• Title/Summary/Keyword: ratio limit

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Favorable Outcome in Elderly Asian Patients with Metastatic Renal Cell Carcinoma Treated with Everolimus: The Osaka Urologic Oncology Group

  • Inamoto, Teruo;Azuma, Haruhito;Nonomura, Norio;Nakatani, Tatsuya;Matsuda, Tadashi;Nozawa, Masahiro;Ueda, Takeshi;Kinoshita, Hidefumi;Nishimura, Kazuo;Kanayama, Hiro-Omi;Miki, Tsuneharu;Tomita, Yoshihiko;Yoshioka, Toshiaki;Tsujihata, Masao;Uemura, Hirotsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1811-1815
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    • 2014
  • Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.

Characteristic of Wave Diffraction and Reflection for Irregular Waves in SWASH Model Around Small Port Structures (소규모 항만 구조물 주변에서 불규칙파에 대한 SWASH 모형의 반사 및 회절)

  • Kwon, Kyong Hwan;Park, Chang Wook;Park, Il Heum;Kim, Jong Hoon
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.31 no.6
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    • pp.468-477
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    • 2019
  • The numerical model of Boussinesq approximation, which is mainly used for evaluating the port calmness due to the irregular waves, has a limit of applicability of lattice size in ports such as marinas with narrow port openings of around 30m. The SWASH model controls the partial reflection according to the depth, porosity coefficient and structure size when applying the reflected wave incident on the structure and terrain. In this study, the partial reflection evaluation at the front of the structure according to the bottom shape and the shape of the structure are examined. In order to evaluate the reproducibility of the model due to the diffraction waves entering the term, the area of incidence at right angles and inclination of the structure is constructed and compared with the diffraction theory suggested by Goda et al. (1978). The experimental results of the sectional structure reflectances calculated as the depth mean show reflectances similar to the approximate values of the reflectances presented by Stelling and Ahrens (1981). It is considered that the reflected wave is well reproduced according to the control of the reflected wave at the boundary and the shape and topography of the structure. Compared with previous studies to examine the diffraction of the wave incident from the breakwater opening, the wave incidence angle and the shape of the diffraction wave are very similar to the theoretical values, but both oblique and rectangular incidence In the case where the direction concentration is small, the diffraction degree is underestimated in some sections with the crest ratio of 0.5 to 0.6.

Bioequivalence Evaluation of Two Cefquinome 2.5% Injectable Products in Piglets (돼지에서 두 가지 Cefquinome 2.5% 제제의 생물학적 동등성 평가)

  • Song, In-Bae;Kim, Tae-Won;Lee, Hong-Gee;Kim, Myoung-Seok;Hwang, Youn-Hwan;Park, Byung-Kwon;Lim, Jong-Hwan;Yun, Hyo-In
    • Journal of Veterinary Clinics
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    • v.29 no.3
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    • pp.233-236
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    • 2012
  • Cefquinome, a fourth generation cephalosporin, has been solely used for veterinary medicine and has a broad antibacterial spectrum against gram-negatives and gram-positives being very stable to ${\beta}$-lactamases. This study was conducted to evaluate the bioequivalence of two cefquinome 2.5% products in piglets. Plasma cefquinome concentrations were analyzed by liquid chromatography-mass spectrometry (LC/MS). Mean maximum concentration ($C_{max}$) of test product ($Cequus^{(R)}$) and reference product ($Cobactan^{(R)}$) were $4.34{\pm}0.58$ and $4.22{\pm}0.47{\mu}g/mL$, and mean area under the concentration time curve ($AUC_{0{\rightarrow}{\infty}}$) values were $10.43{\pm}1.96$ and $10.25{\pm}2.98{\mu}g{\cdot}h/mL$, respectively. The 90% confidence intervals for the ratio of $C_{max}$ (0.941-1.115), and $AUC_{0{\rightarrow}{\infty}}$ (0.927-1.172) values for the test and reference products were within the acceptable bioequivalence limit of 0.80-1.25. It is concluded that two commercial cefquinome injectable solutions are bioequivalent in their extent of drug absorption in piglets.

