The approach of Healthcare Infrastructure Public-Private Partnership (PPP) in Developing Countries: for the equal good to Korea Interest Group and the Recipient Country

Over the past decade, Public-Private Partnerships (PPPs) have increasingly found their application in the sector of health infrastructure. The objective of this paper is to determine whether PPPs are a viable option for health infrastructure projects in developing countries. For this purpose, the author discusses and describes PPPs in general and specifies features of PPPs, which may be relevant for the healthcare sector and developing countries. In the next step, the author analyses PPP projects that are operating and projects that the author had involved and establishes key learnings from the undertaking. The combined evidence suggests that the PPP model for health infrastructure projects in developing countries can be highly risky for the countries, but also it possesses great insecurity for the participant entities. The author concludes PPP is not a better alternative to ODA in health infrastructure development in developing countries, but it should be an option. Also, the author suggests three conditions, those are prioritizing countries to build partnerships, secure evidence of partner country’s commitment, testify project design through multiple steps for both the public and the private to successfully use PPP for better health delivery.open석

Analysis of Random Telegraph Noise after Soft Breakdown in the Gate Induced Drain Leakage Current

학위논문 (석사)-- 서울대학교 대학원 : 전기·컴퓨터공학부, 2013. 8. 신형철.A Random Telegraph Noise (RTN) in leakage current has been important for discovering the cause of Variable Retention Time (VRT) in Dynamic Random Access Memory (DRAM) cell transistor. Among the several leakage currents, random telegraph noise in Gate Induced Drain Leakage (GIDL) current of a Metal Oxide Semiconductor Field Effect Transistor (MOSFET) is believed as the dominant cause of the VRT. Furthermore, the Soft Breakdown (SBD) has long been one of the main issues of the reliability of MOS transistor when the gate oxide layer is thinner than 4-5 nm. After the SBD occurs, the leakage current suddenly jumps without obvious indication of steps as the stress continues. If the gate tunneling current gradually increases to a certain point, then it will become high enough to cease the circuit to function. There have been many analyses about RTN in gate current after SBD, whereas there is few about RTN in GIDL current. Therefore, there is a need to study RTN in GIDL current after SBD. In this paper, Intrinsic two-level RTN in Gate Induced Drain Leakage (GIDL) RTN in GIDL current after the Soft BreakDown (SBD) by Constant Voltage Stress (CVS) in the gate-drain overlapped region was measured. In order to conduct comparative analysis, we extracted fundamental parameters of the trap, including the time constant, the trap location (xT) and the energy level (ECox-ET), the capture cross section (σc) from the measured RTN. After the first SBD, as the stress is continually given, multi-level GIDL RTN was also observed. As a result, we could predict the gate oxide degradation due to the SBD by observing the GIDL RTN after SBD.Abstract i Contents iii 1. Introduction 1 2. Extraction of Location and Energy Level of Oxide Trap Generated after Soft Breakdown 4 2. 1 Introduction 4 2. 2 Experimetnal 6 2. 3 Model 7 2. 4 Result and Discussion 16 2. 5 Conclusion 28 3. New Equation of Capture Cross Section Involving Tunneling Analysis 30 3. 1 Introduction 30 3. 2 Model and Discussion 31 3. 3 Conclustion 36 4 Conclusion 37 References 39 Abstract in Korean 43Maste

