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Surgery Alone or Postoperative Adjuvant Radiotherapy in Rectal Cancer - With Respect to Survival, Pelvic Control, Prognostic Factor - (직장암에서 수술단독 또는 수술후 방사선치료 -생존율, 골반종양제어율, 예후인자를 중심으로-)

  • Nam, Taek-Keun;Ahn, Sung-Ja;Nah, Byung-Sik
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.327-334
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    • 2001
  • Purpose : To find out the role of postoperative adjuvant radiotherapy in the treatment of rectal cancer by comparing survival, pelvic control, complication rate, and any prognostic factor between surgery alone and postoperative radiotherapy group. Materials and methods : From Feb. 1982 to Dec. 1996 total 212 patients were treated by radical surgery with or without postoperative radiotherapy due to rectal carcinoma of modified Astler-Coiler stage $B2\~C3$. Of them, 18 patients had incomplete radiotherapy and so the remaining 194 patients were the database analyzed in this study. One hundred four patients received postoperative radiotherapy and the other 90 patients had surgery only. Radiotherapy was peformed in the range of $39.6\~55.8\;Gy$ (mean: 49.9 Gy) to the whole pelvis and if necessary, tumor bed was boosted by $5.4\~10\;Gy$. Both survival and pelvic control rates were calculated by Kaplan-Meier method and their statistical significance was tested by Log-rank test. Multivariate analysis was peformed by Cox proportional hazards model. Results : 5-year actuarial survival rate (5YSR) and 5-year disease-free survival rate (5YDFSR) of entire patients were $53\%\;and\;49\%$, respectively. 5YSRs of surgery alone group and adjuvant radiotherapy group were $63\%\;vs\;45\%$, respectively (p=0.03). This difference is thought to reflect uneven distribution of stages between two treatment groups (p<0.05 by $\chi^2-test$) with more advanced disease patients in adjuvant radiotherapy group. 5YSRs of surgery alone vs adjuvant radiotherapy group in MAC B2+3, C1, C2+3 were $68\%\;vs\;55\%$ (p=0.09), $100\%\;vs\;100\%$, $40\%\;vs\;33\%$ (p=0.71), respectively. 5YDFSRs of surgery alone vs adjuvant radiotherapy group in above three stages were $65\%\;vs\;49\%$ (p=0.14), $100\%\;vs\;100\%$, $33\%\;vs\;31\%$ (p=0.46), respectively. 5-year pelvic control rate (5YPCR) of entire patients was $72.5\%$. 5YPCRs of surgery alone and adjuvant radiotherapy group were $71\%\;vs\;74\%$, respectively (p=0.41). 5YPCRs of surgery alone vs adjuvant radiotherapy group in B2+3, C1, C2+3 were $79\%\;vs\;75\%$ (p=0.88), $100\%\;vs\;100\%$, $44\%\;vs\;68\%$ (p=0.01), respectively. Multivariate analysis showed that only stage was significant factor affecting overall and disease-free survival in entire patients and also in both treatment groups. In view of pelvic control, stage and operation type were significant in entire patients and only stage in surgery alone group but in adjuvant radiotherapy group, operation type instead of stage was the only significant factor in multivariate analysis as a negative prognostic factor in abdominoperineal resection cases. Conclusion : Our retrospective study showed that postoperative adjuvant radiotherapy could improve the pelvic control in MAC C2+3 group. To improve both pelvic control and survival in all patients with MAC B2 or more, other treatment modality such as concurrent continuous infusion of 5-FU, which is the most standard agent, with radiotherapy should be considered.

