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Multimodality Treatement in Patients with Clinical Stage IIIA NSCLC (임상적 IIIA병기 비소세포폐암의 다각적 치료의 효과)

  • Lee, Yun Seun;Jang, Pil Soon;kang, Hyun Mo;Lee, Jeung Eyun;Kwon, Sun Jung;An, Jin Yong;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.557-566
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    • 2004
  • Background : To find out effectiveness of multimodality treatments based on induction chemotherapy(CTx) in patients with clinical stage IIIA NSCLC Methods : From 1997 to 2002, 74 patients with clinical stage IIIA NSCLC underwent induction CTx at the hospital of Chungnam National University. Induction CTx included above two cycles of cisplatin-based regimens(ectoposide, gemcitabine, vinorelbine, or taxol) followed by tumor evaluation. In 30 complete resection group, additional 4500-5000cGy radiotherapy(RTx) was delivered in 15 patients with pathologic nodal metastasis. 29 out of 44 patients who were unresectable disease, refusal of operation, and incomplete resection were followed by 60-70Gy RTx in local treatment. Additional 1-3 cycle CTx were done in case of induction CTx responders in both local treatment groups. Results : Induction CTx response rate were 44.6%(complete remission 1.4% & partial response 43.2%) and there was no difference of response rate by regimens(p=0.506). After induction chemotherapy, only 33 out of resectable 55 ones(including initial resectable 37 patients) were performed by surgical treatment because of 13 refusal of surgery by themselves and 9 poor predicted reserve lung function. There were 30(40.5%) patients with complete resection, 2(2.6%) persons with incomplete resection, and 1(1.3%) person with open & closure. Response rate in 27 ones with chest RTx out of non-operation group was 4.8% CR and 11.9% PR. In complete resection group, relapse free interval was 13.6 months and 2 year recur rate was 52%. In non-complete resection(incomplete resection or non-operation) group, disease progression free interval was 11.2 months and 2 year disease progression rate was 66.7%. Median survival time of induction CTx 74 patients with IIIA NSCLC was 25.1months. When compared complete resection group with non-complete resection group, the median survival time was 31.7 and 23.4months(p=0.024) and the 2-year overall survival rate was 80% and 41%. In the complete resection group, adjuvant postoperative RTx subgroup significantly improved the 2-year local control rate(0% vs. 40%, p= 0.007) but did not significantly improve overall survival(32.2months vs. 34.9months, p=0.48). Conculusion : Induction CTx is a possible method in the multimodality treatments, especially followed by complete resection, but overall survival by any local treatment(surgical resection or RTx) was low. Additional studies should be needed to analysis data for appropriate patient selection, new chemotherapy regimens and the time when should RTx be initiated.

A Study on Establishment of Technical Guideline of the Installation and Operation for the Efficient Bio-gasification Facility of Pig Manure and Food Waste(II): - Results of the Precision Monitoring - (가축분뇨 병합처리 바이오가스화를 위한 설계 및 운전 기술지침 마련 연구(II) - 정밀모니터링 결과 중심으로 -)

  • Lee, Dongjin;Moon, HeeSung;Son, Jihwan;Bae, Jisu
    • Journal of the Korea Organic Resources Recycling Association
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    • v.25 no.3
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    • pp.91-98
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    • 2017
  • The purpose of this study is to provide a design and operation technical guideline for meeting the appropriate design criteria to bio-gasification facilities treating organic wastes. 9 anaerobic digestion facilities which is normally operated during the field survey and 14 livestock manure farms were selected for precision investigation. the physicochemical analysis was performed on the moisture and organic contents, nutrients composition (carbohydrate, fat, protein), volatile fatty acids (VFAs), and nitrogen, etc. Volatile solids (VS) of organic wastes brought into the bio-gasification facilities were 2.81 % (animal manure only) and 5.92 % (animal manure+food waste), respectively. Total solids (TS) reults of samples from livestock farms were 5.6 % in piglets and 11~13 % in other kinds of breeding pigs. The actual methane yield based on nutrients contents was estimated to $0.36Sm^3CH_4/kgVS$ which is equivalent to 72 % of theoretical methane yield value. The optimum mixing ratio depending on the effect of the combined bio-gasification was obtained through the continuous stirred-tank reactor (CSTR) which is operated at different mixing ratio of swine manure and food waste leachate. The range of swine manure and food waste leachate from 60:40 to 40:60 were adequate to the appropriate conditions of anaerobic digestion; less than 100 gTS/, more than alkalinity of 1 gCaCO3/L, C/N ratio 12.0~30.0, etc.