문화재 관리에 대한 인지된 성과와 만족도에 관한 연구: 서비스 가치인식의 조절효과를 중심으로

학위논문 (석사)-- 서울대학교 행정대학원 : 행정대학원 행정학과 정책학 전공, 2016. 2. 금현섭.본 연구의 목적은 문화재에 대한 성과인식과 만족도간의 관계를 실증적으로 분석하는데 있다. 특히 이들 관계가 향유자들이 인식하는 문화재의 가치, 즉 문화재 관리를 통해 제공되는 서비스의 가치를 고려했을 때 어떻게 달라지는지 살펴보고자 한다. 지금까지 문화재 정책은 원형보존에 집중하면서 문화재 자체만을 관리 대상으로 삼아왔으나, 최근 들어 문화재 향유 특히, 향유자 입장에서의 문화재 가치 측면이 부각되면서 그들의 만족이 문화재 관리의 중요한 대상이 되고 있다. 문화재 향유에 따른 만족도가 높을수록 문화재 보존 및 개발에 대한 애착이 형성되고 이를 통해 문화재 관리 정책에 대한 수용성 제고 및 문화재 관리를 위한 자발적 노력이 유도될 수 있기 때문이다. 하지만 이러한 인식의 전환에도 불구하고 실제 문화재 향유와 관련한 학술적·정책적 논의는 향유기회의 확대와 같은 양적인 측면에 경사되는 경향이 짙다. 더욱이 서비스에 대한 만족 여부와 그 수준은 소비자가 해당 서비스에 부여하는 가치인식에 따라 달라질 수 있음은 기존 경영학 등 다른 학문분야에서 일반적이라는 점에 착안해 본 연구는 문화재 향유자들이 인식하는 문화재의 가치를 명시적으로 고려함으로써 문화재 향유 만족에 대한 이해를 제고하고자 한다. 이를 위해 문화재청에서 실시한 「2010 문화유산 향유실태 조사」 자료를 분석하였으며, 문화재에 대해 개인이 부여하는 가치를 배움의 공간, 정체성 확인 공간, 그리고 관광 및 휴식공간으로 구분하고 이에 따라 다양한 차원의 만족도 수준을 검토하였다. 분석결과 서비스 전달 차원의 만족 수준은 문화재를 배움의 공간으로 인식하는 사람들과 국가 정체성 확인 공간으로 인식하는 사람들 사이에서 통계적으로 유의미한 차이를 보이고 있었고, 용이성 차원의 만족 수준은 배움의 공간으로 인식하는 사람과 관광 및 휴식 공간으로 인식하는 사람 사이에서 유의미한 차이가 발생하는 것으로 나타났다. 즉, 향유자들이 문화재에 대해 어떤 가치를 부여하는지에 따라 문화재 향유에 따른 만족 수준과 차원이 다르게 나고 있음을 확인할 수 있었다.제 1 장. 서론 1 제1절 연구 목적 및 필요성 1 제2절 연구 범위와 방법 4 1. 연구범위 4 2. 연구방법 5 제 2 장. 이론적 논의와 선행연구 검토 6 제1절 이론적 논의 6 1. 시민만족도 6 1) 개념 및 의의 6 2) 성과평가 수단으로써 만족도 조사의 유용성 7 3) 시민만족도 측정 9 2. 정부성과 14 1) 개념 14 2) 정부성과에 관한 논의 14 3) 정부성과의 측정 17 제2절 선행연구 검토 18 1. 정부성과와 만족도의 관계 18 2. 정부성과와 만족도 관계에 있어서 서비스 가치의 역할 21 1) 만족도 연구에서 가치 변수의 역할 21 2) 문화재 관리에 있어서 가치에 관한 논의 23 제3절 선행연구의 한계 27 제 3 장. 연구문제와 가설 29 제1절 연구문제 29 제2절 연구가설 29 제 4 장. 연구설계 32 제1절 연구자료 32 1. 분석자료 : 문화유산 향유실태조사 32 1) 조사 개요 32 2) 문화유산 향유실태조사의 내용 33 2. 분석범위 33 제2절 변수의 조작적 정의 및 측정 34 1. 종속변수 34 1) 서비스 전달 35 2) 정보 36 3) 용이성 36 4) 친절성 37 2. 독립변수 : 인지된 성과 37 3. 조절변수 : 서비스에 대한 가치인식 38 4. 통제변수 38 1) 개인적 요인 38 2) 지역적 요인 39 제 5 장. 실증결과 분석 41 제1절 자료의 분석방법 41 제2절 결과분석 42 1. 기술통계량과 상관관계 분석 42 1) 주요 변수들의 기술통계 42 2) 서비스 가치인식 관련 기술통계 42 3) 상관관계 분석 47 2. 연구가설 검증 48 1) 인지된 성과와 만족도 관계에 대한 검증 48 2) 서비스 가치인식의 조절효과에 대한 검증 51 제 6 장. 결론 60 제1절 연구결과 요약 60 제2절 연구 시사점과 한계 64 1. 연구의 시사점 64 2. 연구의 한계 65 참고문헌 67 부록 78 [부록 1] 가설 2-1 분석 결과 : (종속변수 : 서비스 전달 만족도) 78 [부록 2] 가설 2-2 분석 결과 : (종속변수 : 정보 만족도) 81 [부록 3] 가설 2-3 분석 결과 : (종속변수 : 용이성 만족도) 84 [부록 4] 가설 2-4 분석 결과 : (종속변수 : 친절성 만족도) 87 Abstract 91Maste