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Development of a Traffic Accident Prediction Model and Determination of the Risk Level at Signalized Intersection (신호교차로에서의 사고예측모형개발 및 위험수준결정 연구)

  • 홍정열;도철웅
    • Journal of Korean Society of Transportation
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    • v.20 no.7
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    • pp.155-166
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    • 2002
  • Since 1990s. there has been an increasing number of traffic accidents at intersection. which requires more urgent measures to insure safety on intersection. This study set out to analyze the road conditions, traffic conditions and traffic operation conditions on signalized intersection. to identify the elements that would impose obstructions in safety, and to develop a traffic accident prediction model to evaluate the safety of an intersection using the cop relation between the elements and an accident. In addition, the focus was made on suggesting appropriate traffic safety policies by dealing with the danger elements in advance and on enhancing the safety on the intersection in developing a traffic accident prediction model fir a signalized intersection. The data for the study was collected at an intersection located in Wonju city from January to December 2001. It consisted of the number of accidents, the road conditions, the traffic conditions, and the traffic operation conditions at the intersection. The collected data was first statistically analyzed and then the results identified the elements that had close correlations with accidents. They included the area pattern, the use of land, the bus stopping activities, the parking and stopping activities on the road, the total volume, the turning volume, the number of lanes, the width of the road, the intersection area, the cycle, the sight distance, and the turning radius. These elements were used in the second correlation analysis. The significant level was 95% or higher in all of them. There were few correlations between independent variables. The variables that affected the accident rate were the number of lanes, the turning radius, the sight distance and the cycle, which were used to develop a traffic accident prediction model formula considering their distribution. The model formula was compared with a general linear regression model in accuracy. In addition, the statistics of domestic accidents were investigated to analyze the distribution of the accidents and to classify intersections according to the risk level. Finally, the results were applied to the Spearman-rank correlation coefficient to see if the model was appropriate. As a result, the coefficient of determination was highly significant with the value of 0.985 and the ranks among the intersections according to the risk level were appropriate too. The actual number of accidents and the predicted ones were compared in terms of the risk level and they were about the same in the risk level for 80% of the intersections.

Evaluation of Colour Difference Between Cotton Dyed Fabrics and Reflection Print Images Using CAD Systems (CAD 시스템을 이용한 면염직물과 스캐닝 프린트 이미지간의 색차 평가)

