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Pharmacokinetic Profiles of Isoniazid and Rifampicin in Korean Tuberculosis Patients (한국인 결핵환자에서 Isoniazid와 Rifampicin의 약동학)

  • Ahn, Seok-Jin;Park, Sang-Joon;Kang, Kyeong-Woo;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.;Cha, Hee-Soo;Kim, Myoung-Min;Choi, Kyung-Eob
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.442-450
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    • 1999
  • Background : Isoniazid(INH) and rifampicin(RFP) are the most effective anti-tuberculosis drugs which make the short-course chemotherapy possible. Although prescribed dosages of INH and RFP in Korea are different from those recommended by American Thoracic Society, there has been few study about pharmacokinetic profiles of INH and RFP in Korean patients who receive INH, RFP, ethambutol(EMB) and pyrazinamide(PZA) simultaneously. Methods : Among the patients with active tuberculosis from Dec. 1997 to July 1998, we selected 17 patients. After an overnight fast, patients were given INH 300mg, RFP 450mg, EMB 800mg and PZA 1500mg daily. Blood samples for the measurement of plasma INH(n=15) and RFP(n=17) level were drawn each at 0, 0.5, 1, 1.5, 2, 4, 6, 8 and 12hrs, and urine was also collected. INH and RFP level in the plasma and the urine were measured by high-performance liquid chromatography(HPLC). Pharmacokinetic parameters such as peak serum concentration(Cmax), time to reach to peak serum concentration(Tmax), half-life, elimination rate constant(Ke), total body clearance(CLtot), nonrenal clearance(CLnr), and renal clearance(CLr) were calculated. Results : 1) Pharmacokinetic parameters of INH were as follows: Cmax; $7.63{\pm}3.20{\mu}g/ml$, Tmax; $0.73{\pm}0.22hr$, half-life; $2.12{\pm}0.84hrs$, Ke; $0.83{\pm}0.15hrs^{-1}$, CLtot; $17.54{\pm}8.89L/hr$, CLnr; $14.74{\pm}8.35L/hr$, CLr; $2.79{\pm}1.31L/hr$. 2) Pharmacokinetic parameters of RFP were as follows: Cmax; $8.93{\pm}3.98{\mu}g/ml$, Tmax; $1.76{\pm}1.13hrs$, half-life; $2.27{\pm}0.54hrs$, Ke; $0.32{\pm}0.08hrs^{-1}$, CLtot; $14.63{\pm}6.60L/hr$, CLr; $1.04{\pm}0.55L/hr$, CLnr; $13.59{\pm}6.21L/hr$. 3) While the correlation between body weight and Cmax of INH was not statistically significant (r=-0.514, p value>0.05), Cmax of RFP was significantly affected by body weight of the patients(r=-0.662, p value<0.01). Conclusion : In Korean patients with tuberculosis, 300mg of INH will be sufficient to reach the ideal peak blood level even in the patients over 50kg of body weight However, 450mg of RFP will not be the adequate dose in the patients who weigh over 50~60kg.

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The Process of Establishing a Japanese-style Garden and Embodying Identity in Modern Japan (일본 근대 시기 일본풍 정원의 확립과정과 정체성 구현)