Effect of Radiation Dose for Radiotherapy on Ovarian Follicle Atresia in Rat (치료 방사선량이 쥐의 난포 퇴축에 미치는 영향)

  • Lee, Won-Jeong;Seon, Jong-Ryul;Yoo, Se-Jong;Ahn, Bong-Seon
    • Journal of Radiation Protection and Research
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    • v.37 no.4
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    • pp.208-212
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    • 2012
  • In previous studies, ovarian follicle in rat has been used a higher radiation dose than that for cancer radiotherapy in clinical practice. The aim of this study was to evaluate the effect of radiation dose used for cancer radiotherapy on ovarian follicle atresia in rat. Mice of 4-week-old female were whole body irradiated with 2 cGy or 2 Gy (Mevatron 67, Siemens, Germany) and sacrificed by cervical dislocation. Ovaries were collected at 24 hours after irradiation to observe the degree of follicular atresia. Ovaries were fixed in neutral formaldehyde solution for 24 hours and embedded with paraffin. Cutted in $5{\mu}m$ thickness with microtome and stained with hematoxylin and eosin (H&E) and TUNEL immunohistochemical stain, and examined histologically under a light microscope. All data were presented as mean ${\pm}SD$, calculating the ratio of normal or atretic follicles to total ovarian follicles. Statistical analysis was performed by the Mann Whitney test using the SPSS ver 19.0. Ratio of atretic to total follicles of 2 Gy group was significantly higher than control or 2 cGy groups (p<0.05). Ratio of normal to total follicles of 2 Gy group was significantly lower than control group in preantral follicle (64.0 vs. 87.7, p=0.027). Ratio of normal to total follicles of 2 cGy group was significantly increased more than control or 2 Gy groups in antral follicle, and there were no significant difference between control and 2 Gy groups (p=0.522). Radiation dose of 2 Gy for cancer radiotherapy have a significant effect on ovarian follicle atresia in rat.

A Study on Anaerobic Treatment and Energy Recovery Technology of Food Waste by Using Hybrid Anaerobic Reactor (Hybrid Anaerobic Reactor를 이용한 음식물쓰레기의 혐기성처리 및 에너지 회수에 관한 연구)