Corrosion Resistance of Surface and Cross Section of Al-Mg Films on Steel Sheet Prepared by PVD Method

Steel is one of widely used materials in various industries because of its excellent mechanical properties and low manufacturing costs. However it is highly susceptible to aggressive corrosion environments such as seawater, thus surface protection as coatings is necessary when using it properly. Aluminium coatings are used for the corrosion protection of ferrous metal for two main reasons. Firstly, aluminium, with its air-formed passive oxide film, forms an effective barrier layer against attacking materials. Secondly, if the underlying substrate is exposed at, for example, the base of pre-existing defects or corrosion pits, the aluminium coating will afford a degree of sacrificial protection to the substrate. A drawback of pure aluminium is, nevertheless, that since its corrosion potential is not far removed from that of many steels, it is unable to provide adequate levels of sacrificial protection, particularly under natural exposure conditions. If aluminium is alloyed with small amounts of active metals such as magnesium, its corrosion potential can be reduced, leading to a significant improvement in sacrificial properties. Therefore, Al-Mg alloy coating was studied and Al-Mg films using the physical vapor deposition(PVD) method that is drawing great attention as an alternative to the conventional coating process were also examined. In addition, cutting section is inevitable when using the surface-treated steel sheet, thus galvanic corrosion properties of Al-Mg films were also studied. In this experiment, Al-Mg films were deposited onto steel substrates using the eco-friendly PVD method under 10 ~ 31 wt.% Mg contents. The total thickness of every specimen was equal to 5㎛. And then heat treatment was conducted at temperature of 400℃ for 10 minutes. The material properties of Al-Mg films were investigated by using SEM, GDS and XRD. The corrosion behaviour of the Al-Mg films determined using neutral salt fog test and electrochemical techniques. After the salt spray test, corrosion products were analyzed by SEM, EDS and XRD at the beginning, middle, and end of the test. Non heat treated Al-Mg specimens were analyzed after 48h, 96h, 168h, and heat treated Al-Mg specimens were analyzed after 72h, 168h, 240h. Based on the results of the immersion and salt spray tests, heat treated Al-Mg films obviously showed good corrosion resistance compared to non-heat treated Al-Mg films. In the salt spray test in a 5% NaCl environment, Al-Mg films containing 31 wt.% Mg had the most excellent corrosion resistance. In case of the immersion test in a 3% NaCl solution, Al-Mg films ranging from 18 to 22 wt.% Mg had the most excellent corrosion resistance. Also the mechanism of anti-corrosion can be obtained by the analysis of Al-Mg film's corrosion products at each stage. Consequently, the results of these experiments obtained were as follows-. The difference in corrosion properties between the salt spray test and immersion test is considered the density of corrosion products by the difference of oxygen concentration. Therefore, it is needed to apply the method of estimating the corrosion resistance considering the differences according to environmental conditions. -. It is thought therefore that the property of Al-Mg films can be improved by heat treatment and uniform distribution of intermetallic compounds.제 1 장 서 론 1.1 연구 배경 및 목적 1.2 연구 진행 내용 제 2 장 이론적 배경 2.1 진공 및 플라즈마를 이용한 표면처리 2.1.1 플라즈마의 정의 및 이용 2.1.2 플라즈마를 이용한 표면처리 2.1.3 PVD법 2.2 박막의 정의 및 형성 2.2.1 박막의 정의 및 특징 2.2.2 박막의 형성 2.3 내식성 코팅막 2.3.1 부식의 전기화학적 반응 2.3.2 내식성을 위한 금속피복의 분류 제 3 장 실험 방법 3.1 실험 장치 및 박막의 제작 조건 3.1.1 실험 장치 3.1.2 시험편의 준비 3.1.3 막의 제작 및 열처리 3.2 제작 막의 분석 및 내식성 평가 3.2.1 표면 및 단면의 몰포로지 분석 3.2.2 조성분포 분석 3.2.3 성분 상 및 결정구조 분석 3.2.4 전기화학적 내식성 평가 제 4 장 실험 결과 및 고찰 4.1 프로세스 조건에 따른 Al-Mg 막의 재료특성 분석 4.1.1 막의 몰포로지 및 조성분포 분석 4.1.2 성분 상 및 결정구조 분석 4.2 프로세스 조건에 따른 Al-Mg 막의 내식성 평가 4.2.1 Al-Mg 막 표면의 전기화학적 내식성 평가 4.2.2 Al-Mg 막 단면의 전기화학적 내식성 평가 4.3 Al-Mg 막의 부식방식 특성 관계 고찰 4.3.1 Al-Mg 막의 재료특성과 내식성 관계 고찰 4.3.2 방식전위에서 철의 적녹발생 원인 고찰 제 5 장 결

