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201. A Call for the Aggressive Treatment of Oligometastatic and Oligo-Recurrent Non-Small Cell Lung Cancer

Author

Patel, Pretesh R., Yoo, David S., Niibe, Yuzuru, Urbanic, James J., and Salama, Joseph K.

Subjects
Article Subject
Abstract

Metastatic non-small cell lung cancer (NSCLC) carries a dismal prognosis. Clinical evidence suggests the existence of an intermediate, or oligometastatic, state when metastases are limited in number and/or location. In addition, following initial curative therapy, many patients present with limited metastatic disease, or oligo-recurrence. Metastasis-directed, anti-cancer therapies may benefit these patients. A growing evidence-base supports the use of hypofractionated, image-guided radiotherapy (HIGRT) for a variety of malignant conditions including inoperable stage I NSCLC and many metastatic sites. When surgical resection is not possible, HIGRT offers an effective alternative for local treatment of limited metastatic disease. Early studies have produced promising results when HIGRT was delivered to all known sites of disease in patients with oligometastatic/oligo-recurrent NSCLC. In a population of patients formerly considered rapidly terminal, these studies report five year overall survival rates of 13–22%. HIGRT for metastatic NSCLC warrants further study. We call for large, intergroup, and even international randomized trials incorporating HIGRT and other metastasis-directed therapies into the treatment of patients with oligometastatic/oligo-recurrent NSCLC.

Published
2012
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202. How Well Does the New Lung Cancer Staging System Predict for Local/Regional Recurrence After Surgery?: A Comparison of the TNM 6 and 7 Systems

Author

Chino, Junzo, Hubbs, Jessica, Onaitis, Mark, Boyd, Jessamy, Pepek, Joseph, Ready, Neal, Kelsey, Chris, D'Amico, Thomas, Marks, Lawrence, and Yoo, David

Subjects
neoplasms, digestive system diseases
Abstract

INTRODUCTION: To evaluate how well the tumor, node, metastasis (TNM) 6 and TNM 7 staging systems predict rates of local/regional recurrence (LRR) after surgery alone for non-small cell lung cancer. METHODS: All patients who underwent surgery for non-small cell lung cancer at Duke between 1995 and 2005 were reviewed. Those undergoing sublobar resections, with positive margins or involvement of the chest wall, or those who received any chemotherapy or radiation therapy (RT) were excluded. Disease recurrence at the surgical margin, or within ipsilateral hilar and/or mediastinal lymph nodes, was considered as a LRR. Stage was assigned based on both TNM 6 and TNM 7. Rates of LRR were estimated using the Kaplan-Meier method. A Cox regression analysis evaluated the hazard ratio of LRR by stage within TNM 6 and TNM 7. RESULTS: A total of 709 patients were eligible for the analysis. Median follow-up was 32 months. For all patients, the 5-year actuarial risk of LRR was 23%. Conversion from TNM 6 to TNM 7 resulted in 21% stage migration (upstaging in 13%; downstaging in 8%). Five-year rates of LRR for stages IA, IB, IIA, IIB, and IIIA disease using TNM 6 were 16%, 26%, 43%, 35%, and 40%, respectively. Using TNM 7, corresponding rates were 16%, 23%, 37%, 39%, and 30%, respectively. The hazard ratios for LRR were statistically different for IA and IB in both TNM 6 and 7 but were also different for IB and IIA in TNM 7. CONCLUSIONS: LRR risk increases monotonically for stages IA to IIB in the new TNM 7 system. This information might be valuable when designing future studies of postoperative RT.

Published
2011
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209. FM mode-locking and coupled optoelectronic oscillation in a composite-cavity electro-optic microchip laser

Author

Yoo, David K.

Subjects
Electrical engineering, Physics::Optics, Integrated circuits, Optoelectronics
Abstract

A push for improved performance from modern communication links has resulted in an ever-increasing demand for architectures which can provide greater bandwidth and lower noise while maintaining a low cost and small form factor. In this vein, the use of laser mode-locking to generate both low noise microwave oscillations and short optical pulses simultaneously is of interest, and the potential utility of this phenomenon has already driven much research in mode-locking in many types of lasers. Compact solidstate lasers are another attractive potential source for the generation of microwave carriers in analog systems, as well as optical pulses for digital applications.This thesis concerns itself with the design of FM mode-locked composite-cavity electro-optic microchip lasers. In particular, the consequences of scaling these devices to operate at millimeter-wave frequencies where the cavity resonance frequencies begin to approach the gain bandwidth are considered. The requirements necessary for strict control of both the transverse and longitudinal cavity modes are discussed. The cavity geometry necessary for optimization of the interaction between the microwaves and optical waves is introduced. A semiclassical model based on the Maxwell-Bloch equations capable of illuminating the time-domain dynamics of the laser is formulated for a Fabry-Perot cavity under electro-optic modulation. Using these concepts, a prototype is developed, characterized, and experimentally studied.