  • Yoon Young-Bong;Park Jin-Young;Ju Jin-Young;Kim Myung-Ho
    • Journal of environmental and Sanitary engineering
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    • v.20 no.1 s.55
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    • pp.64-75
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    • 2005
  • The total production of food waste was about 11,398ton/day('03) in Korea. Also, food waste was treated by landfill, incineration, reuse and anaerobic digestion. The method of food waste treatment depended primarily on landfill. However, the method of landfill causing social problems was prevented to treat food waste in the first of January 2005.12) Thus, anaerobic digestion is an important method to treat food waste because of possibility of energy recovery as methane gas. In this study, the possibility of food waste treatment containing high organic material and low pH in the one stage anaerobic reactor to save cost and time and energy recovery using $CH_{4}$ gas by the hybrid anaerobic reactor (HAR) was measured. The HAR was designed by combing the merits of the anaerobic filter (AF) to minimize the microorganism shock when food waste of very low pH was injected and up-flow anaerobic sludge blanket (UASB) to prevent from plugging and channeling phenomena by large suspended solids when semi solids were injected. Granule was packed in the section of HAR. The purpose of the BMP experiment was to measure the amount of methane generated when organic material was resolved under anaerobic conditions, to grasp bio resolution of organic material. Total accumulated methane production per VS amount was $0.471(m^{3}/\cal{kg}\;VS)$. So, the value was about $81.2\%$ of theoretical methane production which was $0.58(m^{3}/\cal{kg}\;VS)$ by elementary analysis and organic matter removal velocity (K) was $0.18(d^{-1})$. From these results, food waste was treated by anaerobic treatment. From this study, $CH_{4}$ generation from food waste (11,398 ton/day) could be estimated. By using an energy conversion factor of Braun's study, $5.97KWh/m^{3}\;CH4,\;60\%\;of\;CH_{4}$ gas generation, the amount of total energy producing food waste is to 6,727MWh/day. It could be confirmed that energy recovery using $CH_{4}$ gas was possible. Above these results, food waste containing organic matters of high concentration could be treated in HRT 30 days under an anaerobic condition, using the hybrid anaerobic reactor and reuse of $CH_{4}$ gas was possible.

Experimental and Clinical Study of Staple-Line Reinforcement Using Expanded Polytetrafluoroethylene in Thoracoscopic Bullectomy for Spontaneous Pneumothorax (자연 기흉 환자에서 봉합선 보강이 흉강경 폐부분 절제술에 미치는 영향: 동물실험 및 임상연구)

  • 문석환;심성보;왕영필;윤정섭;조건현;박재길;박만실;최시영;곽문섭
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.904-910
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    • 2003
  • Thoracoscopic bullectomy (VATS-B) is now the preferred treatment for spontaneous pneumothorax despite of higher recurrence rate than open thoracotomy. Several methods have been used to prevent this problem. The effectiveness of staple line reinforcement (SLR) in VATA-B using endostaplers was assessed by clinical and experimental study. Meterial and Method: In experimental study, canine lungs were harvested immediately (group I N=5) and 48 hours (group II N=5) after stapling. The pressures at which initial air leaks occurred were measured. In clinical study from February 1997 to March 1999, 106 procedures in 104 patients undergoing VATS-B for spontaneous pneumothorax were classified into two groups according to the presence of SLR and were compared. Result: The average pressure of the initial air leakage was significantly higher in SLR than that of staples alone (18$\pm$1.6 vs 48$\pm$3 mm Hg in group I; 23.8$\pm$1.9 vs 54$\pm$4.6 mm Hg in group II, p<0.001). In the clinical data, there were significant differences seen in the duration of drainage, the total length of endostaplers used, and the duration of the postoperative hospital stay between patients with staple alone and patients with SLR (4.4$\pm$1.4 vs 3.1$\pm$1.1 days in duration of drainage, 92.3$\pm$28.1 vs 71.1$\pm$30.6 mm in total length of endostaplers used, 5.9$\pm$1.9 vs 4.6$\pm$1.7 days in postoperative hospital stays, p<0.001). Conclusion: SLR was effective for preventing prolonged air leakage and responsible for shorter hospital stays after VATS-B for the treatment of spontaneous pneumothorax.

Recognition, purchase, and consumption of edible insects in Korean adults (한국 일부 성인의 식용곤충에 대한 인식, 구매 및 섭취 실태)