시상하부 뇌실곁핵 세포의 전기생리학적 활성을 조절하는 전압의존성 K+ 통로의 분자생물학적 특성

학위논문 (박사)-- 서울대학교 대학원 : 협동과정뇌과학전공, 2014. 8. 류판동.시상하부에 존재하는 뇌실곁핵(hypothalamic paraventricular nucleusPVN)은 구조적으로 또는 기능적으로 구별되는 이질적인 세포들로 이루어져 있다. 이들 세포들의 전기생리학적 특성과 A-type K+ 전류(IA)의 관련성은 잘 알려져 있지만, 그 분자적 특성에 대해서는 밝혀진 바가 없다. 따라서, 본 연구에서는 IA를 인코딩하는 전압의존성 K+ 통로(voltage-gated K+ channelKv 통로)가 PVN의 전리생리학적인 특성에 관여할 것이라고 가정하고, 성격이 다른 세포 형태(type I, type II)에서의 Kv 통로 발현차이와, 심부전이나 에스트로겐에 의해 그 활성이 변화하는 교감신경조절세포에서의 Kv 통로 발현변화를 살펴보고자 하였다. PVN에서 특정 세포에서의 분자적 정보를 얻기 위해, 단일세포 역전사-중합효소연쇄반응법(single cell reverse transcription-polymerase chain reactionsingle cell RT-PCR) 또는 단일세포 실시간 역전사-중합효소연쇄반응법 (single cell real-time RT-PCR)을 실시하였다. 그 결과, type I, type II 모두에서 다양한 Kv 채널 subunit들의 발현이 관찰되었는데 그 중, Kv4.2와 Kv4.3은 그 발현 정도에 있어서 type II에서보다 type I에서 유의적으로 높게 나타났다. 교감신경조절세포에서도 Kv4.2와 Kv4.3의 발현이 관찰되었는데, 심부전 유발에 따라 그 발현이 다르게 조절되었다. Kv4.2는 증가되고 Kv4.3은 감소되었다. 반면 에스트로겐에 의해서는 Kv4.2만이 선택적으로 감소되었으며 Kv4.3은 변화가 없었다. 또한 IA 의 감소도 함께 관찰되었다. 이러한 에스트로겐의 영향은 바소프레신이 특이적으로 적게 분포되어 있는 dorsal cap 영역에서만 관찰되었다. 위의 연구결과는 Kv4.2와 Kv4.3이 PVN의 type I, type II를 구별하고 교감신경조절세포의 전기생리학적 활성을 조절하는 데 주요하게 작용하며, 질병이나 호르몬 변화에 의해 서로 독립적으로 조절되고 있음을 보여준다. 따라서, Kv 통로는 자율신경계와 내분비계의 기능 이상에 따른 PVN의 신경전달 변화에 참여하는 하나의 기전으로 여겨진다.The hypothalamic paraventricular nucleus (PVN) comprises anatomically and functionally distinct neuronal populations. The A-type K+ current (IA) is involved in their different electrophysiological properties, but the molecular identity responsible for these differences remains unknown. Accordingly, I hypothesized that voltage-gated K+ (Kv) channels encoding IA are molecular components underlying the determination of electrophysiological characteristics, and compared expressions of Kv channel subunits between distinct neuronal populations in the PVN, using single cell analysis (single cell reverse transcription-polymerase chain reaction [RT-PCR] or single cell real-time RT-PCR). Results revealed that several Kv channel subunits were expressed in type I and type II PVN neurons which are electrophysiologically distinct. However, the expression density of Kv4.2 and Kv4.3 was significantly higher in type I than in type II neurons. These two subunits were also expressed in the presympathetic neurons, which project to the rostral ventrolateral medulla (RVLMPVN-RVLM), but were differentially regulated during heart failure: Kv4.2 was up-regulated whereas Kv4.3 was down-regulated. In contrast, estrogen replacement into ovariectomized female rats down-regulated Kv4.2 mRNA levels, but did not affect Kv4.3 in the PVN-RVLM neurons. Estrogen also diminished IA density. These estrogenic effects occurred specifically in the dorsal cap parvocellular subdivision where vasopressin is remarkably sparse. Taken together, Kv4.2 and Kv4.3 are important molecular components underlying the determination of electrophysiological characteristics of different cell types and the modulation of neuronal properties of the presympathetic neurons. The finding of the differential and selective regulations of these two subunits under different pathophysiological conditions suggests that Kv4.2 and Kv4.3 play different roles independently of each other in the coordination of responses of the PVN to various types of stimuli.ABSTRACT CONTENTS LIST OF FIGURES LIST OF TABLES ABBREVIATIONS BACKGROUND CHAPTER I Single cell analysis of Kv channels that determine neuronal types of rat PVN neurons ABSTRACT INTRODUCTION MATERIALS AND METHODS RESULTS DISCUSSION CONCLUSIONS CHAPTER II Differential regulation of Kv4 channel subunits in rat presympathetic PVN neurons after myocardial infarction ABSTRACT INTRODUCTION MATERIALS AND METHODS RESULTS DISCUSSION CONCLUSIONS CHAPTER III Selective regulation of Kv channels in rat presympathetic PVN neurons by estrogen replacement ABSTRACT INTRODUCTION MATERIALS AND METHODS RESULTS DISCUSSION CONCLUSIONS CHAPTER IV Differential distributions of neuropeptides in rat presympathetic PVN neurons ABSTRACT INTRODUCTION MATERIALS AND METHODS RESULTS DISCUSSION CONCLUSIONS GENERAL CONCLUSIONS REFERENCES ABSTRACT IN KOREANDocto