  • Kim, Jeong-hwa;Song, Kyung-hern;Baek, Min-sook
    • Journal of the Korean Society of Clothing and Textiles
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    • v.27 no.12
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    • pp.1381-1389
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    • 2003
  • 컴퓨터와 첨단영상매체의 발달로 디자인 분야에서도 컴퓨터를 사용하여 색을 자유롭게 선택할 수 있는 그래픽 소프트웨어가 도입되고 있으나 영상정보의 색채 재현성과 영상입출력 장치의 다양화로 인한 색채 불일치에 대한 문제들이 극복해야할 시급한 과제로 부각되고 있다. 따라서, 색채 영상정보 입출력장치의 색채구현 성능과 인간의 색채인지 원리이론을 바탕으로 색보정 알고리즘이 발전하여 색보정 엔진의 개발이 국제적으로 활발히 진행되고 있는 연구 분야임에도 불구하고 국내에서는 그 연구사례가 상대적으로 극히 미비한 실정이며, 더욱이, CAD 시스템을 이용한 패션/텍스타일 디자인 분야에서는 이에 대한 연구가 거의 이루어지지 않고 있다. 본 연구에서는 염색 직물의 색을 CAD시스템을 이용하여 soft-copy로 재현하고 이것을 다시 hard-copy로 출력하여 물리적 측정치와 주관적 색채 인지도간의 일치도를 비교하고, 물리적, 주관적 색차의 한계치를 제시함으로써, 패션/텍스타일 디자인 CAD시스템 운용에 기초가 되는 자료를 제공하려 하였다. 연구의 절차는 객관적 측정과 주관적 평가 두 단계로 나누어 진행되었다 연구에 사용된 직물은 7가지 색상의 면 염직물로써, CAD시스템을 이용하여 각 직물당 5개의 soft-copy를 재현하고, 이것을 다시 hard-copy로 출력하여 spectrophotometer를 이용해 물리적 측정(ΔE, ΔL, Δc, Δh)을 실시하였다. 또한 주관적 평가에는 20명의 의류학 전공 학생들이 참여하였다. 결과 분석에는 분산분석과 Friedman분석이 사용되었다. 연구 결과 색차 측정에 대한 물리적 측정치와 1차 주관적 평가치 사이의 일치도는 90.5%로 나타났으며, 2차 주관적 평가치와의 rank order는 거의 일치하는 것으로 나타났다. 또한 주관적 평가에서 피험자들은 색차인지에 있어 CIELAB 색채공간의 각각의 색요소 차이보다는 전체 색차에 더 영향을 받는 것으로 나타났다.녹색콩풍뎅이의 유충에 의하여 피해를 받는 것이 확인되었다. 녹색콩풍뎅이 유충의 피해를 받은 금잔디는 황화되거나 시들음 증상이 있었고, 이듬해 봄에는 잔디의 회복이 지연되었다.ic conductivity. The changes of $varepsilon$′ and $varepsilon$" were well estimated with this modified Havriliak-Negami model.05). 상기의 결과를 토대로, 성장과 전어체내 지방산조성에 있어서 뱀장어 치어의 사료내 EPA와 DHA의 첨가효과 미약한 것으로 판단되며, 사료내 LNA (n-3)와 LA(n-6) HUFA을 각각 0.35%, 0.65% 첨가했을 때 WG, SGR, FE, PER이 가장 높았으나, 이전의 실험(Takeuchi, 1980)과 동일한 수준인 n-3와 n-6를 각각 0.5%씩 첨가한 실험구와는 유의적인 차이를 보이지 않았다. 이렇게 볼 때, 뱀장어 치어의 필수지방산은 LNA (n-3), LA (n-6)이고, 그 적정수준은 각각 0.35-0.5%, 0.5-0.65%임을 보여준다.George W, Bush)가 새로운 지도자로 취임하여 얼마 되지 않은 2001년 9월 11일 사상 초유로 본토에서 알 카에다 테러리스트 조직에 의해 공격받게 되었다. 뉴욕의 세계무역센터 빌딩 2개가 완전히 붕괴되고, 펜타곤에 민간 여객기가 충돌하여 많은 사람이 살상 당하고, 전체적으로 세계 80여 개국으로부터의 6천여 명이 살상되었다. 전 세계와 미국은 국제 테러리스트들의 야만적 행위에 대해 경악하고 이제 미국은 그 대외정책의 최우선순위를 국제 테러를 발본색원하는 것에 두게 되었다. 본 논문은 1998년 한국에서 새로이 출범한 김대중 행정부가 북한에 대해 실시한 포용정책이 어떠한 성과를 거두고 어떠한 문제점을 간과하고 있는가에 대해 논의하고, 대북 정책의 새로운 지평을 논의하는 것을 목적으로 하고

Comparision of Group and Individual Social Support on Burden and Family Functioning in Families with Asthmatic Children (집단 사회적지지와 개별 사회적지지가 천식아동 가족의 부담감과 가족기능에 미치는 영향)

  • 전화연
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.418-428
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    • 1999
  • The main purpose of this study was to identify the effects of group social support and individual social support on the reduction of burden and improvement in family functioning of families with asthmatic children. The design of this study was a randomized pre-posttest quasi-experimental design to compare the two experimental groups. The theoretical framework for this study was derived from the study of burden in family caregivers by Suh and Oh (1993) based on the main effect model of social support theories. The data were collected from February 12, 1998 to May 29, 1998 at the pediatric out patient department of a university hospital located in Suwon city. The sample consisted of 39 family members who were identified as families with asthmatic children, Eighteen subjects were randomly assigned to the group social support group and 21 were assigned to the individual social support group. Group and individual social support members were seen for 60 to 90 minutes, four times over one to three weeks. The instruments used in this study were the Burden Scale developed by Suh & Oh(1993), the Visual Analogue Scale, and the Family Adaptability Cohesion Evaluation Scale(FACES-III) developed by Olson, Portner, and Lavee(1985). The collected data were analyzed using Mann-Whitney test, x$^2$-test, Wilcoxon sign rank test, t-test, ANOVA (Scheff), Pearson correlation coefficient. multiple regression, and social support process and content analysis. The results are as follow : 1. There was no significant difference before the experimental treatment among the subjects in the group social support group and individual social support group for general characteristics, burden, or family functioning. 2. Hypothesis 1 : “There will be a greater reduction on the burden score of the group social support group compared to the individual social support group” was not statistically significant(U=174.5, p=.683). The burden scores showed a significant decrease after participation in social support as compared to before participation for both groups. However there was a tendency for more reduction in the burden scores for the group social support than for individual social support. 3. Hypothesis 2 : “There will be a greater improvement in the family functioning scores for the group social support group compared to the individual social support group” was not statistically significant(U=153.0. p=.309). There was a tendency toward improvement in the family functioning scores of the group social support as compared to that of the individual social support. 4. According to the length of the treatment period, families with asthmatic children displayed affirmative responses, and the families set up a self-help group of mothers with asthmatic children in order to share their experiences, to get information and to solve their problems. In conclusion, it was found that group social support was the more effective nursing intervention for reducing burden and for improving family functioning of families with asthmatic children.

