• Title/Summary/Keyword: treatment of choice

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Long Term Results of Radiation Therapy in Early Glottic Cancer (초기 성문암의 방사선치료: 장기 추적결과)

  • Kim, Jin-Hee;Byun, Sang-Jun
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.29-34
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    • 2009
  • Purpose: This study was designed to evaluate long-term results in terms of failure, survival and voice preservation after radiation therapy for early glottic cancer. Materials and Methods: From February 1988 to December 2003, 70 patients with early glottic cancer were treated with radiation therapy at Keimyung University Dongsan Medical Center. Patient age distribution was from 39 to 79 years, with a median age of 62 years. All patients had squamous cell carcinoma. According to the TNM stage, 58 patients had stage I disease, 12 patients had stage II disease; 67 patients were male. The laryngeal area was irradiated with the use of bilateral opposing fields with/without a wedge filter with 6 MV photons at a total dose of $54{\sim}70.2$ Gy in $1.8{\sim}2.2$ Gy fractions over $6{\sim}8$ weeks. We delivered a median radiation dose of 60 Gy for stage I patients and a median radiation dose of 66 Gy for stage II patients. Salvage surgery was performed in patients with local recurrence. The voice preservation rate was analyzed after all treatments including salvage surgery. Follow-up periods were from 13 to 180 months, with a median follow-up period of 77.5 months. The survival rate was analyzed by the use of the Kaplan Meier method and log rank test. A comparison of two groups was performed with the use of the chi-squared test. Results: The local control rate was 98.5% (69/70). The five-year-overall survival rate was 93.9%. The five-year disease free survival rate (5YDFS) was 84.1% and the 5YDFS after radiation and salvage surgery was 92.8%. According to stage, the 5YDFS was 93.1% and 91.7% for stage I and stage II respectively. Thirteen patients (18.5%) had local failure with 24 months of median time to local failure and nine patients received salvage surgery; however, four patients were lost to follow-up after a diagnosis of recurrence. Only two patients died due to a distant metastasis at 33 months and 71 months after radiation therapy, respectively. Nine patients died due to other diseases with a median time of 73 months. There were no severe acute or chronic complications after radiation therapy. Voice preservation was ultimately achieved in 88.5% (62/70) of patients. Conclusion: We considered that radiation therapy was effective and we achieved excellent survival and voice preservation in early laryngeal cancer. The use of radiation therapy should be the first choice for the treatment of early glottic cancer.

THE MORPHOLOGICAL OBSERVATION OF HUMAN GINGIVAL FIBROBLASTS ATTACHMENT AND SPREADING ON THE MECHANICAL TREATED TITANIUM PLASMA SPRAYED IMPLANT SURFACE (기계적 표면 처리된 TITANIUM PLASMA SPRAYED IMPLANT에 대한 치은섬유아세포전개양상의 형태학적 관찰)