  • An, Joon-Young;Jun, Da-Seul
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.41 no.3
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    • pp.59-66
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    • 2023
  • This study attempts to examine the process of establishing a Japanese-style garden in the modern period through the perspectives of garden designers, spatial composition, spatial components, and materials used in their works, and to use it as data for embodying the identity of Korean garden. The results are as follows: First, by incorporating elements associated with Koreanness into the modern garden culture, there are differences in location, presence, and subjectivity when compared to Japan. This reflects Japan's relatively seamless cultural continuity compared to Korea's cultural disconnection during the modern period. Second, prior to the modern period, Japan's garden culture spread and continued to develop throughout the country without significant interruptions. However, during the modern period, the Meiji government promoted the policy of 'civilization and enlightenment (Bunmei-kaika, 文明開化)' and introduced advanced European and American civilizations, leading to the popularity of Western-style architectural techniques. Unfortunately, the rapid introduction of Western culture caused the traditional Japanese culture to be overshadowed. In 1879, British architect Josiah Condor guided Japanese architects and introduced atelier and traditional designs of Japanese gardens into the design. The garden style of Ogawa Jihei VII, a garden designer in Kyoto during the Meiji and Taisho periods, was accepted by influential political and business leaders who sought to preserve Japan's traditional culture. And a protection system of garden was established through the preparation of various laws and regulations. Third, as a comprehensive analysis of Japanese modern gardens, the examination of garden designers, Japanese components, materials, elements, and the Japanese-style showed that Yamagata Aritomo, Ogawa Jihei VII, and Mirei Shigemori were representative garden designers who preserved the Japanese-style in their gardens. They introduced features such as the creation of a Daejicheon(大池泉) garden, which involves a large pond on a spacious land, as well as the naturalistic borrowed scenery method and water flow. Key components of Japanese-style gardens include the use of turf, winding garden paths, and the variation of plant species. Fourth, an analysis of the Japanese-style elements in the target sites revealed that the use of flowing water had the highest occurrence at 47.06% among the individual elements of spatial composition. Daejicheon and naturalistic borrowed scenery were also shown. The use of turf and winding paths were at 65.88% and 78.82%, respectively. The alteration of tree species was relatively less common at 28.24% compared to the application of turf or winding paths. Fifth, it is essential to discover more gardens from the modern period and meticulously document the creators or owners of the gardens, the spatial composition, spatial components, and materials used. This information will be invaluable in uncovering the identity of our own gardens. This study was conducted based on the analysis of the process of establishing the Japanese-style during Japan's modern period, utilizing examples of garden designers and gardens. While this study has limitations, such as the absence of in-depth research and more case studies or specific techniques, it sets the stage for future exploration.

The difference of image quality using other radioactive isotope in uniformity correction map of myocardial perfusion SPECT (심근 관류 SPECT에서 핵종에 따른 Uniformity correction map 설정을 통한 영상의 질 비교)

  • Song, Jae hyuk;Kim, Kyeong Sik;Lee, Dong Hoon;Kim, Sung Hwan;Park, Jang Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.2
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    • pp.87-92
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    • 2015
  • Purpose When the patients takes myocardial perfusion SPECT using $^{201}Tl$, the operator gives the patients an injection of $^{201}Tl$. But the uniformity correction map in SPECT uses $^{99m}Tc$ uniformity correction map. Thus, we want to compare the image quality when it uses $^{99m}Tc$ uniformity correction map and when it uses $^{201}Tl$ uniformity correction map. Materials and Methods Phantom study is performed. We take the data by Asan medical center daily QC condition with flood phantom including $^{201}Tl$ 21.3 kBq/mL. After postprocessing with this data, we analyze CFOV integral uniformity(I.U) and differential uniformity(D.U). And we take the data with Jaszczak ECT Phantom by American college of radiology accreditation program instruction including $^{201}Tl$ 33.4 kBq/mL. After post processing with this data, we analyze spatial Resolution, Integral Uniformity(I.U), coefficient of variation(C.V) and Contrast with Interactive data language program. Results In the flood phantom test, when it uses $^{99m}Tc$ uniformity correction map, Flood I.U is 3.6% and D.U is 3.0%. When it uses $^{201}Tl$ uniformity correction map, Flood I.U is 3.8% and D.U is 2.1%. The flood I.U is worsen about 5%, but the D.U is improved about 30% inversely. In the Jaszczak ECT phantom test, when it uses $^{99m}Tc$ uniformity correction map, SPECT I.U, C.V and contrast is 13.99%, 4.89% and 0.69. When it uses $^{201}Tl$ uniformity correction map, SPECT I.U, C.V and contrast is 11.37%, 4.79% and 0.78. All of data are improved about 18%, 2%, 13% The spatial resolution was no significant changes. Conclusion In the flood phantom test, Flood I.U is worsen but Flood D.U is improved. Therefore, it's uncertain that an image quality is improved with flood phantom test. On the other hand, SPECT I.U, C.V, Contrast are improved about 18%, 2%, 13% in the Jaszczak ECT phantom test. This study has limitations that we can't take all variables into account and study with two phantoms. We need think about things that it has a good effect when doctors decipher the nuclear medicine image and it's possible to improve the image quality using the uniformity correction map of other radionuclides other than $^{99m}Tc$, $^{201}Tl$ when we make other nuclear medicine examinations.

