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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.

Annealing Cycle Dependence of MR Properties for Free Layer in $Ni_{25}Mn_{75}-Spin$ Valve Films ($Ni_{25}Mn_{75}-Spin$ Valve 박막 자유층의 열처리 순환수에 따른 자기저항 특성)

  • 이낭이;이주현;이가영;김미양;이장로;이상석;황도근
    • Journal of the Korean Magnetics Society
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    • v.10 no.2
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    • pp.62-66
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    • 2000
  • Annealing cycle number and nonmagnetic layer thickness dependences of interlayer coupling field ( $H_{inf}$ ) and coercivity ( $H_{cf}$ ) of free magnetic layer on NiMn alloy-spin valve films (SVF) were investigated. The SVF is Glass (7059)/N $i_{81}$F $e_{l9}$(70 $\AA$)/Co(10 $\AA$)/Cu(t $\AA$)/Co(15 $\AA$)N $i_{81}$$Fe_{19}$(35 $\AA$)/N $i_{25}$M $n_{75}$(250 $\AA$)Ta(50 $\AA$) films, it were fabricated using the dc sputtering method at different pinning layer thickness and nonmagnetic spacer thickness (Cu thickness; 30 $\AA$, 35 $\AA$, 40 $\AA$) of NiMn alloy with 25 at.%. Ni In case that Cu thickness of SVF is 35 $\AA$ and peak exchange coupling field ( $H_{ex}$) was 620 Oe, while coercivity $H_{c}$ = 280 Oe and MR ratio showed 2.5%. As for $H_{inf}$ and $H_{cf}$ , every SVF increased up to the stabilized values with the increase of annealing cycle number 15, which were $H_{inf}$ of 120 Oe and $H_{cf}$ of 75 Oe. The increase of $H_{cf}$ with the annealing cycle number seems to be caused by the effective reduction of Cu layer thickness due to the increase of interfacial mixing of Cu layer and Co layer. In addition, the $H_{inf}$ and $H_{cf}$ dependences of free NiFe layer by the interfacial mixing effect were appeared the different aspects when Cu layer becomes more thinner and thicker than Cu layer thickness of 35 $\AA$, respectively.ively....

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The Study of Reducing Radiation Exposure Dose and Comparing SUV According to Applied IRIS (Iterative Reconstruction in Image Space) for PET/CT (PET/CT 검사 시 IRIS (Iterative Reconstruction in Image Space) 적용에 따른 CT 피폭선량 감소와 PET SUV 비교 연구)

  • Do, Yong Ho;Song, Ho Jun;Lee, Hyung Jin;Lee, Hong Jae;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.29-34
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    • 2012
  • Purpose : Presently, hardwares and softwares for reducing radiation exposure are continually developed for PET/CT examination. Purpose of this study is to evaluate effectiveness of reducing radiation exposure dose of CT and SUV changes of PET when applied each kernel to ACCT (Attenuation Correction Computed Tomography) according to adopted IRIS (Iterative Reconstruction in Image Space) software. Materials and Methods : Biograph mCT (Siemens, Germany) was used as a PET/CT scanner. Using AAPM CT performance phantom, from standard (120 kVp, 100 mAs), 7 scans were conducted by reducing 15 mAs each. After image reconstruction by FBP (Filtered Back Projection) and IRIS, noise and spatial resolution were evaluated. The same method was applied to anthropomorphic chest phantom and acquired images were compared. NEMA IEC body phantom was used for SUV evaluation. Injected dose rate for hot sphere (hot) and background cylinder (BKG) were 1:8. CT dose condition (120 kVp, 50 mAs) was the same for each scan and PET scan durations were 1, 2, 3 and 4min. After scanning, each kernel of IRIS was applied to ACCT. And PET images were reconstructed by ACCT adopted IRIS for comparing SUV changes. Results : AAPM phantom test for noise evaluation, SD for FBP 100 mAs, IRIS 55 mAs were 8.8 and 8.9. FBP 85 mAs, IRIS 40 mAs were 9.5 and 9.7. FBP 70 mAs, IRIS 25 mAs were 11.9 and 11.1. Above mAs condition for FBP and IRIS, SD showed similar values. And for spatial resolution test, there was no significant difference. For chest phantom test, when applied the same mAs and kernel to both of FBP and IRIS, every applied kernels showed reduced noise. Lower mAs and higher kernel value showed higher noise reduction. There was no considerable difference only except for I70 very sharp kernel for SUV comparison using NEMA IEC body phantom. Conclusion : In this study, low mAs (55 mAs) applied IRIS and standard mAs (100 mAs) applied FBP showed similar noise. And only except for I70 kernel, there was no significant SUV changes. It is possible to reduce needless radiation exposure and acquire better image quality than FBP's through applying appropriate kernel of IRIS to PET/CT.