  • Whang, Yun-Hi;Lee, Jae-Mok;Suh, Jo-Young
    • Journal of Periodontal and Implant Science
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    • v.25 no.3
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    • pp.741-755
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    • 1995
  • Currently titanium is the material of choice for implants because of its biological acceptance. This high degree of biocompatibility is thought to result, in part, from the protective and stable oxide layer that presumably aids in the bonding of the extracellular matrix at the implant-tissue interface. Endosseous dental implants are interfaced with bone, connective tissue, and epithelium when implanted into the jaw bone. The soft tissue interface including connective tissue and epithelium is one of the most critical factors in the determination of implant maintenance and prognosis. For maintenance of failing or failed implants, it is essential to treat the implant fixture surface to remove bacterial endotoxins and make a surface tolerated by surrounding soft and hard tissues. In this study, the effect of mechanical treatment on titanium plasma sprayed implant on adhesiveness and proliferation of human gingival fibroblasts and changed surface characteristics were studied. titanium plasma sprayed discs manufactured by Friedrichsfeld company were treated with loaw speed stone bur, a rubber point and a jetpolisher. Its surface components were analyzed with Energy dispersive X-ray spectroscopy to evaluate whether the surface characteristics were altered or not. To observe the spreading pattern of the human gingival fibroblasts which attached to the all specimens author used the scanning electron microscope. The results were as follows : Pure titanium and plasma sprayed titanium, stone polished titanium showed titanium peak and small amout of aluminum, so there was no alteration on surface characteristics. Under the scanning electron microscopic examination in the initial attachment of human gingival fibroblast, there was a slight enhancement in pure titanium, stone polished titanium than plasma sprayed titanium. After 6 hours, the pure titanium and stone polished titanium showed human gingival fibroblasts were elongated and connected with numerous processes. Human gingival fibroblasts were more intimately attached on the pure titanium discs than on the other discs. The human gingival fibroblasts attached on the plasma sprayed titanium by thin and elongated processes. After 24 hours, the human gingival fibroblasts connected with each other via numerous processes and compeletly covered the pure titanium and stone polshed titanium discs. Human gingival fibroblasts had multiple point contacts with more long and thin lamellopodia and showed a little bare surface on plasma sprayed titanium discs.

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A single case study using Contextual Support Model based music therapy intervention for a terminal pediatric patient (말기질환 아동을 위한 환경적 지지모델(The Contextual Support Model of Music Therapy)에 근거한 음악치료사례연구)

  • Jun, Mi Hye
    • Journal of Music and Human Behavior
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    • v.2 no.2
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    • pp.15-31
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    • 2005
  • Terminal pediatric patient include congenital metabolic abnormalities, chromosome aberrations, congenital anomalies, neuromuscular diseases and other incurable conditions as well as malignant tumors. One third of these diseases are cancers, and two thirds of cancers are lymphadenoma and leukemia. Terminal pediatric patient may feel fear, anger and frustration against treatment process in hospitals, lose control of themselves and stay in helplessness due to restrictions within controlled hospital environment. This study examined the relationship between hospitalized childrens behavior and music using Contextual Support Model of Music Therapya theory stating therapeutic music environments possess three elements of Structure, Autonomy support and Involvement, and increase childrens active engagement. Focused on these three therapeutic elements, this study analyzed music therapy cases of terminally ill children to examine the relationship between childrens behavior and music as environmental supportive medium in the environment. This study is on a single case case subject, a 10-year-old girl with acute lymphocytic leukemia. Nine sessions of music therapy activities were conducted and analyzed using qualitative method. Focusing on three therapeutic elements of Contextual Support Model, analysis of sessions was made on the basis of activities specifically designed for this study. Main music therapy activities included singing while playing musical instruments, singing while listening to music through CD player, making up songs, and searching for song lines. The findings of this study are as follows: a) in terms of Structure, music therapy suggested a direction for effective musical activities for terminally ill children by providing environments where child can sing, play musical instruments and make up songs; b) in terms of Autonomy support, music therapy encouraged childs voluntary participation by giving her chances to make choice while singing or playing musical instruments; c) in terms of Involvement, child could gain positive approval of the therapist and conduct musical activities in cooperation with the therapist. Music therapy serves as supportive medium in the environment, develops spontaneity and self-reliance in emotionally depressed children, and promotes voluntary attitudes in the restricted hospital environment. Based on the positive effects of music therapy, more studies need to be conducted with an approach to more various terminal pediatric patients.