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The 1998, 1999 Patterns of Care Study for Breast Irradiation after Mastectomy in Korea (1998, 1999년도 우리나라에서 시행된 근치적 유방 전절제술 후 방사선치료 현황 조사)

  • Keum,, Ki-Chang;Shim, Su-Jung;Lee, Ik-Jae;Park, Won;Lee, Sang-Wook;Shin, Hyun-Soo;Chung, Eun-Ji;Chie, Eui-Kyu;Kim, Il-Han;Oh, Do-Hoon;Ha, Sung-Whan;Lee, Hyung-Sik;Ahn, Sung-Ja
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.7-15
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    • 2007
  • [ $\underline{Purpose}$ ]: To determine the patterns of evaluation and treatment in patients with breast cancer after mastectomy and treated with radiotherapy. A nationwide study was performed with the goal of improving radiotherapy treatment. $\underline{Materials\;and\;Methods}$: A web- based database system for the Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Randomly selected records of 286 eligible patients treated between 1998 and 1999 from 17 hospitals were reviewed. $\underline{Results}$: The ages of the study patients ranged from 20 to 80 years (median age 44 years). The pathologic T stage by the AJCC was T1 in 9.7% of the cases, T2 in 59.2% of the cases, T3 in 25.6% of the cases, and T4 in 5.3% of the cases. For analysis of nodal involvement, N0 was 7.3%, N1 was 14%, N2 was 38.8%, and N3 was 38.5% of the cases. The AJCC stage was stage I in 0.7% of the cases, stage IIa in 3.8% of the cases, stage IIb in 9.8% of the cases, stage IIIa in 43% of the cases, stage IIIb in 2.8% of the cases, and IIIc in 38.5% of the cases. There were various sequences of chemotherapy and radiotherapy after mastectomy. Mastectomy and chemotherapy followed by radiotherapy was the most commonly performed sequence in 47% of the cases. Mastectomy, chemotherapy, and radiotherapy followed by additional chemotherapy was performed in 35% of the cases, and neoadjuvant chemoradiotherapy was performed in 12.5% of the cases. The radiotherapy volume was chest wall only in 5.6% of the cases. The volume was chest wall and supraclavicular fossa (SCL) in 20.3% of the cases; chest wall, SCL and internal mammary lymph node (IMN) in 27.6% of the cases; chest wall, SCL and posterior axillary lymph node in 25.9% of the cases; chest wall, SCL, IMN, and posterior axillary lymph node in 19.9% of the cases. Two patients received IMN only. The method of chest wall irradiation was tangential field in 57.3% of the cases and electron beam in 42% of the cases. A bolus for the chest wall was used in 54.8% of the tangential field cases and 52.5% of the electron beam cases. The radiation dose to the chest wall was $45{\sim}59.4\;Gy$ (median 50.4 Gy), to the SCL was $45{\sim}59.4\;Gy$ (median 50.4 Gy), and to the PAB was $4.8{\sim}38.8\;Gy$, (median 9 Gy) $\underline{Conclusion}$: Different and various treatment methods were used for radiotherapy of the breast cancer patients after mastectomy in each hospital. Most of treatment methods varied in the irradiation of the chest wall. A separate analysis for the details of radiotherapy planning also needs to be followed and the outcome of treatment is needed in order to evaluate the different processes.

