to the Addition of Li2CO3 (Li2CO3 첨가에 따른 입방정 Bi1.5Zn1.0Nb1.5O7(c-BZN)의 상 변화 및 그에 따른 유전특성 변화 연구)

  • Yuseon Lee;Yunseok Kim;Seulwon Choi;Seongmin Han;Kyoungho Lee
    • Journal of the Microelectronics and Packaging Society
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    • v.30 no.4
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    • pp.79-85
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    • 2023
  • A novel low-temperature co-fired ceramic (LTCC) dielectric, composed of (1-4x)Bi1.5Zn1.0Nb1.5O7-3xBi2Zn2/3Nb4/3O7-2xLiZnNbO4 (x=0.03-0.21), was synthesized through reactive liquid phase sintering of Bi1.5Zn1.0Nb1.5O7-xLi2CO3 ceramic at temperatures ranging from 850℃ to 920℃ for 4 hours. During sintering, Li2CO3 reacted with Bi1.5Zn1.0Nb1.5O7, resulting in the formation of Bi2Zn2/3Nb4/3O7, and LiZnNbO4. The resulting sintered body exhibited a relative sintering density exceeding 96% of the theoretical density. By altering the initial Li2CO3 content (x) and consequently modulating the volume fraction of Bi1.5Zn1.0Nb1.5O7, Bi2Zn2/3Nb4/3O7, and LiZnNbO4 in the final sintered body, a sample with high dielectric constant (εr), low dielectric loss (tan δ), and the temperature coefficient of dielectric constant (TCε) characterized by NP0 specification (TCε ≤ ±30 ppm/℃) was achieved. As the Li2CO3 content increased from x=0.03 mol to x=0.15 mol, the volume fraction of Bi2Zn2/3Nb4/3O7 and LiZnNbO4 in the composite increased, while the volume fraction of Bi1.5Zn1.0Nb1.5O7 decreased. Consequently, the dielectric constant (εr) of the composite materials varied from 148.38 to 126.99, the dielectric loss (tan δ) shifted from 5.29×10-4 to 3.31×10-4, and the temperature coefficient of dielectric constant (TCε) transitioned from -340.35 ppm/℃ to 299.67 ppm/℃. A dielectric exhibiting NP0 characteristics was achieved at x=0.09 for Li2CO3, with a dielectric constant (εr) of 143.06, a dielectric loss (tan δ) value of 4.31×10-4, and a temperature coefficient of dielectric constant (TCε) value of -9.98 ppm/℃. Chemical compatibility experiment with Ag electrode revealed that the developed composite material exhibited no reactivity with the Ag electrode during the co-firing process.

Influence of Oxygen Concentration on the Food Consumption and Growth of Common Carp, Cyprinus carpio L. (잉어 Cyprinus carpio의 먹이 섭취량과 성장에 미치는 용존산소량의 영향)