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An Exercise Rehabilitation Field Revitalization Plan for Promoting Elderly Sport for All (노인생활체육 진흥을 위한 운동재활분야 활성화 방안)

  • Cho, Kyoung-Hwan
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.4
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    • pp.305-319
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    • 2020
  • A The purpose of this study was to determine the present state of the exercise rehabilitation field, promote elderly sport for all, and present a revitalization program for higher quality of life for the elderly in the coming era of the Fourth Industrial Revolution and aged society. Literature review was performed to analyze the actual conditions of the activities for elderly sport for all and the relevant field of exercise rehabilitation, analyze the elderly health and welfare and elderly sport for all programs, and present a plan for revitalizing the field of exercise rehabilitation to promote elderly sport for all. First, it is necessary to reinforce the awareness and promotion of the need and importance of exercise rehabilitation in inducing seniors to participate in sport for all. Second, it is necessary to make it compulsory to place sport leaders for seniors at such places as elderly leisure and welfare centers and promote expertise in managing elderly health guidance efficiently through cooperation with welfare workers. Third, it is necessary to make it compulsory to take exercise rehabilitation and similar subjects in the curriculums of sport for all, elderly sport welfare, and silver welfare sport as well as the subject of volunteering activities at such places as elderly leisure and welfare centers with the aim of giving opportunities for career choice. Fourth, it is necessary to develop characterized exercise rehabilitation programs at senior welfare centers, community centers for the elderly, and elderly classes and employ experts equipped with exercise event and exercise rehabilitation capabilities as itinerant lecturers to contribute to the government's job creation policies through cooperation between the Ministry of Culture, Sports, and Tourism (MOCST) and the Ministry of Health and Welfare (MOHW). Fifth, it is necessary to make a greater investment in research and development required for elderly sport for all. Sixth, it is necessary to develop and distribute various exercise rehabilitation treatment videos and guidelines that seniors can use for themselves. This is associated with the fifth one; in particular, it is urgent to devise measures against Coronavirus 19. Seventh, it is necessary to reduce inefficiency and budget waste caused by overlapped tasks by establishing a new elderly sports promotion organization through adjustment by MOCST and MOHW; it is also necessary to increase the functions of organization establishment with the aim of reinforcing the education area, which involves post-retirement health care, exercise rehabilitation, safety accident prevention, and virus.

Outcomes of the arterial switch operation in complete transposition of the great arteries (완전 대혈관 전위에서 대혈관 치환술 후의 예후)

  • Cho, Min-Jung;Park, Ji-Ae;Lee, Hyoung-Doo;Sung, Si-Chan;Choo, Ki-Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.910-916
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    • 2009
  • Purpose : The arterial switch operation (ASO) has become the preferred procedure for the surgical management of transposition of the great arteries (TGA). We conducted a retrospective evaluation of our experience in 30 patients seen from January 2003 to July 2008, in order to determine outcomes and related risk factors after the arterial switch operation. Methods : Patients charts, surgical reports, and echocardiograms were retrospectively reviewed. And they were analyzed in 2 different groups: complex (n=16) versus simple TGAs (n=14). Complex TGAs are TGAs with VSD or the Taussig-Bing anomaly with or without aortic arch anomalies. Simple TGAs are defined as TGAs with intact ventricular septum having no such anomalies. Median follow-up time was 44 months (3-63 months). Results : Hospital mortality was 0%. However, follow-up echocardiographies revealed potential complications, including stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, and right or left ventricular outflow tract obstructions. Great arterial relationship (side-by-side), association of aortic arch anomalies, and the existence of the Taussig- Bing anomaly were assessed as significant risk factors of neo-aortic and/or neo-pulmonary valvar regurgitation in this series. On the other hand, right or left ventricular outflow tract obstructions were more frequently found in patients demonstrating VSD, side-by-side positioned great arteries, or associated coronary anomalies. Conclusion : The ASO is the procedure of choice in the treatment of TGA. However, special attention and follow-ups are needed to detect residual problems like the stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, as well as ventricular outflow tract obstructions.