Comparison of Growth Charateristics, Forage Yield and Growth Analysis in Corn Hybrids for Silage Production (Silage용 옥수수의 생육특성, 수량 및 생육해석의 품종간 비교)

  • 김창호;박상철;이효원;강희경
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.18 no.2
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    • pp.79-88
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    • 1998
  • This experiment was conducted from May to August in 1997 to selected the wrn hybrids being suitable for silage at farm in the Kongju National University through the comparison of growth characteristics, forage yield and growth analysis about native and imported corn hybrids for silage production. In this experiment, trial design was a randomized block design with three replication, testing varieties were 4 hybrids (Suwon 19, Kwanganok, Whengsungok, Suwonok ) of native corn hybrids and 13 hybrids (P 3156, P 3352, P 3144w, DK 501, DK 689, DK 713, DK 729, H 643.99, H 545.64, H 645.12, HC 7466, H 644.18, H ALISEO) of imported corn hybrids. The results obtained are summarized as follows; 1. The emergence rate of H643.99 was the highest with 97.0%. In rice black streaked dwarf virus(RBSOV), the hybrid of HC 7466 was lower infected with 1.6% than other hybrids. The plant hight of P 3144w was the highest with 339 cm and the stem length of P 3156 was the highest with 261 cm. In native com hybrids, the plant height and stem length of Kwanganok were recorded with 306 cm and 235 cm, respectively. 2. Leaf number and leaf area of Kwanganok were the greatest with 16 sheet per plant and $5,180\;{\textrm{m}^2}/l0a$, respectively. H 645.12 and H 545.64 had the greatest in ear to total dry matter ratio with 49.5% and 49.4%, respectively. 3. The fresh matter yield was significantly difference between growth stage, So Suwon 19 had the most level at 15 days before silking, P 3352 had the most level at silking date, Kwananok had the most level at 35 days a after silking. The fresh matter yield of native com hybrids such as Suwon 19 and Kwanganok was not apparent diffreences as compared with imported corn hybrids. 4. As the results of survey with dry weight, the quantity of dry matter accumulation were increase after silking. The varieties of P 3352, P 3156, Kwanganok, OK 713 were more quantity of dry matter production than DK 501, HC 7466. The Kwanganok of native com hybrid and Pioneer strain with high percentage of dry matter were higher dry weight than Limagrain strain. 5. HC 7466 had the largest LAR with $6.53\;{\textrm{cm}^2}/g$, H545.12 had the lowest LAR with $3.30\;{\textrm{cm}^2/g}$. P 3144 had the largest LAI, DeKalb strain including DK 713 were larger apparently than Limagrain strain including HC 7466 with 3.15. 6. The RGR of testing varieties was little difference of statistical significantly, but DK 501, and HC 7466 were lower than other corn hybrids. The CGR of native and American varieties was no apparent differences, but that of Limagrain strains were a large variation. According to the results obtained by this experiment, the eary growth such as emergence rate and RBSDV infection rate of Limagrain strains was more excellent than other strains. P 3156, P 3352, P 3144w, DK 713 and HC 7466 were suitable for silage condition such as dry matter yield, percentage of dry matter and % ear to total dry matter. The fresh and dry matter yield of native corn hybrids such as Suwon 19 and Kwanganok were not apparent differences as compared with imported corn hybrids, but percentage of dry matter was lower than other imported corn hybrids.

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Business Relationships and Structural Bonding: A Study of American Metal Industry (산업재 거래관계와 구조적 결합: 미국 금속산업의 분석 연구)