  • SAIFABADI Jafar;KIM In-Bae
    • Journal of Aquaculture
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    • v.2 no.2
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    • pp.53-90
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    • 1989
  • Feeding proper level of ration matchable with the appetite of fish will enhance production and also prevent waste of food and its consequence, side effects such as pollution of culture medium. To pursue this goal, elaborate studies on dissolved oxygen concentrations- as the major force in inducing appetite and the growth outcome are necessary. The growth of common carp of 67, 200, 400, 600, and 800 gram size groups was studied at oxygen concentrations ranging from 2.0 to 6 mg/$\iota$ in relation to rations from 1 to as many percent of the initial body weight as could be consumed under constant temperature of $25^{\circ}C$. The results from the experiments are summarized as followings; 1. Appetite: The smaller fish exhibited higher degree of appetite than the bigger ones at the same oxygen concentrations. The bigger the fish the less tolerant it was to the lower oxygen thersholds, and the degree of tolerence decreased as ration level increased. 2. Growth : Growth rate (percent per day) increased - unless consumption was suppressed by low oxygen levels- as the ration was increased to maximum. In case of 67 g fish, it reached the highest point of $5.05\%$ / day at $7\%$ ration under 5.0 mg/$\iota$ of oxygen. In case of 200 g fish, the maximum growth rate of $3.75\%$/day appeared at the maximum ration of $6\%$ under 5.5 mg/$\iota$ of oxygen. In 400 g fish, the highest growth of $3.37\%$/day occurred at the maximum ration of $5\%$ and 6.0 mg/$\iota$ of oxygen. In 600 g fish, the highest growth rate of $2.82\%$ /day was at the maximum ration of $4\%$ under 5.5 mg/$\iota$ oxygen. In case of 800g fish, the highest growth rate of $1.95\%$/day was at maximum tested ration of $3\%$ under 5.0 mg/$\iota$ oxygen. 3. Food Conversion Efficiency: Food conversion efficiency ($\%$ dry feed converted into the fish tissue) first increased as the ration was increased, reached maximum at certain food level, then started decreasing with further increase in the ration. The maximum conversion efficiency stood at higher feeding rate for the smaller fish than the larger ones. In case of 67 g fish, the maximum food conversion efficiency was at $4\%$ ration within 3.0-4.0 mg/$\iota$ oxygen. In 200g fish, the maximum efficiency was at $3\%$ ration within 4.0-4.5 mg/$\iota$ oxygen. In 400g fish, the maximum efficiency was at $2\%$ ration within 4.0 - 4.5 mg/$\iota$ oxygen. In 600 and 800g fish, the maximum conversion efficiency shifted to the lowest ration ($1\%$) and lower oxygen ranges. 4. Behaviour: The fish within uncomfortably low oxygen levels exhibited suppressed appetite and movements and were observed to pass feces quicker and in larger quantity than the ones in normal condition; in untolerably low oxygen the fish were lethargic, vomited, and had their normal skin color changed into pale yellow or grey patches. All these processes contributed to reducing food conversion efficiency. On the other hand, the fish within relatively higher oxygen concentrations exhibited higher degree of movement and their food conversion tended to be depressed when compared with sister groups under corresponding size and ration within relatively low oxyen level. 5. Suitability of Oxygen Ranges to Rations: The oxygen level of 2.0- 2.5 mg/$\iota$ was adequate to sustain appetite at $1\%$ ration in all size groups. As the ration was increased higher oxygen was required to sustain the fish appetite and metabolic activity, particularly in larger fish. In 67g fish, the $2\%$ ration was well supported by 2.0-2.5 mg/$\iota$ range; as the ration increased to $5\%$, higher range of 3.0-4.0 mg/$\iota$ brought better appetite and growth; from 5 till $7\%$ (the last tested ration for 67 g fish) oxygen levels over 4.0 mg/$\iota$ could sustain appetite. In 200 g fish, the 2 and $3\%$ rations brought the best growth and conversion rates at 3.5-4.5 mg/$\iota$ oxygen level; from 3 till $6\%$ (the last tested ration at 200 g fish) oxyge groups over 4.5 mg/$\iota$ were matchable with animal's appetite. In 400, 600, and 800 g fish, all the rations above $2\%$ had to be generally supported with oxygen levels above 4.5 mg/$\iota$.

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Four-year change and tracking of serum lipids in Korean adolescents (강화지역 청소년의 4년간 혈청 지질의 변화와 지속성)

  • Lee, Kang-Hee;Suh, Il;Jee, Sun-Ha;Nam, Chung-Mo;Kim, Sung-Soon;Shim, Won-Heum;Ha, Jong-Won;Kim, Suk-Il;Kang, Hyung-Gon
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.1 s.56
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    • pp.45-59
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    • 1997
  • It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probabilities of remaining at the same group were more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in the future to investigate the long-term change of lipids from adolescents to adults.

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The Research on Recommender for New Customers Using Collaborative Filtering and Social Network Analysis (협력필터링과 사회연결망을 이용한 신규고객 추천방법에 대한 연구)