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Analysis of the Effects of Behavioral Factors on the Seafarers' Career Path (해기직업 경로상의 행동요인 영향 분석)

  • Kim, Young-Mo;Jun, Sang-Yup;Hwang, Byeong-Ho;Kang, In-Chul;Jeong, Hae-Jong
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.15 no.4
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    • pp.369-374
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    • 2009
  • It is difficult to improve maritime safety in the aspect of human elements without seafarers' job satisfaction. Therefore, through the career development for seafarers from their entries into the job to their retirements, longer and more stable seafarers' life on board ship could be achieved together with maritime safety. This study aims at the establishment of seafarers' career path model and the verification of six hypotheses by using the questionnaire data of 2,830 respondents of students, slip officers and shore-based ex-seafarers. The results of analyses of behavior factors on the career path are as follows; first, it is important to improve educational environment and to provide seafarers with detailed information on seafarer's life; second, economic factors such as income-level and etc. do not play a role in promoting motivation of going to sea; third, the guidance to shore jobs at proper time increases seafarers' job satisfaction and induces longer stay at sea; last, it is necessary to simplify the licence system for seafarers, to allow seafarers to acquire higher class certificates, and to work at higher rank on board ships as early as possible.

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Recent Mortality Trends in Korea (최근(最近) 한국인(韓國人)의 사망력(死亡力) 경향(傾向)에 관(關)한 고찰(考察))

  • Kim, Il-Soon;Lee, Dong-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.2 no.1
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    • pp.61-76
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    • 1969
  • A review has been made of mortality trends in Korea from 1958 to 1967 analyzing the data by sex, age and cause of death. The crude death rates and age specific death rates were estimated by the model of N. Keyfitz life table which had been developed by the data of the 1960's national census. The cause specific death rates shown in this article are based on the following: all deaths occurring in the death-registration are expressed as a numberator, while the denominator was estimated from the regular national census data by interpolation method. It is estimated that only an average of about 40% of deaths which occurred during a year were registered during 1958 to 1967. The validity and the reliability of the diagnosis of causes of death seem to be extremely poor in this country. Therefore the cause specific death rates in this article are aimed to reveal trends of causes of registered death ana not for the actual level of death rates. For 10 years very interesing mortality trends were observed : 1. The trend in the crude death rates was downward slowly. 2. The estimated death rate for the infant in 1960 was still high up to 100 per 1,000. 3. The rates for mortality attributed to such infectious diseases as pneumonia, bronchitis, gastroenteritis and measles decreased an average 40-60%. 4. The death rates for over-all tuberculosis decreased only 9.8%. 90% of the decrease was contributed by those in the less-than-15 year age group. 5. The death rates for chronic diseases, such as vascular diseases affecting the central nervous system, malignant neoplasm, major heart diseases and all accidents rose about 40-60%. 6. The rank order of the 10 leading causes of death showed large changes over the years, except for pneumonia and tuberculosis which occupyed 1st and 2nd places respectively. Vascular diseases affecting the central nervous system moved from 5th to 3rd place and malignant neoplasm from 6th to 4th place, The major heart diseases moved from 10th to 6th place and all accidents from 10th to 7th place. On tile other hand, gastroenteritis moved from 3rd to 5th place and influenja from 4th to 8th place.