  • Han, Sang-Lin;Kim, Yun-Tae;Oh, Chang-Yeob;Chung, Jae-Moon
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.3
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    • pp.115-132
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    • 2008
  • Metal industry is one of the most representative heavy industries and the median sales volume of steel and nonferrous metal companies is over one billion dollars in the case America [Forbes 2006]. As seen in the recent business market situation, an increasing number of industrial manufacturers and suppliers are moving from adversarial to cooperative exchange attitudes that support the long-term relationships with their customers. This article presents the results of an empirical study of the antecedent factors of business relationships in metal industry of the United States. Commitment has been reviewed as a significant and critical variable in research on inter-organizational relationships (Hong et al. 2007, Kim et al. 2007). The future stability of any buyer-seller relationship depends upon the commitment made by the interactants to their relationship. Commitment, according to Dwyer et al. [1987], refers to "an implicit or explicit pledge of relational continuity between exchange partners" and they consider commitment to be the most advanced phase of buyer-seller exchange relationship. Bonds are made because the members need their partners in order to do something and this integration on a task basis can be either symbiotic or cooperative (Svensson 2008). To the extent that members seek the same or mutually supporting ends, there will be strong bonds among them. In other words, the principle that affects the strength of bonds is 'economy of decision making' [Turner 1970]. These bonds provide an important idea to study the causes of business long-term relationships in a sense that organizations can be mutually bonded by a common interest in the economic matters. Recently, the framework of structural bonding has been used to study the buyer-seller relationships in industrial marketing [Han and Sung 2008, Williams et al. 1998, Wilson 1995] in that this structural bonding is a crucial part of the theoretical justification for distinguishing discrete transactions from ongoing long-term relationships. The major antecedent factors of buyer commitment such as technology, CLalt, transaction-specific assets, and importance were identified and explored from the perspective of structural bonding. Research hypotheses were developed and tested by using survey data from the middle managers in the metal industry. H1: Level of technology of the relationship partner is positively related to the level of structural bonding between the buyer and the seller. H2: Comparison level of alternatives is negatively related to the level of structural bonding between the buyer and the seller. H3: Amount of the transaction-specific assets is positively related to the level of structural bonding between the buyer and the seller. H4: Importance of the relationship partner is positively related to the level of structural bonding between the buyer and the seller. H5: Level of structural bonding is positively related to the level of commitment to the relationship. To examine the major antecedent factors of industrial buyer's structural bonding and long-term relationship, questionnaire was prepared, mailed out to the sample of 400 purchasing managers of the US metal industry (SIC codes 33 and 34). After a follow-up request, 139 informants returnedthe questionnaires, resulting in a response rate of 35 percent. 134 responses were used in the final analysis after dropping 5 incomplete questionnaires. All measures were analyzed for reliability and validity following the guidelines offered by Churchill [1979] and Anderson and Gerbing [1988]., the results of fitting the model to the data indicated that the hypothesized model provides a good fit to the data. Goodness-of-fit index (GFI = 0.94) and other indices ( chi-square = 78.02 with p-value = 0.13, Adjusted GFI = 0.90, Normed Fit Index = 0.92) indicated that a major proportion of variances and covariances in the data was accounted for by the model as a whole, and all the parameter estimates showed statistical significance as evidenced by large t-values. All the factor loadings were significantly different from zero. On these grounds we judged the hypothesized model to be a reasonable representation of the data. The results from the present study suggest several implications for buyer-seller relationships. Theoretically, we attempted to conceptualize the antecedent factors of buyer-seller long-term relationships from the perspective of structural bondingin metal industry. The four underlying determinants (i.e. technology, CLalt, transaction-specific assets, and importance) of structural bonding are very critical variables of buyer-seller long-term business relationships. Our model of structural bonding makes an attempt to systematically examine the relationship between the antecedent factors of structural bonding and long-term commitment. Managerially, this research provides industrial purchasing managers with a good framework to assess the interaction processes with their partners and, ability to position their business relationships from the perspective of structural bonding. In other words, based on those underlying variables, industrial purchasing managers can determine the strength of the company's relationships with the key suppliers and its state of preparation to be a successful partner with those suppliers. Both the supplying and customer companies can also benefit by using the concept of 'structural bonding' and evaluating their relationships with key business partners from the structural point of view. In general, the results indicate that structural bonding gives a critical impact on the level of relationship commitment. Managerial implications and limitations of the study are also discussed.