A Study on the Forecasting Model on Market Share of a Retail Facility -Focusing on Extension of Interaction Model- (유통시설의 시장점유율 예측 모델에 관한 연구 -상호작용 모델의 확장을 중심으로)

  • 최민성
    • Journal of Distribution Research
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    • v.5 no.2
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    • pp.49-68
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    • 2001
  • In this chapter, we summarize the results on the optimal location selection and present limitation and direction of research. In order to reach the objective, this study selected and tested the interaction model which obtains the value of co-ordinates on location selection through the optimization technique. This study used the original variables in the model, but the results indicated that there is difference in reality. In order to overcome this difference, this study peformed market survey and found the new variables (first data such as price, quality and assortment of goods, and the second data such as aggregate area, and area of shop, and the number of cars in the parking lot). Then this study determined an optimal variable by empirical analysis which compares an actual value of market share in 1988 with the market share yielded in the model. However, this study found the market share in each variables does not reflect a reality due to an assumption of λ-value in the model. In order to improve this, this study performed a sensitivity analysis which adds the λ value from 1.0 to 2.9 marginally. The analyzed result indicated the highest significance with the market share ratio in 1998 at λ of 1.0. Applying the weighted value to a variable from each of the first data and second data yielded the results that more variables from the first data coincided with the realistic rank on sales. Although this study have some limits and improvements, if a marketer uses this extended model, more significant results will be produced.

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Optimum Rheological Mixed ratio of Jumbo Squid and Alaska Pollock Surimi for Gel Product Process (대형오징어와 명태혼합 어묵의 가열겔화시 물성에 영향을 미치는 최적 혼합비)

  • LEE Nahm-Gull;YOO Seung-Geun;CHO Young-Je
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.32 no.6
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    • pp.718-724
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    • 1999
  • This study was investigated the changes of the properties of matter such as the gel formation of the combined fish based on the mixed rate between the ocean jumbo squid and Alaska pollock surimi, and compared the relationships between the gel formation and water holding capacity. The changes of the gel formation based on 20 min fish grinding time and $2.5\%$ salt concentration according to the mixed rate was thought as the optimal addition limit. There was no significant function of gel product more than $20\%$ Jumbo squid meat. The more squid meat in the mixed meat could make the lower breaking stress but 7:3 rate of pollock : squid could retain breaking strain. The effect of the moisture content on mixed fish meat was studied and the drastic decrease of the gel formation and water holding capacity was indicated in $78\%$.

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Measurement of Operator Exposure During Treatment of Fungicide Difenoconazole on Grape Orchard (포도 과수원에서 살균제 Difenoconazole의 농작업자 노출량 측정)

  • Cho, ll Kyu;Park, Joon Seong;Park, So Hyun;Kim, Su Jin;Kim, Back Jong;Na, Tae Wong;Nam, Hyo Song;Park, Kyung Hun;Lee, Jiho;Kim, Jeong-Han
    • Korean Journal of Environmental Agriculture
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    • v.35 no.4
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    • pp.286-293
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    • 2016
  • BACKGROUND: 18% of difenoconazole+iminoctadin triacetate microemulsion (3%+15%) formulation were mixed and sprayed as closely as possible to normal practice on the ten of farms located in the Youngju of South Korea. Patches, cotton gloves, socks, masks and XAD-2 resin were used to measure the potential exposure for applicators wearing standardized whole-body outer and inner dosimeter (WBD). This study has been carried out to determine the dermal and inhalation exposure to difenoconazole during preparation of spray suspension and application with a power sprayer on a grape orchard. METHODS AND RESULTS: A personal air monitor equipped with an air pump IOM sampler and cassette and glass fiber filter were used for inhalation exposure. The field studies were carried out in a grape orchard. The temperature and relative humidity were monitored with a thermometer and a hygrometer. Wind speed was measured using a pocket weather meter. All mean field fortification recoveries were between 97.3% and 119.6% in the level of 100 LOQ (limit of quantification) while the LOQ for difenoconazole was $0.025{\mu}g/mL$ using HPLC-UVD. The arms exposure to difenoconazole for the mixer/loader (0.0794 mg) was higher than other body parts (head, hands, upper body, legs). The exposure to difenoconazole in the legs for applicator (3.78 mg) was highest in the parts of body. The dermal exposure for mixer/loader and applicator were 0.02 and 2.28 mg on a grape orchard, respectively. The inhalation exposure during application was estimated as 0.02 mg. The ratio of inhalation exposure to dermal exposure was equivalent to 0.9% of the dermal exposure. CONCLUSION: The inhalation exposure for applicator indicated $18.8{\times}10^{-3}mg$, which was level of 0.9% of the dermal exposure (2.28 mg). Operator exposure (0.004 mg/kg bw/day) to difenoconazole during treatment for grape is calculated as 2.5% of the established AOEL (0.16 mg/kg bw/day).