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Development of Neural Network Based Cycle Length Design Model Minimizing Delay for Traffic Responsive Control (실시간 신호제어를 위한 신경망 적용 지체최소화 주기길이 설계모형 개발)

  • Lee, Jung-Youn;Kim, Jin-Tae;Chang, Myung-Soon
    • Journal of Korean Society of Transportation
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    • v.22 no.3 s.74
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    • pp.145-157
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    • 2004
  • The cycle length design model of the Korean traffic responsive signal control systems is devised to vary a cycle length as a response to changes in traffic demand in real time by utilizing parameters specified by a system operator and such field information as degrees of saturation of through phases. Since no explicit guideline is provided to a system operator, the system tends to include ambiguity in terms of the system optimization. In addition, the cycle lengths produced by the existing model have yet been verified if they are comparable to the ones minimizing delay. This paper presents the studies conducted (1) to find shortcomings embedded in the existing model by comparing the cycle lengths produced by the model against the ones minimizing delay and (2) to propose a new direction to design a cycle length minimizing delay and excluding such operator oriented parameters. It was found from the study that the cycle lengths from the existing model fail to minimize delay and promote intersection operational conditions to be unsatisfied when traffic volume is low, due to the feature of the changed target operational volume-to-capacity ratio embedded in the model. The 64 different neural network based cycle length design models were developed based on simulation data surrogating field data. The CORSIM optimal cycle lengths minimizing delay were found through the COST software developed for the study. COST searches for the CORSIM optimal cycle length minimizing delay with a heuristic searching method, a hybrid genetic algorithm. Among 64 models, the best one producing cycle lengths close enough to the optimal was selected through statistical tests. It was found from the verification test that the best model designs a cycle length as similar pattern to the ones minimizing delay. The cycle lengths from the proposed model are comparable to the ones from TRANSYT-7F.

Middle School Students' Perception of Body Image and Allowance for Plastic Surgery (중학생의 신체상 지각수준과 성형수술 허용도)