Published
2006
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211. Reliability-oriented optimal design of intentional mistuning for a bladed disk with random and interval uncertainties.

Author

Yoo, David, Lee, Ikjin, and Tang, J.

Subjects
*ROTATING disks, *OPTIMAL designs (Statistics), *MONTE Carlo method, *SIMULATION methods & models, *UNCERTAINTY
Abstract

When interblade coupling is weak, the dynamic response of a bladed disk is very sensitive to the presence of uncertainties. Excessive response variation can be very harmful. Previous studies have indicated that introducing blade-to-blade difference in nominal design, known as intentional mistuning, could reduce the level of response variation. In this research, an efficient computational framework that yields the optimal design of intentional mistuning is developed to maximize the bladed disk reliability. Both the random uncertainty of blades and the interval uncertainty of disk connections are considered. The Metropolis–Hastings algorithm is applied to find the worst case response under interval uncertainty, and Monte Carlo simulation is employed to account for the random mistuning effect. A gradient-based approach is then established to find the minimum design modification needed to achieve a designated reliability level. Case studies are carried out to illustrate the effectiveness of the proposed method. [ABSTRACT FROM AUTHOR]

Published
2017
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219. Entrepreneurship and Religion: Korean Immigrants in Houston, Texas

Author

Yoo, David

Subjects
Entrepreneurship and Religion: Korean Immigrants in Houston, Texas (Book), Books -- Book reviews, Regional focus/area studies, Sociology and social work
Abstract

By Victoria Hyonchu Kwon. New York: Garland Publishing, 1997. Pp. 159. DAVID YOO Claremont-McKenna College Based on her doctoral dissertation at the University of Houston, sociologist Victoria Hyonchu Kwon's ethnographic [...]

Published
1998

220. An HLA-Based Approach to Quantify Achievable Performance for Tactical Edge Applications

Author

ARMY RESEARCH LAB ADELPHI MD, Rivera, Brian, Tufarolo, John A., Comparetto, Gary, Lakshminarayan, Vinay, Mirhakkak, Mohammad, Page, Ernest H., Schult, Nancy, Yoo, David, ARMY RESEARCH LAB ADELPHI MD, Rivera, Brian, Tufarolo, John A., Comparetto, Gary, Lakshminarayan, Vinay, Mirhakkak, Mohammad, Page, Ernest H., Schult, Nancy, and Yoo, David

Abstract

The DoD is pursuing an end-to-end, seamless, network-centric enterprise communications infrastructure to support a wide range of operating conditions and network topologies. Evaluating the achievable performance of this communications infrastructure, as it evolves, is essential to the user community in order to guide their ongoing requirements, design, and procurement activities. Tactical edge applications present significant challenges to network evaluation methods since they often include mobile ad-hoc networks (MANETs) that employ a wide range of platform types (ground-based, air-based, and satellite-based), traffic types (data, voice, video, and multimedia), delivery methods (unicast and multicast), offered traffic loads (kilobits/sec through megabits/sec), and numbers of nodes (from 10s to 1000s). The complexity exhibited by tactical edge applications typically demands the use of Modeling and Simulation (M&S) techniques, supported by high-fidelity models, to adequately quantify achievable performance on an end-to-end basis. However, these high-fidelity models often have very long runtimes, and restrictive limitations on scenario sizing. We investigate the application of the DoD High Level Architecture (HLA) and High Performance Computing (HPC) platforms to address the performance demands associated with analyzing tactical edge applications. A federation comprised of two Soldier Radio Waveform (SRW) federates and one Wireless Network after Next (WNaN) federate is developed and executed within an HPC environment at Aberdeen Proving Grounds (APG). High-fidelity OPNET models are used to represent the SRW and WNaN waveforms. Situational Awareness (SA) multicast traffic is delivered among the nodes represented within each of the three federates. Unicast traffic is exchanged between the SRW federates, in the presence of this SA background traffic, using the WNa, Prepared in collaboration with Pragmeering Corp., Woodbridge, VA and The Mitre Corp., McLean, Va.