Treatment of Contaminated Sediment for Water Quality Improvement of Small-scale Reservoir (소하천형 호수의 수질개선을 위한 퇴적저니 처리방안 연구)

  • 배우근;이창수;정진욱;최동호
    • Journal of Soil and Groundwater Environment
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    • v.7 no.4
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    • pp.31-39
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    • 2002
  • Pollutants from industry, mining, agriculture, and other sources have contaminated sediments in many surface water bodies. Sediment contamination poses a severe threat to human health and environment because many toxic contaminants that are barely detectable in the water column can accumulate in sediments at much higher levels. The purpose of this study was to make optimal treatment and disposal plan o( sediment for water quality improvement in small-scale resevoir based on an evaluation of degree of contamination. The degree of contamination were investigated for 23 samples of 9 site at different depth of sediment in small-scale J river. Results for analysis of contaminated sediments were observed that copper concentration of 4 samples were higher than the regulation of hazardous waste (3 mg/L) and that of all samples were exceeded soil pollution warning levels for agricultural areas. Lead and mercury concentration of all samples were detected below both regulations. Necessary of sediment dredge was evaluated for organic matter and nutrient through standard levels of Paldang lake and the lower Han river in Korea and Tokyo bay and Yokohama bay in Japan. The degree of contamination for organic matter and nutrient was not serious. Compared standard levels of Japan, America, and Canada for heavy metal, contaminated sediment was concluded as lowest effect level or limit of tolerance level because standard levels of America and Canada was established worst effect of benthic organisms. The optimal treatment method of sediment contained heavy metal was cement-based solidification/stabilization to prevent heavy metal leaching.

Constitutional Issue Review of Compensation for Inevitable Medical Accidents During Delivery (불가항력 의료사고 보상사업에 대한 헌법적 쟁점 검토)

  • JUN, HYUN JUNG
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.153-185
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    • 2020
  • In principle, even if serious consequences such as death or serious injury of a patient occur as a result of a medical accident, if the medical malpractice of a health care worker is not recognized, the health care worker is not held liable for said consequences. However, with the opening of the Korea Medical Dispute Mediation and Arbitration Agency on April 7, 2012, a system was established to compensate health care personnel for their medical malpractices only in the case of "injuries caused by medical accidents in the course of childbirth" (hereinafter referred to as "program for compensation of medical accidents"). Article 46 paragraph 1 of the current Medical Dispute Mediation Act, which is the basis of the Force Majeure Medical Accident Compensation System, stipulates that "medical accidents under delivery" claims are to be determined by the Medical Accident Compensation Review Committee are subject to the compensation project. And the details of the compensation, ratio of sharing financial resources for compensation, scope of compensation, and the guidelines and procedure for the payment of compensations are prescribed by Presidential Decree. In other words, the Presidential Decree requires the state to pay 70 percent of the compensation funds, and 30 percent of the above funds among health care providers. The Constitutional Court has decided on the 2015Hun-Ga13 that the scope of the health care institution's founders and the share of the compensation funds cannot be directly determined by the law, and that the portion delegated by the Presidential decree does not violate the Principle of Legal Protection nor Comprehensive Nondelegation Doctrine. However, this can be seen as an exclusion of accountability for force-induced delivery accidents even if there is no negligence of the medical staff. If the nature of the system is a type of social security system with a social compensatory nature, it could consider eliminating the health care innovator's cost-sharing provisions, leaving the full cost to the state. However, it is also necessary to review institutional protocols that strengthen the efforts of medical institutions in areas such as analysis of the causes of medical accidents and measures to prevent their recurrence. In addition, I think that the conclusion of the Act is in line with the purpose of the Comprehensive Wage Support Regulations that at minimum the law sets an upper limit of the compensation funds that are to be paid by health and medical institutions. Moreover, it is reasonable for the Medical Accident Compensation Review Committee to specify gestational age and weight of births, which are the criteria for compensation, under the Enforcement Decree of the Medical Dispute Mediation Act, in relation to the criteria for payment of contributions by the Medical Accident Compensation Review Committee, and to set the detailed criteria.