  • Bae, Jin-Ju;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.5
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    • pp.25-42
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    • 2004
  • This study set out to investigate the relations between middle school students' perception of body image and their allowance for plastic surgery, to understand their perception of body image and desire for plastic surgery, and provide some data needed to warn against reckless plastic surgery and guide the students effectively. For those purposes, an examination was conducted of the relationships between the individual characteristics and perception levels of body image, the individual characteristics and allowance for plastic surgery, and perception levels of body image and allowance for plastic surgery. The subjects were drawn from sour middle schools located in two regions of Gyeonggi Province. Total 922 boys and girls were surveyed on a questionnaire, which was developed based on the pretest of previous literature, reviewed for appropriateness, and tested for reliability and reasonableness. The body image on the five scale was greater as the perception level was higher. The allowance for plastic surgery was also greater as the scores were more. The findings were as follows: First, the relationships between individual characteristics and perception levels of body image were examined. The third graders showed the highest perception level, being followed by the first and second graders. The girls were more perceptive than the boys, and those who were extrovert were more perceptive than those who were introvert. Those students whose parents earned 2 million won or more a month and who adapted themselves to the environmental changes had a higher perception level. In a word, the girls from the middle class that were well adapted, felt happy, and were extrovert had a higher perception level of body image. Second, the connections between individual characteristics and allowance for plastic surgery were investigated. The third graders were the most admissive of plastic surgery, followed by the second and first graders. That is, the upper graders were more admissive of plastic surgery. In addition, the girls were more admissive than the boys, and those who were extrovert were more than those who were introvert. There were no significant differences according to the monthly income of the parents, grades, adaptability to surroundings, and happiness, which results almost resembled the findings of a study conducted on adults. Third, there were negative correlations found between the perception levels of body image and the allowance for plastic surgery. To elaborate, the higher the perception levels were, the lower the allowance was, and vice versa. As for the items, the subjects showed more allowance for plastic surgery when they scored less in the item of caring about appearance, importance of looking pretty to others, and efforts to improve appearance. When they had a low value of body and easily felt tired, they were highly acceptive of plastic surgery. The allowance for plastic surgery was also great when their perception was much of how healthy they felt, how important they felt about their bodies, how they were satisfied with their current appearances, how they evaluated the appearance of others, how much they were satisfied physically, and how much demanding they were for physical changes. Meanwhile, there were no correlations between the allowance and physical attraction, the degree for one's activities to be hindered, and sickness. In short, the demand for plastic surgery was 41% for the girls and 20.2% for the boys. Just as the study on adults reported, those who had a low or negative perception of body image were more acceptive of plastic surgery. The middle school students were generally positive about their bodies with the lowest perception level at 2.91 and the highest at 3.21. Their individual allowance for plastic surgery was related to their individual body images, which were in turn affected by the mass communication, surrounding environments, and social values. Thus it's necessary for the entire society to try to improve or change the overall perception. Helping measures should be taken so that the students can form right sense of values about their bodies, avoid the obsession with appearance and appearance-based evaluation, and exercise righteous criteria against humans beings and things. In conclusions, the following suggestions were made: they need to develop such questionnaires or tools as can measure the body image of teens and fit the reality. Moreover, body image improvement programs should be more diverse and more applicable to teens. Despite the consistent reports that prove the correlations between body image and plastic surgery, there has been little effort to apply such factors as experience of the life of the disabled, volunteer activities for the disabled and at the hospitals, and others that can induce changes to body image to the body image improvement programs. In the future, comparative research should be carried out on body image and plastic surgery.

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Distribution of Cadminum Fractions in Paddy Soils and Their Relation to Cadmium Content in Brown Rice (답토양중(畓土壤中) Cadmium의 형태별(形態別) 분포(分布)와 현미중(玄米中) Cadmium 함량(含量)과의 관계연구(関係硏究))

  • Lim, Sun-Uk;Kim, Sun-Kwan
    • Korean Journal of Soil Science and Fertilizer
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    • v.16 no.1
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    • pp.28-35
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    • 1983
  • The object of this study was to investigate the distribution of Cd fractions in paddy soils in relation to some soil characteristics and to find out the relationships between soil Cd fractions and Cd content in brown rice. Thirty six soils and rice samples were collected from the paddy field adjacent to zinc mining sites at harvest time in 1981. Total Cd content of brown rice samples was analyzed. A sequential extraction procedure was used to fractionate Cd in soils into the designated forms of exchangeable, adsorbed, organically bonded, carbonate, sulfide, and residual Cd. The results obtained were as follows: 1. The distribution of Cd fractions in soil showed a wide difference depending on soil properties. As an average value it was observed that organically bonded Cd amounted 43.7%; residual Cd, 6.5%; and other fractions, 10-15%. 2. With higher soil pH, organically bonded and carbonate Cd fraction tended to be higher but exchangeable fraction lower. Other forms of Cd showed no difference with soil reaction. 3. Organically bonded fraction was positively correlated with soil organic matter content, while others except adsorbed fraction showed an adverse tendency. 4. The relation of fraction distribution to soil C E C was similar to the case of organic matter. 5. Cadmium content in brown rice showed significant possitive correlation with organically bonded Cd content (r = 0.655) and carbonate, Cd content of soil (r = 0.328) but there was no significant correlation with contents of other forms.