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Results of Total Body Irradiation in Allogeneic Bone Marrow Transplantation for Acute Non-Lymphocytic Leukemia (급성 골수성 백혈병에서 동종골수이식을 위한 전신 방사선 조사의 치료 결과)

  • Chung Su Mi;Choi Ihl Bohng;Kim In Ah;Kim Sung Hwan;Kang Ki Mun;Shinn Kyung Sub;Kim Choon Choo;Kim Dong Jip
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.247-253
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    • 1992
  • Between August 1987 and July 1991, 22 patients with acute nonlymphocytic leukemia have received allogeneic bone marrow transplantation (BMT) with non-T-lymphocyte-depleted marrow obtained from matched sibling donors. Of these patients, 12 patients were in first complete remission (CR) and 10 patients in second CR or greater or in relapse. All patients were treated with a preparative regimen consisting of cyclophosphamide (CTX, 60 mg/kg) or combined drugs, and 850 cGy single-dose or $150\~200$ cGy fractionated total body irradiation (TBI) administered twice daily for a total dose of $1200\~1320$ cGy. Survivors have been followed from 8 to 64.5 months (median, 24 months). The overall 2 year survival rate, relapse rate and incidence of radiation pneumonitis and graft versus host disease (GVHD) have been evaluated by age, phase of disease, initial WBC count, modality of TBI or conditioning chemotherapy. Overall 2 year survival was $58{\%}$. The median survival was 31 months and mean survival was 23.2 months. Overall survival have significant impact in patients of age >19 years old (p=0.008), patients in first CR (p=0.09). Two year survival rate is significantly correlated with age ( >19 vs $\leqq$19, $79.4\%$ vs $14.3\%$, p=0.0008), regimen of chemotherapy (CTX vs combined drug, $76.9\%\;vs\;33.3\%$, p=0.04), phase of disease (1st CR vs \geqq2nd$ CR or relapse, $83.3\%\;vs\;30\%$, p=0.01) and method of TBI (fractionated vs single dose, $70.7\%\;vs\;37.5\%$, p=0.05). The influence of French-American-British (FAB) subtypes on relapse rate is not significant, but initial WBC count > 20000/$mm^3$ is associated with increased relapse rate. There is difference in the rate of radiation pneumonitis ($14.3\%\;vs\;25\%$), GVHD ($14.3\%\;vs\;50\%$) and relapse ($21.4\%\;vs\;50\%$) according to fractionated versus single-dose TBI. As mentioned above, fractionated TBI is compatible for the preparative regimen combined with chemotherapy En allogeneic BMT of first CR patients under 41 years of age with suitable donor. Those results from a retrospective, non-randomized study clearly need additional clinical data, ideally from a randomized study.

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Investigation of Study Items for the Patterns of Care Study in the Radiotherapy of Laryngeal Cancer: Preliminary Results (후두암의 방사선치료 Patterns of Care Study를 위한 프로그램 항목 개발: 예비 결과)

  • Chung Woong-Ki;Kim I1-Han;Ahn Sung-Ja;Nam Taek-Keun;Oh Yoon-Kyeong;Song Ju-Young;Nah Byung-Sik;Chung Gyung-Ai;Kwon Hyoung-Cheol;Kim Jung-Soo;Kim Soo-Kon;Kang Jeong-Ku
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.299-305
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    • 2003
  • Purpose: In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. Materials and Methods: We analyzed the clinical data on patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 In the South-west area of Korea. Eligiblity criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologlst who are members of forean Southwest Radiation Oncology Group. SPSS vl0.0 software was used for statistical analysis. Results: Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years(median, 61). Laryngeal cancer occurred predominantly In males (10 : 1 sex ratio). Twenty-eight patients (62$\%$) had primary cancers in the glottis and 17 (38$\%$) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98$\%$). Twenty-four of 28 glottic cancer patients (86$\%$) had AJCC (American Joint Committee on Cancer) stage I/II, but 50$\%$ (8/16) had In supraglottic cancer patients (p=0.02). Most patients(89$\%$) had the symptom of hoarseness. indirect laryngoscopy was done in all patients and direct laryngoscopy was peformed in 43 (98$\%$) patients. Twenty-one of 28 (75$\%$) glottic cancer cases and 6 of 17 (35$\%$) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18$\%$) glottic and 8 (47$\%$) supraglottic patients. Chemotherapy and radiation was used in 2 (7$\%$) glottic and 3 (18$\%$) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6 MV X-ray was used with conventional fractionation. The iraction size was 2 Gy In 80$\%$ of glottic cancer patients compared with 1.8 Gy in 59$\%$ of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 ey and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items were developed or the study of the patterns of care In laryngeal cancer. Conclusion: The study Items for laryngeal cancer were developed. In the near future, a web system will be established based on the Items Investigated, and then a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radlotherapy.