Molecular Testing in Diagnosis of Thyroid Cancer

With increasing prevalence of thyroid nodules, clinicians are increasingly impelled to identify the optimal predictor of thyroid cancer, with the goal of guiding management based on assessed risk. Fine-needle aspiration cytology is the gold standard diagnostic method for thyroid nodules. However, fine-needle aspiration cytology is not perfect and adjuncts which might complement its predictive value are being investigated from several innovative perspectives. For these vigorous efforts, remarkable advances have been achieved in understanding several major biologic areas of thyroid cancer, including the molecular alterations for loss of radioiodine avidity of thyroid cancer, the pathogenic role of the MAP kinase and PI3K/Akt pathways and their related genetic alterations in thyroid tumorigenesis and pathogenesis. These exciting advances provide unprecedented opportunities for development of molecular-based novel diagnostic and therapeutic strategies for thyroid cancer. The common somatic genetic changes in thyroid cancer of follicular cell origin (RET/PTC, NTRK, RAS, BRAF, PAX8-PPARγ) are generally mutually exclusive, with distinct genotype–histologic subtype associations of thyroid cancer. Mutation analysis in fine needle aspiration samples has been applied to improve the diagnostic accuracy. In studies regarding gene expression profiling, aberrant gene methylation and miRNA have shown significant progress toward identification of biomarkers that could improve the accuracy of fine needle aspiration cytology in the evaluation of patients with thyroid nodule and prediction of disease aggressiveness. Future clinical trials evaluating the accuracy and cost-effectiveness of applying these biomarkers in the management of thyroid neoplasm should be considered.ope

Coupling of LETM1 up-regulation with oxidative phosphorylation and platelet-derived growth factor receptor signaling via YAP1 transactivation

Persistent cellular proliferation and metabolic reprogramming are essential processes in carcinogenesis. Here, we performed Gene Set Enrichment Analysis (GSEA) and found that that LETM1, a mitochondrial calcium transporter, is associated with cellular growth signals such as platelet-derived growth factor (PDGF) receptor signaling and insulin signaling pathways. These results were then verified by qRT-PCR and immnunoblotting. Mechanistically, up-regulation of LETM1 induced YAP1 nuclear accumulation, increasing the expression of PDGFB, PDGFRB and THBS4. Consistent with this, LETM1 silencing caused loss of YAP1 nuclear signal, decreasing the expression of PDGFB, PDGFRB and THBS4. Immunohistochemical staining consistently indicated a positive association between LETM1 up-regulation, YAP1 nuclear localization and high PDGFB expression. In clinical data analysis, LETM1 up-regulation in thyroid cancer was found to be related to aggressive tumor features such as lymphovascular invasion (LVI, P < 0.001) and lymph node metastasis (LNM, P = 0.011). Multivariate analysis demonstrated that LETM1 up-regulation increases the risk of LVI and LNM (OR = 3.455, 95% CI = 1.537-7.766 and OR = 3.043, 95% CI = 1.282-7.225, respectively). Collectively, these data suggest that up-regulation of LETM1 induces sustained activation of proliferative signaling pathways, such as PDGF signal pathway by AKT induced YAP1 transactivation, resulting in aggressive thyroid cancer phenotypes.ope