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Seasonal Variations in Mood and Behavior in Korean High School Students (한국의 고등학생에서 기분과 행동의 계절적 변동)

  • Lee, Moon-Soo;Joung, Yoo-Sook;Hong, Sung-do-David;Ko, Young-Hoon;Kim, Seung-Hyun;Joe, Sook-Haeng;Jung, In-Kwa;Kim, Leen;Lee, Heon-Jeong
    • Sleep Medicine and Psychophysiology
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    • v.12 no.2
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    • pp.111-116
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    • 2005
  • Objectives: Although many reports have been written on seasonal variations in mood and behavior in foreign countries, few reports have dealt with Korean adolescents, except medical students. The goal of this study was to estimate the frequency of seasonal variations in mood and behavior among Korean high school students. Methods: A total of 656 high school students living in southeastern Seoul participated in this study. The subjects were investigated with the Korean translated version of the Seasonal Pattern Assessment Questionnaire (SPAQ), and their responses were evaluated for seasonal patterns in mood and behavior change according to Kasper's criteria to make SAD (seasonal affective disorder) or SSAD (subclinical seasonal affective disorder) diagnosis. Results: A total of 565 subjects completed the questionnaire and the responses (M:F=324:241) were collected and used for analysis. The mean age was 16.73 (SD=0.65) years, and mean global seasonality score 5.88 (SD=4.72). Of the respondents, 413 (73.1%) reported problems related with seasonal changes. Total prevalence rates were 13.6% for SAD, 10.8% for S-SAD. The estimated frequencies were 5.1% for summer SAD, 3.2% for summer S-SAD, 0.5% for winter SAD and 1.1% for winter S-SAD. The prevalence rate of summer SAD or S-SAD was higher than winter SAD or S-SAD. Conclusion: The subjects showed a higher prevalence rate of summer type than winter type in SAD or S-SAD. These results were similar to those of other studies carried out in East Asian countries. However, the unpleasant feelings resulting from high temperature and humidity in summer rather than depression may have influenced the results. Therefore, it is necessary to make new SAD criteria of the SPAQ suitable for East Asian countries.

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An Experimental Study on Time Dependency of Strain for Saturated Clay (포화점토(飽和粘土)의 변형(變形)에 있어서 시간의존성(時間依存性)에 관한 실험적(實驗的) 연구(研究))

  • Park, Byong Kee;Lee, Jin Soo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.4 no.3
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    • pp.43-52
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    • 1984
  • This paper is concerned with the strain characteristics of the time effect on the remoulded saturated day sampled from the downstream of the Yeongsan river, and the constitutive equation that can generally explain time-dependent behaviors of norma1ly consolidated clay. This paper examines whether or not the afore-said constitutive equation can be applied to the remoulded Mooan-clay. Throughout this study, the conclusions obtained are as follows. 1. Throughout the isotropic consolidation test for 7 days and the isotropic relaxation test, the existence of the static and dynamic yielding surfaces is confirmed respectively. 2. The characteristics of time effect of the deformation, namely, the existence of a unique stress-strain-time relation, is conformed from the experimental result on the Mooan-clay. 3. The prodictions of the stress path and the strain on the Cam-clay theory is not consistent with those observed during the experiments. 4. Constitutive equation(2-3-12) obtained by applying Cam-clay theory to Perzyna's elastic-viscoplasticity theory can explain the behavior of pore water pressure during isotropic stress relaxation, concerned with time dependency under undrained condition. The equation can also explain the results of the undrained triaxial compression test for the clay with different strain rate under the same or different consolidation history. 5. This constitutive equation has eight material parameters which can be determined from triaxial compression tests.