A Study about Clinical Characteristics of Methicillin Resistant-Coagulase Negative Staphylococcus Infections in Neonatal Intensive Care Unit (신생아 중환자실에서 Methicillin Resistant-Coagulase Negative Staphylococcus 감염에 대한 임상적 고찰)

  • Yoon, Soon Hwa;Sung, Tae Jung;Shin, Seon Hee;Kim, Sung Koo;Lee, Kon Hee;Yoon, Hae Sun
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.112-120
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    • 2004
  • Purpose : Methicillin Resistant-Coagulase Negative Staphylococcus(MR-CNS) infection has become an increasingly important cause of morbidity in NICU infants. We investigated the c linical characteristics of MR-CNS sepsis. Methods : This study included 40 neonates with MR-CNS sepsis who were admitted to the neonatal intensive care unit of Kangnam Sacred Heart Hospital, Hallym University from January 1998 to July 2002. MR-CNS sepsis was defined as MR-CNS recovery from blood with clinical symptoms and signs of infection. Retrospective analyses of the medical records of patients with MR-CNS sepsis were performed. The analyses included demographic findings, clinical features, hospital courses, risk factors for infection including invasive procedures and mortality. Results : From 1998 to 2002, there were 40 cases of MR-CNS sepsis, comprising 17.7% of late onset infections in NICU of Kangnam Sacred Heart Hospital. The male/female ratio was 1.5 : 1. The mean gestational age of infected babies was $32.4{\pm}4.3$ weeks at birth. And the first positive MR-CNS culture was done in the day $10.6{\pm}9.3$ after birth. Clinical symptoms such as fever, dyspnea, cyanosis, grunting, bradycardia, vomiting and diarrhea were frequent in MR-CNS. Mechanical ventilation was applied in 12 cases and catheter was inserted in 11 cases. The mortality(12.5%) directly attributable to MR-CNS sepsis was similar to other late onset infections. Conclusion : MR-CNS is a pathogen responsible for most late onset and nosocomial infections. And it will be life-threatening in high-risk neonate. Awareness of increasing infections due to MR-CNS in NICU is important not only for infection control but also placing a great limit in use of antibiotics and invasive procedures, especially in premature infants.

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Establishment of Safe Management Guideline Based on Uptake Pattern of Pesticide Residue from Soil by Radish (토양잔류 농약의 무 흡수양상 및 토양 안전관리기준 설정)

  • Hwang, Jeong-In;Kwak, Se-Yeon;Lee, Sang-Hyeob;Kang, Min-Su;Ryu, Jun-Sang;Kang, Ja-Gun;Jung, Hye-Hyeon;Hong, Sung-Hyeon;Kim, Jang-Eok
    • Korean Journal of Environmental Agriculture
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    • v.35 no.4
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    • pp.278-285
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    • 2016
  • BACKGROUND: Uptake patterns of ${\alpha}$-, ${\beta}$-isomers and sulfate metabolite of endosulfan (ED) by radishes grown in treated soils with ED concentrations of 2 and 10 mg/kg were investigated to establish soil management guidelines for ensuring the safety of radishes from ED residues. METHODS AND RESULTS: All samples of soils and radish plants separated into shoot and root parts were analyzed for ED residues using a gas-chromatography mass spectrophotometer, and the results were used to calculate the bioconcentration factor (BCF), indicating the ratio of ED concentrations between radishes and soils. During the experimental period, uptake and distribution rates of ED-sulfate in radishes were the highest, followed by ${\alpha}$- and ${\beta}$-ED. The BCF values to initial ED concentrations in soils were greater for root parts (0.0077 to 0.2345) than for shoot parts (0.0002 to 0.0429) and used to obtain regression equations by time. Long-term BCFs estimated by the obtained equations ($R^2$ of 0.86 to 1.00) were evaluated with the maximum residue limit (0.1 mg/kg) of ED for radishes, in order to suggest safe management guidelines of ED for radish-cultivating soils. CONCLUSION: Suggested guidelines showed the significant dependency on duration for radish cultivation and exposed concentration of ED in soil.