  • Park, Eun-Sun;Choi, Mi-Kyeong
    • Journal of Nutrition and Health
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    • v.53 no.2
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    • pp.190-202
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    • 2020
  • Purpose: This study aims to evaluate the recognition, purchase, and intake status of edible insects in adults, who are the main consumers of edible insects, and to provide the information necessary to expand the production and consumption of edible insects and related products in the future. Methods: A total of 453 adults (172 males and 281 females) aged 19 years and older were surveyed regarding their awareness of edible insects, purchase and consumption experience, and intention to purchase and consume, and the differences between them were analyzed according to gender and age groups. Data collection took place from December 2018 to January 2019. Results: Those who had knowledge of edible insects accounted for 87.0%, whereas those who had more than average knowledge were 75.9%, suggesting recognition was relatively high. Men had more experience than women in purchasing or consuming edible insects and related products (45.9% vs. 31.0%, p < 0.01). In terms of age, experience was 22.5% in 20-30s, 44.6% in 40-50s, and 63.1% in 60s and older, showing significant growth as age increased (p < 0.001). The satisfaction level of edible insects was highest in taste (3.4 points), and especially for shape and appearance, it decreased as age reduced (p < 0.001). The most common reason for not being willing to use edible insects was feeling repulsive (4.1 points), which was significantly more common in women than in men (4.3 vs. 3.9, p < 0.001), and lower with age (p < 0.001). The most needed information display for using edible insects was country of origin (63.8%), the main nutrient in edible insects was protein (93.6%), and the most preferred form of products was powder (39.5%). Conclusion: According to the above results, the recognition of edible insects was high, whereas experience of using edible insects and intention to use edible insects were low especially in women and younger groups. The reason for this is that consumers are dissatisfied with edible insects due to their appearance. This study is expected to be used as basic data for expanding the production and consumption of edible insects and related products in the future.

The Relationship between Pesticide Exposure and Central Nervous System Symptoms (농약 노출과 중추신경 증상과의 관련성)

  • Kwon, Young-Jun;Kang, Tae-Sun;Kim, Kyung-Ran;Lee, Kyung-Sook;Ju, Young-Su;Song, Jae-Chul
    • Journal of agricultural medicine and community health
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    • v.29 no.2
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    • pp.265-285
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    • 2004
  • Objectives: The acute toxic effects of pesticide are well known. Concern has also been expressed that long-term exposure may result in damage to the central nervous system. This study was conducted to test the hypothesis that central nervous system symptoms might occur due to pesticide exposure. Methods: In a cross-sectional study, first, cumulative exposure index (CEI) was estimated. Neurologic symptoms (Q-16 questionnaire) for 541 farmers (exposed to pesticides) were compared with 119 non-exposed persons in spraying season nine rural areas in Korea. Results: The pesticides poisoning rates for last 3 months were 67.2% for orchard farmers, 55.3%for dry field farmers, and 20.5% for husbandry farmers, respectively, showing significant difference (p<0.001). Compared with non-exposure group, exposure groups (especially, orchard farmers) reported significantly more neurologic symptoms and had a higher overall neurological symptoms score (p<0.001). Factors related to the positive neurological symptoms (answers "yes" to six or more of Q-16 questionnaire) adjusted for age, sex, education level, smoking and alcohol drinking were type of farming (OR 3.08, 95% CI 1.50-6.30 in orchard farmers vs non-exposure group), CEI (OR 2.75, 95% CI 1.12-6.78 in Q3 vs Q1), past poisoning (OR 1.97, 95% CI 1.21-3.20 vs normal), current mild poisoning (OR 3.03, 9500 CI 1.47-6.22 vs normal) and current moderate poisoning (OR 6.34, 95% CI 3.03-13.25 vs normal), respectively. Conclusions: These results suggest that long-term exposure to pesticides appears to be associated with subtle changes in the central nervous system.