Diagnosis of Interstitial Lung Disease -Comparison of HRCT, Transbronchial Lung Biopsy and Open Lung Biopsy- (간질성 폐질환의 진단 -HRCT, 경기관지폐생검, 개흉폐생검의 비교-)

  • Park, Jae-Seuk
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.65-74
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    • 1999
  • Background : Open lung biopsy(OLB) has conventionally been regarded as the gold standard for the diagnosis in interstitial lung disease. With recent advances in diagnostic technique such as high resolution computed tomography(HRCT), and transbronchial lung biopsy(TBLB) which provide relatively accurate diagnosis of ILD, it is necessary to reevaluate the role of these methods in the diagnosis of ILD. Methods: We carried out a retrospective analysis of nineteen patients who underwent OLB at Dankook University Hospital for the diagnosis of acute and chronic ILD, between May 1995 and June 1998. By reviewing the medical records, the demographic findings, underlying conditions, HRCT and TBLB findings, OLB diagnosis, therapy after OLB, and complication of OLB were evaluated. Results: Thirteen patients(68.4%) had chronic ILD(symptom duration over 2 weeks prior to OLB), and six patients(31.6%) had acute ILD(symptom duration less than 2 weeks). Specific diagnosis were reached in 92%(12/13) of chronic ILD(5 bronchiolitis obliterans organizing pneumonia(BOOP), 2 constrictive bronchiolitis, 3 usual interstitial pneumonia, 1 hypersensitivity pneumonitis, 1 eosinophilic pneumonia), and in all patients of acute ILD(5 acute interstitial pneumonia, 1 pneumocystis carinii pneumonia). HRCT were performed in all patients and a correct first choice diagnosis rate of HRCT was 42%(5/12) in chronic ILD. In chronic ILD patients, 62%(8/13) received specific therapy(steroid therapy in 7 patients and moving in one patient), after OLB, but in acute ILD, all patients received specific therapy(steroid therapy in 5 patients and steroid and antibiotic therapy in one patient) after OLB. The in-hospital mortality after OLB was 5.3%(1/19). Conclusion: OLB is an excellent diagnostic technique with relatively low complications in patients with ILD. Therefore OLB should be considered in patients with ILD when the specific diagnosis is important for the treatment, especially in patients with acute ILD.

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Diagnostic Methods Used in the Bone Infections in Children (소아기 골 감염의 진단방법에 관한 조사)

  • Lee, Eun Sil;Choi, Kwang Hae
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.210-217
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    • 1997
  • Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

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Sasang Herb medicine, IRCT (InfraRed Computer Thermography), Yakchim (Korean herb-acupuncture) remedy (체통환자(體痛患者)의 사상의학적(四象醫學的) 사초(四焦)와 이목구비(耳目口鼻)를 중심(中心)으로 한 체열(體熱) 분석(分析))