Long-term oncologic outcomes of papillary thyroid mircrocarcinoma according to the presence of clinically apparent lymph node metastasi: a large retrospective analysis of 5,348 patients

Purpose: Active surveillance (AS) of low-risk papillary thyroid microcarcinoma (PTMC) may reduce the risk of overtreatment of clinically insignificant cancer. However, the absence of predictor for the progression of PTMC resulted in treatment delay and potentially compromising cure of aggressive disease. Therefore, to anticipate potential damage of delayed surgery, we investigated the oncologic outcomes of patients with low-risk PTMC initially eligible for AS except clinically apparent lymph node metastasis (LNM), imitating delayed surgery with neck dissection. Materials and methods: A total of 5,348 patients, enrolled between 1987 and 2016, with low-risk PTMC initially eligible for AS were included regardless of LNM. We classified our study patients into two groups: Group I, lobectomy with prophylactic central cervical node dissection; Group II, total thyroidectomy with modified radical neck dissection for LNM. In addition, we investigated the oncological outcomes of patients with second-wave surgery due to lateral lymph node recurrence (Group III, subgroup of Group I). Results: Group I showed more favorable clinicopathological characteristics compared with Group II. In Group I, only 29 (0.58%) of 4,927 patients underwent second-wave surgery with neck dissection for lateral lymph node recurrences, whereas in Group II, all 22 (5.23%) of 421 patients underwent second-wave selective node dissection because of nodal recurrence. Disease-free survival rates were significantly different between Groups I and II (P<0.05). Of note, the recurrence rate of Group II was still significantly higher than that of Group III (5.2% vs 0%, respectively; P=0.021). In addition, Kaplan-Mayer survival analysis indicated poor disease-free survival rates in Group II compared with Group III (P<0.05). Conclusion: The long-term treatment outcome of PTMC without LNM was favorable even if the recurrence occurs during follow-up period compared with that of PTMC with LNM. It should be noted that AS might be able to cause poor prognosis due to clinically apparent LNM.ope

Dynamic risk stratification in medullary thyroid carcinoma: Single institution experiences

Recently, dynamic risk stratification has been found to be more valuable than static anatomic staging system in nonmedullary thyroid cancer and this strategy has also been accepted in medullary thyroid cancer (MTC). The present study was designed to compare the clinical usefulness of response to initial therapy stratification with a traditional anatomic staging system.From August 1982 to December 2012, a total of 144 MTC patients underwent thyroidectomy in Yonsei University Hospital. Among them, 117 (82.2%) patients with complete clinical data and sustained follow-up were enrolled in this study. Clinicopathological features and surgical outcomes were analyzed by retrospective medical chart review. Mean follow-up duration was 85.78 ± 62.51 months.In this study, mean tumor size was 1.94 ± 1.40 cm and 22 (18.9%) patients had hereditary MTC; 95 (81.1%) patients had sporadic MTC. Stage I patients had highest probability of excellent response to initial therapy (92.1%). Stage IV patients had highest probability of biochemical and structural incomplete response to initial therapy (57.5% and 30.3%) and lowest probability of excellent response to initial therapy (12.1%). Both response to initial therapy stratification and TNM staging system offered useful prognostic information in this study. The TNM staging system provided risk stratification pertaining to disease-free survival (DFS), disease-specific survival (DSS), and the probability of having no evidence of disease at final outcome, but did not provide risk stratification pertaining to the probability of having biochemical persistent/recurrence disease at final outcome. However, response to initial therapy stratification provided risk stratification pertaining to not only DFS, DSS, and the probability of having no evidence of disease at final outcome but also the probability of having biochemical persistent/recurrence disease at final outcome.In this study, we demonstrated that dynamic risk stratification with adjusted response to initial therapy system can offer more useful prognostic information than anatomic staging system in MTC.ope