An Analysis on Factors Affecting Local Control and Survival in Nasopharvngeal Carcinoma (비인두암의 국소 종양 치유와 생존율에 관한 예후 인자 분석)

  • Chung Woong-Ki;Cho Jae-Shik;Park Seung Jin;Lee Jae-Hong;Ahn Sung Ja;Nam Taek Keun;Choi Chan;Noh Young Hee;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.91-99
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    • 1999
  • Propose : This study was performed to find out the prognostic factors affecting local control, survival and disease free survival rate in nasopharyngeal carcinomas treated with chemotherapy and radiation therapy. Materials and Methods : We analysed 47 patients of nasopharyngeal carcinomas, histologically confirmed and treated at Chonnam University Hospital between July 1986 and June 1996, retrospectively. Range of patients' age were from 16 to 80 years (median; 52 years). Thirty three (70$\%$) patients was male. Histological types were composed of 3 (6$\%$) keratinizing, 30 (64$\%$) nonkeratinizing squamous cell carcinoma and 13 (28$\%$) undifferentiated carcinoma. Histoiogicai type was not known in 1 patient (2$\%$). We restaged according to the staging system of 1997 American Joint Committee on Cancer Forty seven patients were recorded as follows: 71: 11 (23$\%$), T2a; 6 (13$\%$), T2b; 9 (19$\%$), 73; 7 (15$\%$), 74: 14 (30$\%$), and NO; 7 (15$\%$), Nl: 14 (30$\%$), N2; 21 (45%), N3: 5 (10%). Clinical staging was grouped as follows: Stage 1; 2 (4$\%$), IIA: 2 (4$\%$), IIB; 10 (21$\%$), III; 14 (30$\%$), IVA; 14 (30$\%$) and IVB; 5 (11$\%$). Radiation therapy was done using 6 MV and 10 MV X- ray of linear accelerator. Electron beam was used for the Iymph nodes of posterior neck after 4500 cGy. The range of total radiation dose delivered to the primary tumor was from 6120 to 7920 cGy (median; 7020 cGy). Neoadjuvant chemotherapy was performed with cisplatin +5-fluorouracil (25 patients) or cisplatin+pepleomycin (17 patients) with one to three cycles. Five patients did not received chemotherapy. Local control rate, survival and disease free suwival rate were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of survival rates between groups. multivariate analysis using Cox proportional hazard model was done for finding prognostic factors. Results: Local control rate was 81$\%$ in 5 year. Five year survival rate was 60$\%$ (median survival; 100 months). We included age, sex, cranial nerve deflicit, histologic type, stage group, chemotherapy, elapsed days between chemotherapy and radiotherapy, total radiation dose, period of radiotherapy as potential prognostic factors in multivariate analysis. As a result, cranial none deficit (P=0.004) had statistical significance in local control rate. Stage group and total radiation dose were significant prognostic factors in survival (P=0.000, P=0.012), and in disease free survival rates (P=0.003, P=0.008), respectively. Common complications were xerostomia, tooth and ear problems. Hypothyroidism was developed in 2 patients. Conclusion : In our study, cranial none deficit was a significant prognostic factor in local control rate, and stage group and total radiation dose were significant factors in both survival and disease free survival of nasopharyngeal carcinoma. We have concluded that chemotherapy and radiotherapy used in our patients were effective without any serious complication.