  • Kim, Su-Beom;Song, Il-Byung
    • Journal of Sasang Constitution and Immune Medicine
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    • v.8 no.1
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    • pp.377-393
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    • 1996
  • Lumbago is the common disease in the human, many people have been sicked the Lumbago. As the traditional methods of Lumbago treatment, acupuncture, moxibustion, herb medicines have been applied to a patient, nowadays, new methods have been applied physical remedy, Yakchim (Korean herb acupuncture) remedy, Chuna remedy to. This report was collected 73 Lumbago patients by name, sex, age, motive, symptoms, X-ray, CT, MRI, lRCT, Sasang constitution type, Sasang herb medicine, Yakchim, Chuna, period of remedy, satisfaction of remedy, at the "WooRee Korean Medical Clinic" during 21 months from Sep. 14, 1994 to May 25, 1996. And this report was studied about the distribution of the Sasang constitution type, the Sasang herb medicine, the effect, the period. The results were as follows: 1. Lumbago patients were distributed like that; Taeum-ln (太陰人) 47 (66.3 %), Soyang-In 16 (21.9 %), Soum-In (13.7 %), Taeyang-In (太陽人) 0. This was different from distribution of Donguisuseibowon (東醫壽世保元), Taeum-In (太陰人) 50%, Soyang-In (少陽人) 30 %, Soum-In (少陰人) 20 %, Taeyang-In (太陽人) little, this report shows that the number of Taeum-In (太陰人) is more than that of Donguisuseibowon and the number of Soum-In is less than that of Donguisuseibowon. 2. The average satisfaction of remedy was 60.3 %, Taeum-In's satisfaction was 66.0 %, Soum-In's satisfaction was 56.3 %, Soyang-In's satisfaction was 60.0 %. 3. The effective herb medicines were as follows, Soyang-In used the Hyong Bang Ji Hwang Tang (荊防地黃湯), Yuk Mi Ji Hwang Tang (六味地黃樓), Soum-In used the Sib Yi Mi Goan Jung Tang (十二味寬中湯), Taeum-In used the Chung Sim Yon Ja Tang (淸心蓮子陽), Chung Pae Sa Gan Tang (淸師爾肝湯), Yeol Da Han So Tang (熱多寒少湯). 4. The period of remedy was about 6 weeks. The period of remedy of each types was as follows, Taeum-In was about 5.7 weeks, Soum-In was about 6.8 weeks, Soyang-In was about 4.2 weeks. 5. The method of Lumbago remedy is divided three types, sprain Lumbago, Pyobyong (表病 : outside Syndromes) Libyong (裡病 : inside symdromes). Soum-In's methods are Pyobyong's ascending the Yang (陽), adding the Gi (氣) [升陽益氣], and Libyong's descending the inside Yim (裡陰) [裡陰降氣], Soyang-In's methods are Pyobyongs's decending the outside-Yim [表陰降氣], and Libyong's ascending the cool Yang (濟陽) [淸陽上升]. Taeum-In's methods are Pyobyong's ascending the Lung's Yang (肺陽升氣), and Libyong's colding the dried hot liver (淸肝燥熱). Taeyang's methods are strong the liver and making Yim. (補r肝生陰) 6. There are two methods for using the YakChim (Korean herb-acupuncture) by Sasang constitution medicine, one is to select the Yakchim, the other is to choice the point for appling the Yakchim. The first, to select the Yakchim, the other is follows; Soum-In can select the bee Venom, Soyang-In can select the H.O. (Hong Whoa 紅花), Taeum-In can select the I (Hodo 胡挑), V, O.K. (Ungdarn, 薦膽), Uwhang 牛黃, Sa-Hyang 麝香, etc., Palgang Yakchim (eight principles Korean herb-acupuncture (八剛藥鐵)) could made by abstracted Sasang herb medicine. The second, to choice the points for applying the Yakchim are used in the TaeGiuk Acupuncture method (太梗針法), Sacho (四焦, four warmer) by Sasang constritutional physiology and pathology.

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Clinical Study on Thoracic Actinomycosis (흉부 방선균종의 임상적 고찰)

  • Hong, Sang-Bum;Kim, Woo-Sung;Lee, Jae-Hwan;Bang, Sung-Jo;Shim, Tae-Son;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Lee, In-Chul;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1058-1066
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    • 1998
  • Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.

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Herbicidal Phytotoxicity under Adverse Environments and Countermeasures (불량환경하(不良環境下)에서의 제초제(除草劑) 약해(藥害)와 경감기술(輕減技術))