  • Shin, Chang-Hoon;Lee, Ji-Won;Yang, Han-Na;Choi, Il Young
    • Journal of Intelligence and Information Systems
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    • v.18 no.4
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    • pp.19-42
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    • 2012
  • Consumer consumption patterns are shifting rapidly as buyers migrate from offline markets to e-commerce routes, such as shopping channels on TV and internet shopping malls. In the offline markets consumers go shopping, see the shopping items, and choose from them. Recently consumers tend towards buying at shopping sites free from time and place. However, as e-commerce markets continue to expand, customers are complaining that it is becoming a bigger hassle to shop online. In the online shopping, shoppers have very limited information on the products. The delivered products can be different from what they have wanted. This case results to purchase cancellation. Because these things happen frequently, they are likely to refer to the consumer reviews and companies should be concerned about consumer's voice. E-commerce is a very important marketing tool for suppliers. It can recommend products to customers and connect them directly with suppliers with just a click of a button. The recommender system is being studied in various ways. Some of the more prominent ones include recommendation based on best-seller and demographics, contents filtering, and collaborative filtering. However, these systems all share two weaknesses : they cannot recommend products to consumers on a personal level, and they cannot recommend products to new consumers with no buying history. To fix these problems, we can use the information which has been collected from the questionnaires about their demographics and preference ratings. But, consumers feel these questionnaires are a burden and are unlikely to provide correct information. This study investigates combining collaborative filtering with the centrality of social network analysis. This centrality measure provides the information to infer the preference of new consumers from the shopping history of existing and previous ones. While the past researches had focused on the existing consumers with similar shopping patterns, this study tried to improve the accuracy of recommendation with all shopping information, which included not only similar shopping patterns but also dissimilar ones. Data used in this study, Movie Lens' data, was made by Group Lens research Project Team at University of Minnesota to recommend movies with a collaborative filtering technique. This data was built from the questionnaires of 943 respondents which gave the information on the preference ratings on 1,684 movies. Total data of 100,000 was organized by time, with initial data of 50,000 being existing customers and the latter 50,000 being new customers. The proposed recommender system consists of three systems : [+] group recommender system, [-] group recommender system, and integrated recommender system. [+] group recommender system looks at customers with similar buying patterns as 'neighbors', whereas [-] group recommender system looks at customers with opposite buying patterns as 'contraries'. Integrated recommender system uses both of the aforementioned recommender systems to recommend movies that both recommender systems pick. The study of three systems allows us to find the most suitable recommender system that will optimize accuracy and customer satisfaction. Our analysis showed that integrated recommender system is the best solution among the three systems studied, followed by [-] group recommended system and [+] group recommender system. This result conforms to the intuition that the accuracy of recommendation can be improved using all the relevant information. We provided contour maps and graphs to easily compare the accuracy of each recommender system. Although we saw improvement on accuracy with the integrated recommender system, we must remember that this research is based on static data with no live customers. In other words, consumers did not see the movies actually recommended from the system. Also, this recommendation system may not work well with products other than movies. Thus, it is important to note that recommendation systems need particular calibration for specific product/customer types.

Optimum Radiotherapy Schedule for Uterine Cervical Cancer based-on the Detailed Information of Dose Fractionation and Radiotherapy Technique (처방선량 및 치료기법별 치료성적 분석 결과에 기반한 자궁경부암 환자의 최적 방사선치료 스케줄)

  • Cho, Jae-Ho;Kim, Hyun-Chang;Suh, Chang-Ok;Lee, Chang-Geol;Keum, Ki-Chang;Cho, Nam-Hoon;Lee, Ik-Jae;Shim, Su-Jung;Suh, Yang-Kwon;Seong, Jinsil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.143-156
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    • 2005
  • Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

Research for Space Activities of Korea Air Force - Political and Legal Perspective (우리나라 공군의 우주력 건설을 위한 정책적.법적고찰)