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Determination of Weight Coefficients of Multiple Objective Reservoir Operation Problem Considering Inflow Variation (유입량의 변동성을 고려한 저수지 연계 운영 모형의 가중치 선정)

  • Kim, Min-Gyu;Kim, Jae-Hee;Kim, Sheung-Kown
    • Journal of Korea Water Resources Association
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    • v.41 no.1
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    • pp.1-15
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    • 2008
  • The purpose of this study is to propose a procedure that will be able to find the most efficient sets of weight coefficients for the Geum-River basin in Korea. The result obtained from multi-objective optimization model is inherently sensitive to the weight coefficient on each objective. In multi-objective reservoir operation problems, the coefficient setting may be more complicated because of the natural variation of inflow. Therefore, for multi-objective reservoir operation problems, it may be important for modelers to provide reservoir operators with appropriate sets of weight coefficients considering the inflow variation. This study presents a procedure to find an appropriate set of weight coefficients under the situation that has inflow variation. The proposed procedure uses GA-CoMOM to provide a set of weight coefficient sets. A DEA-window analysis and a cross efficiency analysis are then performed in order to evaluate and rank the sets of weight coefficients for various inflow scenarios. This proposed procedure might be able to find the most efficient sets of weight coefficients for the Geum-River basin in Korea.

The Effect of Total Patellectomy in the Prosthetic Replacement of Proximal Tibia (경골 근위부 종양에서 인공 삽입물 사용시 슬개골 전적출술이 관절기능 회복에 미치는 영향)

  • Park, Il-Hyung;Kim, Jae-Do;Ihn, Joo-Chul;Chun, In-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.8-17
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    • 1996
  • The purpose of this study is a comparative evaluation of range motion, especially extension deficit between the group of total patellectomy and that of intact patella, after reconstruction of the patellar tendon in the prosthetic replacement of a proximal tibia. Between 1990 and 1994, 15 patients who had a primary malignancy on proximal tibia were operated on. All patients were evaluated clinically and radiographically. Two patients were excluded because one had a deep infection treated with arthrodesis of the knee and the other was a composite allograft. The mean follow-up of the 13 patients was 27 months(15-47), including 10 osteosarcomas, 1 chondrosarcoma, 1 malignant fibrous histiocytoma and 1 malignant giant cell tumor. Eleven patients had a resection of the proximal tibia and 2 had an extracapsular total knee resection with distal femur. Reconstruction of the defect was done in 8 cases with a custom-made Link Endo-Model Total Rotation Knee Joint Prosthesis, and in 5 with How Medica Modular Resection System (HMRS). We used two methods to reconstruct the ligamentum patellae. Fixation of the patellar tendon to the prosthesis only with suturing and/or stapling(group SS) was done in 7. Transposition of gastrocnemius muscle to enhance fixation and to cover the prosthesis(group TG) was done in 6. Regardless of fixation methods, total patellectomy was done in 5 either to lengthen the patellar tendon or to make primary skin closure easier or for both. In 8 cases, patella was left intact or resurfaced with polyethylene prosthesis. Active extension was measured while the patient was in a sitting position. There is no statistically meaningful difference in terms of extension deficit (Wilcoxon rank test, p=0.8800) between patellectomy group and intact patella group, and between group of fixation only with suturing and that of gastrocnemius transposition. Two cases of extension deficit over 30 degree were seen in group SS and in the group of intact patella. Conclusively, total patellectomy could be an option without increasing the risk of extension deficit when primary skin closure is difficult or patellar tendon is a little bit short to be fixed. There is no rating in the Enneking system of functional evaluation that this finding into consideration.