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The Role of the Soft Law for Space Debris Mitigation in International Law (국제법상 우주폐기물감축 연성법의 역할에 관한 연구)

  • Kim, Han-Taek
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.469-497
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    • 2015
  • In 2009 Iridium 33, a satellite owned by the American Iridium Communications Inc. and Kosmos-2251, a satellite owned by the Russian Space Forces, collided at a speed of 42,120 km/h and an altitude of 789 kilometers above the Taymyr Peninsula in Siberia. NASA estimated that the satellite collision had created approximately 1,000 pieces of debris larger than 10 centimeters, in addition to many smaller ones. By July 2011, the U.S. Space Surveillance Network(SSN) had catalogued over 2,000 large debris fragments. On January 11, 2007 China conducted a test on its anti-satellite missile. A Chinese weather satellite, the FY-1C polar orbit satellite, was destroyed by the missile that was launched using a multistage solid-fuel. The test was unprecedented for having created a record amount of debris. At least 2,317 pieces of trackable size (i.e. of golf ball size or larger) and an estimated 150,000 particles were generated as a result. As far as the Space Treaties such as 1967 Outer Space Treaty, 1968 Rescue Agreement, 1972 Liability Convention, 1975 Registration Convention and 1979 Moon Agreement are concerned, few provisions addressing the space environment and debris in space can be found. In the early years of space exploration dating back to the late 1950s, the focus of international law was on the establishment of a basic set of rules on the activities undertaken by various states in outer space.. Consequently environmental issues, including those of space debris, did not receive the priority they deserve when international space law was originally drafted. As shown in the case of the 1978 "Cosmos 954 Incident" between Canada and USSR, the two parties settled it by the memorandum between two nations not by the Space Treaties to which they are parties. In 1994 the 66th conference of International Law Association(ILA) adopted "International Instrument on the Protection of the Environment from Damage Caused by Space Debris". The Inter-Agency Space Debris Coordination Committee(IADC) issued some guidelines for the space debris which were the basis of "the UN Space Debris Mitigation Guidelines" which had been approved by the Committee on the Peaceful Uses of Outer Space(COPUOS) in its 527th meeting. On December 21 2007 this guideline was approved by UNGA Resolution 62/217. The EU has proposed an "International Code of Conduct for Outer Space Activities" as a transparency and confidence-building measure. It was only in 2010 that the Scientific and Technical Subcommittee began considering as an agenda item the long-term sustainability of outer space. A Working Group on the Long-term Sustainability of Outer Space Activities was established, the objectives of which include identifying areas of concern for the long-term sustainability of outer space activities, proposing measures that could enhance sustainability, and producing voluntary guidelines to reduce risks to long-term sustainability. By this effort "Guidelines on the Long-term Sustainability of Outer Space Activities" are being under consideration. In the case of "Declaration of Legal Principles Governing the Activities of States in the Exp1oration and Use of Outer Space" adopted by UNGA Resolution 1962(XVIII), December 13 1963, the 9 principles proclaimed in that Declaration, although all of them incorporated in the Space Treaties, could be regarded as customary international law binding all states considering the time and opinio juris by the responses of the world. Although the soft law such as resolutions, guidelines are not binding law, there are some provisions which have a fundamentally norm-creating character and customary international law. In November 12 1974 UN General Assembly recalled through a Resolution 3232(XXIX) "Review of the role of International Court of Justice" that the development of international law may be reflected, inter alia, by the declarations and resolutions of the General Assembly which may to that extend be taken into consideration by the judgements of the International Court of Justice. We are expecting COPUOS which gave birth 5 Space Treaties that it could give us binding space debris mitigation measures to be implemented based on space debris mitigation soft law in the near future.