  • Shin, Sung-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.18
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    • pp.135-183
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    • 2003
  • Aerospace force is a determining factor in a modem war. The combat field is expanding to space. Thus, the legitimacy of establishing aerospace force is no longer an debating issue, but "how should we establish aerospace force" has become an issue to the military. The standard limiting on the military use of space should be non-aggressive use as asserted by the U.S., rather than non-military use as asserted by the former Soviet Union. The former Soviet Union's argument is not even strongly supported by the current Russia government, and realistically is hard to be applied. Thus, the multi-purpose satellite used for military surveillance or a commercial satellite employed for military communication are allowed under the U.S. principle of peaceful use of space. In this regard, Air Force may be free to develop a military surveillance satellite and a communication satellite with civilian research institute. Although MTCR, entered into with the U.S., restricts the development of space-launching vehicle for the export purpose, the development of space-launching vehicle by the Korea Air Force or Korea Aerospace Research Institute is beyond the scope of application of MTCR, and Air Force may just operate a satellite in the orbit for the military purpose. The primary task for multi-purpose satellite is a remote sensing; SAR sensor with high resolution is mainly employed for military use. Therefore, a system that enables Air Force, the Korea Aerospace Research Institute, and Agency for Defense Development to conduct joint-research and development should be instituted. U.S. Air Force has dismantled its own space-launching vehicle step by step, and, instead, has increased using private space launching vehicle. In addition, Military communication has been operated separately from civil communication services or broadcasting services due to the special circumstances unique to the military setting. However, joint-operation of communication facility by the military and civil users is preferred because this reduces financial burden resulting from separate operation of military satellite. During the Gulf War, U.S. armed forces employed commercial satellites for its military communication. Korea's participation in space technology research is a little bit behind in time, considering its economic scale. In terms of budget, Korea is to spend 5 trillion won for 15 years for the space activities. However, Japan has 2 trillion won annul budget for the same activities. Because the development of space industry during initial fostering period does not apply to profit-making business, government supports are inevitable. All space development programs of other foreign countries are entirely supported by each government, and, only recently, private industry started participating in limited area such as a communication satellite and broadcasting satellite, Particularly, Korea's space industry is in an infant stage, which largely demands government supports. Government support should be in the form of investment or financial contribution, rather than in the form of loan or borrowing. Compared to other advanced countries in space industry, Korea needs more budget and professional research staff. Naturally, for the efficient and systemic space development and for the prevention of overlapping and distraction of power, it is necessary to enact space-related statutes, which would provide dear vision for the Korea space development. Furthermore, the fact that a variety of departments are running their own space development program requires a centralized and single space-industry development system. Prior to discussing how to coordinate or integrate space programs between Agency for Defense Development and the Korea Aerospace Research Institute, it is a prerequisite to establish, namely, "Space Operations Center"in the Air Force, which would determine policy and strategy in operating space forces. For the establishment of "Space Operations Center," policy determinations by the Ministry of National Defense and the Joint Chief of Staff are required. Especially, space surveillance system through using a military surveillance satellite and communication satellite, which would lay foundation for independent defense, shall be established with reference to Japan's space force plan. In order to resolve issues related to MTCR, Air Force would use space-launching vehicle of the Korea Aerospace Research Institute. Moreover, defense budge should be appropriated for using multi-purpose satellite and communication satellite. The Ministry of National Defense needs to appropriate 2.5 trillion won budget for space operations, which amounts to Japan's surveillance satellite operating budges.

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A Comparison of Tiotropium 18㎍, Once Daily and Ipratropium 40㎍, 4 Times Daily in a Double-Blind, Double-Dummy, Efficacy and Safety Study in Adults with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 Tiotropium 1일 1회, 1회 18㎍ 요법과 Ipratropium 1일 4회, 1회 40㎍ 요법의 치료효과 및 안전성 비교)

  • Kim, Seung Joon;Kim, Myung Sook;Lee, Sang Haak;Kim, Young Kyoon;Moon, Hwa Sik;Park, Sung Hak;Lee, Sang Yeub;In, Kwang Ho;Lee, Chang Youl;Kim, Young Sam;Kim, Hyung Jung;Ahn, Chul Min;Kim, Sung Kyu;Kim, Kyung Rok;Cha, Seung Ick;Jung, Tae Hoon;Kim, Mi Ok;Park, Sung Soo;Choi, Cheon Woong;Yoo, Jee Hong;Kang, Hong Mo;Koh, Won Jung;Ham, Hyoung Suk;Kang, Eun Hae;Kwon, O Jung;Lee, Yang Deok;Lee, Heung Bum;Lee, Yong Chul;Rhee, Yang Keun;Shin, Won Hyuk;Kwon, Sung Yeon;Kim, Woo Jin;Yoo, Chul Gyu;Kim, Young Whan;Shim, Young Soo;Han, Sung Koo;Park, Hye Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew;Kim, Mi Hye;Lee, Won Yeon;Yong, Suk Joong;Shin, Kye Chul;Choi, Byoung Whui;Oh, Yeon Mok;Lim, Chae Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Jung, Sung Soo;Kim, Ju Ock;Ko, Young Chun
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.498-506
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    • 2005
  • Background : This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules ($18{\mu}g$ once daily) with a ipratropium metered dose inhaler (2 puffs of $20{\mu}g$ q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). Method : After the initial screening assessment and a two-week run-in period, patients received either tiotropium $18{\mu}g$ once daily or ipratropium $40{\mu}g$ four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second ($FEV_1$) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. Result : In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted $FEV_1$ of 42 (12)% were analyzed. The trough $FEV_1$ response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. Conclusion : This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.