Published
2011

227. Cultural Tug of War: The Korean Immigrant Family and Church in Transition

Author

Yoo, David

Subjects
Cultural Tug of War: The Korean Immigrant Family and Church in Transition (Book), Korean Americans and Their Religions: Pilgrims and Missionaries from a Different Shore (Book), Books -- Book reviews, Philosophy and religion
Abstract

By Young Lee Hertig. Abingdon, 288 pp., $12.00 paperback. Korean Americans and Their Religions: Pilgrims and Missionaries from a Different Shore. Edited by Ho-Youn Kwon, Kwang Chung Kim and R. [...]

Published
2003

231. Prospective Trial of Synchronous Bevacizumab, Erlotinib, and Concurrent Chemoradiation in Locally Advanced Head and Neck Cancer

Author

Yoo, David S., primary, Kirkpatrick, John P., additional, Craciunescu, Oana, additional, Broadwater, Gloria, additional, Peterson, Bercedis L., additional, Carroll, Madeline D., additional, Clough, Robert, additional, MacFall, James R., additional, Hoang, Jenny, additional, Scher, Richard L., additional, Esclamado, Ramon M., additional, Dunphy, Frank R., additional, Ready, Neal E., additional, and Brizel, David M., additional

Published
2012
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237. Treatment‐induced changes in vocal cord mobility and subsequent local recurrence after organ preservation therapy for laryngeal carcinoma

Author

Lee, Walter T., primary, Yoo, David S., additional, Puscas, Liana, additional, Witsell, David, additional, M. Cohen, Seth, additional, R. Fisher, Samuel, additional, Scher, Richard, additional, Broadwater, Gloria, additional, Ready, Neal, additional, R. Brizel, David, additional, and Esclamado, Ramon M., additional

Published
2011
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240. Legacies

Author

Kao, Mary Uyematsu, primary, Yoo, David K., additional, and Leong, Russell C., additional

Published
2011
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250. Does Blast Medium Affect Heterotopic Ossification in a Blast-amputation Model?

Author

Jaffe, David, Yoo, David, Blevins, Jason, Gasbarro, Gregory, Hughes, Tyler, Paryavi, Ebrahim, Nguyen, Thao, Fourney, William, and Pellegrini, Vincent

Subjects
HETEROTOPIC ossification, PATHOLOGICAL physiology, ARM amputation, FLUOROQUINOLONES, RADIOGRAPHY, LABORATORY rats
Abstract

Background: Heterotopic ossification (HO) develops after nearly 2/3 of traumatic blast amputations in the contemporary battlefield. This phenomenon has potentially devastating consequences for servicemen and women and its pathophysiology warrants further investigation using a previously developed animal blast model. Questions/purposes: We asked, what is the (1) severity (quantity) and (2) type (location) of HO bone formation after a hindlimb blast amputation with two distinct blast media. We hypothesized that a more 'war-relevant' blast medium could be a more accurate model and potentially intensify the development of HO. Methods: Using a Sprague-Dawley rat model, the pathophysiology of ectopic bone formation in a traumatic hindlimb blast amputation was evaluated. Twenty-four animals underwent blast amputations and closure based on a previously established experimental model. Half the amputations were subjected to blasted sand and the other 1/2 to blasted water. Serial orthogonal radiography was performed on each animal until euthanasia at 24 weeks to track the development of HO. Heterotopic bone severity and type were assessed by three independent graders at each time using a novel grading scale to assess quantity and quality of HO. Results: All animals had radiographic evidence of HO develop. No differences were observed in ectopic bone development between sand and water blasting regarding severity or type at any time. Animals that received water and sand blasting had moderate HO develop at 24 weeks (median, 2.0 and 2.5 weeks, respectively; range, 1-3 weeks; difference of medians, 0.5; p = 0.67). At the time of euthanasia, 10 animals that were water blasted had Type 3 HO compared with 11 in the sand-blasted group (p = 1.00). Conclusions: Our study showed a clear development of HO after hindlimb blast amputation in a Sprague-Dawley rat model; however, no difference was observed in HO development based on the type of blast media. This suggests it is the blast mechanism that induces ectopic bone development, regardless of the blasted medium. The grading scale we developed for our animal-model study provided a reliable means of assessing HO severity and type. Clinical Relevance: We anticipate that future investigations will elucidate similarities between service members' wartime extremity injuries and the animal model used in our study, and with focused future research this model may have beneficial therapeutic implications as the pathophysiology of HO development is further understood. [ABSTRACT FROM AUTHOR]

Published
2015
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