  • Kwon, Y.W.;Hwang, H.S.;Kang, B.H.
    • Korean Journal of Weed Science
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    • v.13 no.4
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    • pp.210-233
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    • 1993
  • The herbicide has become indispensable as much as nitrogen fertilizer in Korean agriculture from 1970 onwards. It is estimated that in 1991 more than 40 herbicides were registered for rice crop and treated to an area 1.41 times the rice acreage ; more than 30 herbicides were registered for field crops and treated to 89% of the crop area ; the treatment acreage of 3 non-selective foliar-applied herbicides reached 2,555 thousand hectares. During the last 25 years herbicides have benefited the Korean farmers substantially in labor, cost and time of farming. Any herbicide which causes crop injury in ordinary uses is not allowed to register in most country. Herbicides, however, can cause crop injury more or less when they are misused, abused or used under adverse environments. The herbicide use more than 100% of crop acreage means an increased probability of which herbicides are used wrong or under adverse situation. This is true as evidenced by that about 25% of farmers have experienced the herbicide caused crop injury more than once during last 10 years on authors' nationwide surveys in 1992 and 1993 ; one-half of the injury incidences were with crop yield loss greater than 10%. Crop injury caused by herbicide had not occurred to a serious extent in the 1960s when the herbicides fewer than 5 were used by farmers to the field less than 12% of total acreage. Farmers ascribed about 53% of the herbicidal injury incidences at their fields to their misuses such as overdose, careless or improper application, off-time application or wrong choice of the herbicide, etc. While 47% of the incidences were mainly due to adverse natural conditions. Such misuses can be reduced to a minimum through enhanced education/extension services for right uses and, although undesirable, increased farmers' experiences of phytotoxicity. The most difficult primary problem arises from lack of countermeasures for farmers to cope with various adverse environmental conditions. At present almost all the herbicides have"Do not use!" instructions on label to avoid crop injury under adverse environments. These "Do not use!" situations Include sandy, highly percolating, or infertile soils, cool water gushing paddy, poorly draining paddy, terraced paddy, too wet or dry soils, days of abnormally cool or high air temperature, etc. Meanwhile, the cultivated lands are under poor conditions : the average organic matter content ranges 2.5 to 2.8% in paddy soil and 2.0 to 2.6% in upland soil ; the canon exchange capacity ranges 8 to 12 m.e. ; approximately 43% of paddy and 56% of upland are of sandy to sandy gravel soil ; only 42% of paddy and 16% of upland fields are on flat land. The present situation would mean that about 40 to 50% of soil applied herbicides are used on the field where the label instructs "Do not use!". Yet no positive effort has been made for 25 years long by government or companies to develop countermeasures. It is a really sophisticated social problem. In the 1960s and 1970s a subside program to incoporate hillside red clayish soil into sandy paddy as well as campaign for increased application of compost to the field had been operating. Yet majority of the sandy soils remains sandy and the program and campaign had been stopped. With regard to this sandy soil problem the authors have developed a method of "split application of a herbicide onto sandy soil field". A model case study has been carried out with success and is introduced with key procedure in this paper. Climate is variable in its nature. Among the climatic components sudden fall or rise in temperature is hardly avoidable for a crop plant. Our spring air temperature fluctuates so much ; for example, the daily mean air temperature of Inchon city varied from 6.31 to $16.81^{\circ}C$ on April 20, early seeding time of crops, within${\times}$2Sd range of 30 year records. Seeding early in season means an increased liability to phytotoxicity, and this will be more evident in direct water-seeding of rice. About 20% of farmers depend on the cold underground-water pumped for rice irrigation. If the well is deep over 70m, the fresh water may be about $10^{\circ}C$ cold. The water should be warmed to about $20^{\circ}C$ before irrigation. This is not so practiced well by farmers. In addition to the forementioned adverse conditions there exist many other aspects to be amended. Among them the worst for liquid spray type herbicides is almost total lacking in proper knowledge of nozzle types and concern with even spray by the administrative, rural extension officers, company and farmers. Even not available in the market are the nozzles and sprayers appropriate for herbicides spray. Most people perceive all the pesticide sprayers same and concern much with the speed and easiness of spray, not with correct spray. There exist many points to be improved to minimize herbicidal phytotoxicity in Korea and many ways to achieve the goal. First of all it is suggested that 1) the present evaluation of a new herbicide at standard and double doses in registration trials is to be an evaluation for standard, double and triple doses to exploit the response slope in making decision for approval and recommendation of different dose for different situation on label, 2) the government is to recognize the facts and nature of the present problem to correct the present misperceptions and to develop an appropriate national program for improvement of soil conditions, spray equipment, extention manpower and services, 3) the researchers are to enhance researches on the countermeasures and 4) the herbicide makers/dealers are to correct their misperceptions and policy for sales, to develop database on the detailed use conditions of consumer one by one and to serve the consumers with direct counsel based on the database.

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