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A Study on Weight of SWOT Factors for Korea Food Service Franchise Entrepreneur (국내 외식프랜차이즈의 창업을 위한 SWOT요인의 중요도에 관한 연구)

  • Choi, Chae-Bong;Lee, Sang-Suk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.12 no.5
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    • pp.141-162
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    • 2017
  • The International Monetary Fund (IMF) crisis introduced a system for easy layoffs. With recent economic downturn, employees have been asked to retire early and less new jobs have become available. More small businesses as a result have been started. The purpose of this research is to study weight and ranking on SWOT factors of korea food service franchise industry using the SWOT analysis. The Analytic Hierarchy Process (AHP) and Analytic Network Process (ANP) were used to analyze the SWOT found by the surveys. First, the SWOT analysis shows that the franchise owners and the expert group view the industry positively overall and there are more strengths, opportunities than weaknesses, threats. While there are negatives and threats to the industry overall, many people think that there are more opportunities and positive aspects. Second, the franchise owners rank proven business model and platform (S3) as the strongest strength of food service franchise businesses while the expert group ranks management supports (S2) from headquarters as the strongest strength. Third, the expert group and franchise owner group indicate that the weight on unfair franchise contracts with headquarters(W3) and high penalty from breaking a franchise agreement(W4) are 60% of weaknesses. Fourth, both the expert group and franchise owner group indicate that change in people's lifestyle, value system and consumption pattern(O3) as the most important opportunity. Fifth, both groups indicate that changes in consumption pattern(T1) due to ever changing food service industry as the biggest threat. It is ranked higher than the entry of korea food service franchises.

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The Effect of Mother-fetus Interaction Promotion Program of Talking and Tactual Stimulation on Mother-fetus Interaction and Mother-infant play Interaction (태담과 촉각 자극의 모-태아 상호작용 증진 프로그램이 모아 상호작용에 미치는 효과)

  • Kim, Jung-Soon
    • Korean Parent-Child Health Journal
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    • v.5 no.2
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    • pp.253-276
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    • 2002
  • Mother and infant relationship has a great influence on child's developments. Expecially, mother and infant relationship is affected by mother and infant interactions during one year after birth and an omen of mother-infant interaction after birth is mother-fetus interaction. This study was conducted to develop mother-fetus interaction promotion program of talking and tactual stimulation aimed at enhancing sensitivity of primiparas and to evaluate the effect of the nursing intervention program on mother-fetus interaction and mother-infant play interaction. Non-eguivalent control group posttest design was used, and Blumer's symbolic interaction theory and Barnard's mother-infant interaction model was used a conceptual framework of this study. Fifty primiparas and infant(26 mother-infant dyads for intervention group and 24 dyads for control group) were recruited from three general hospital and an OBGY clinic located in Kwang Nung city. Data was collected from January 30th to December 20th in 2001. For the intervention group, programed education which focused on mother-fetus interaction in the 1st trimester. Telephone counselling was provided with interval of two weeks. For two groups, home visiting for data collection of mother- fetus interaction was conducted at 36 to 38 weeks of gestational age. And mother-infant play interactions were assessed at 4 to 6 weeks after birth using videotapes. Play situations were videotaped and two trained observers analyzed the tapes. The data were analyzed using chi-square test and Fisher's Exact Test to test the equivalence of two groups, and the effect of intervention progrom was determined with t-test and Wilcoxon Rank Sum test. The results were as follows: 1. The significant difference was found in mother-fetus interaction between two groups(t=2.085, P=0.0425). It indicated that intervention progrom was effective in improving mother-fetus interaction. 2. The significant difference was found in mother-infant play interaction between two groups(W=347.5, P=0.0001). In subscale analysis, three subscales showed significant differences between the groups: interactional behavior of mother(t=5.921, P=0.0001), interactional behavior of infant(t=5.736, P= 0.0000), and synchronic interactional behavior of mother and infant(t=7.940, P= 0.0000). In conclusion, this study has shown that the applied nursing intervention aimed at enhancing sensitivity of primiparas promoted mother-fetus interaction and mother-infant play interaction. Therefore, this study suggests that this nursing interventions to increase maternal sensitivity to the fetus's movement should be broadly applied to primiparas, which can be beneficial for formation of mother - infant relationship, and for promotion the social, affective, and cognitive developments of their children.

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