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Nationwide surveillance of acute interstitial pneumonia in Korea (급성 간질성 폐렴의 전국적 현황 조사)

  • Kim, Byoung-Ju;Kim, Han-A;Song, Young-Hwa;Yu, Jinho;Kim, Seonguk;Park, Seong Jong;Kim, Kyung Won;Kim, Kyu-Earn;Kim, Dong Soo;Park, June Dong;Ahn, Kang Mo;Kim, Hyo-Bin;Jung, Hyang-Min;Kang, Chun;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.324-329
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    • 2009
  • Purpose : Acute interstitial pneumonia (AIP) is a rare disease, but its prognosis is fatal because of lack of efficient treatment modality. Recently, it has been reported that there was epidemic AIP in Korea. This study aims to investigate the past and current status of AIP in Korea. Methods : We performed a nationwide survey and a prospective study. From August 6 to 15, 2008, a questionnaire survey was conducted to identify the prevalence, local distribution, and response to current treatments. The questionnaire was answered by pediatrician working in 23 referral centers in Korea. In addition, 5 referral centers in Seoul performed a preliminary prospective observational study by obtaining clinical data and specimens from appropriate patients. The Korea Centers for Disease Control and Prevention analyzed the samples for possible pathogens. Results : The survey showed 78 AIP cases had occurred and 36 patients had died. Lung biopsy was performed only on 20 patients. In 2008, 9 AIP cases developed. In a prospective study, 9 (M:F=5:4) patients developed AIP in spring and 7 (78%) died, with the mean rate of death occurring 46 days after diagnosis. Human corona virus 229E, cytomegalovirus, influenza A virus, influenza B virus, and parainfluenza virus were isolated from the respiratory specimens. Conclusion : This study showed nationwide prevalence of AIP in Korea. In addition, because of the high mortality rate and rapid progress, pediatricians need to be aware of the disease. Further studies and a nationwide network are required for reducing the morbidity and mortality rates related to AIP.

Effects of Dietary Ginger and Scutellaria Dry Powder on Antioxidant Capacity and IgG Concentration in Colostrum and Plasma of Sows (모돈에 대한 생강 및 황금 분말 급여가 초유와 혈청의 항산화력과 IgG 농도에 미치는 영향)

  • Lee, Sung-Dae;Jung, Hyun-Jung;Kim, In-Cheul;Park, Jun-Cheol;Kim, Sang-Bum;Cho, Sung-Back;Song, Young-Min
    • Journal of Animal Science and Technology
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    • v.52 no.5
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    • pp.399-406
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    • 2010
  • The objective of this study was to investigate the effects of dietary ginger and Scutellaria on antioxidant capacity and IgG concentration in plasma and colostrum of sows. Twenty-four sows (Landrace $\times$ Yorkshire) in parity 2 were assigned to 3 treatment groups (8 sows per treatment) from 30 day before farrowing up to weaning on day 21 after farrowing. The treatment diets included 1) CON (Basal diet), 2) GDP (0.3% ginger dry powder was used as the replacement of wheat in basal diet) and 3) SDP (0.3% Scutellaria dry powder was used as the replacement of wheat in basal diet). No differences were found in antioxidant capacity and IgG concentration in plasma of sows among all the three treatments. Antioxidant capacity in colostrum was not affected by replacement of ginger and Scutellaria dry powder. IgG and protein concentration in colostrum was significantly higher (P<0.05) in GDP than that in CON and SDP. However, fat and lactose concentration were not affected by treatments. The total amino acid concentration in colostrum was significantly higher (P<0.05) in GDP than that in CON and SDP. Plasma antioxidant capacity was not affected by treatments in piglet on 0 day and 21 day, but tended to increase by supplementation of ginger. On 0 day, plasma IgG in piglet was not detected by replacement of ginger and Scutellaria dry powder. However, plasma IgG concentration in piglets on 21 day was significantly higher (P<0.05) in GDP than that in CON and SDP. These results indicate that colostrum IgG concentration in sows and plasma IgG concentration in piglets were improved by feeding ginger dry powder 30 days before farrowing in comparison to basal diet.