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Possibility of Repeated Use of Elite Donor Cows for Mass Production of OPU-Derived Embryos (OPU 유래 수정란의 대량생산을 위한 고능력 공란우 반복사용 가능성에 관한 연구)

  • Jin, Jong-In;Choi, Byung-Hyun;Kim, Seong-Su;Park, Bun-Young;Lee, Jung-Gyu;Kong, Il-Keun
    • Journal of Embryo Transfer
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    • v.30 no.3
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    • pp.149-159
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    • 2015
  • This study was designed to know the possibility in repeat uses of elite donor cows for getting mass production of OPU-derived embryo production (OPU-IVP). Ultrasound transvaginal ovum pick-up (OPU) performed in 6 Korean native cows was aged 4 to 10 years old. The aspiration of immature oocytes for OPU derived embryo was carried out 2 times per week, and OPU-IVP of $1^{st}$ period was carried out 22~48 sessions from each donors. And the break time for OPU-IVP of $2^{nd}$ period after $1^{st}$ OPU from each donors were 2~25 months. The OPU-IVP of $2^{nd}$ period each donors conducted total 15~65 times for 2~8 months by an ultrasonographic, was guided follicular aspiration system. The average numbers of collected oocytes, grade 1 + grade 2(G1+G2) oocytes and cleavage embryo from $1^{st}$ period OPU-IVP were significantly differences between donors (p<0.05). Total collected oocytes of donor D were significantly higher compared with donors of A, B, C, E and F (average 17.0 per session vs. 11.2, 10.1, 8.5, 10.2 and 9.6; p<0.05) and also oocytes of G1+G2 were significantly higher compared with r A and D and subsequently to donors of B, C, E and F (average 7.9 and 8.5 per session vs. 5.0, 2.7, 6.0 and 1.6; p<0.05). Cleavage rate of donor D was significantly higher compared with donors of A, B, C, E and F (average 13.1 per session vs. 10.1, 9.1, 6.9, 8.9 and 6.7; p<0.05). The average numbers of OPU-IVP for $1^{st}$ period was significantly higher from donors of B, D and E than those from donors of A, C and F (average 6.5, 7.1 and 6.5 per session vs. 3.5, 4.2 and 2.8; p<0.05). The possibility investigation of $2^{nd}$ OPU-IVP was carried out after 2~25 months rest periods from $1^{st}$ period OPU session. Total average numbers of collected oocytes, cleavages and blastocyst development rates were significantly higher from $1^{st}$ period OPU compared with $2^{nd}$ period one (p<0.05). The OPU-IVP efficiency by break for more embryo production from elite cow was analysis comparing without rest of donor A, under 6 months rest period as B and over 6 months rest period as C and then the average numbers of collected oocytes, cleavages and blastocysts were significantly higher from A group (11.8, 9.5 and 5.2 per session) than those from B and C groups (7.9, 6.2 and 2.6 vs. 9.2, 7.5 and 3.9, p<0.05), and also C group was significantly higher than B group. In conclusion, $1^{st}$ period OPU-IVP was more efficient compared with $2^{nd}$ period repeated uses of donor, and the break times for additional production of embryo on donor were needed more than over 6 months after $1^{st}$ period OPU-IVP. This repeating uses of elite donor cows given more emphasis for getting the opportunity on mass production of elite cow OPU-IVP embryo should be increased G1+G2 possibility of genetic improvement of livestock within short period.

Report for Development of Korean Portable Cardiopulmonary Bypass Machine (한국형 이동식 심폐소생기 개발 보고 I. 실험견을 이용한 개흉식과 폐쇄식 심폐소생술 비교)

  • Kim, Hyoung-Mook;Lee, In-Sung;Baek, Man-Jong;Sun, Kyung;Kim, Kwang-Taik;Kim, Yeon-Soo;Kim, Maeng-Ho;Lee, Hye-Won;Lee, Kyu-Back;Kim, Hark-Jei
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.827-836
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    • 1998
  • Background: Effective cardiopulmonary resuscitation (CPR) should provide acceptable hemodynamics for the vital organs during cardiac arrest and early restoration of spontaneous circulation that guarantees long-term, neurologically intact survival. CPR using heart-lung bypass has been suggested as an option for that use. This study was designed to determine the effectiveness of standard CPR techniques, closed-vs. open-chest CPR, which could be used in the future study verifying the role of heart-lung bypass CPR. Material and Method: By using adult mongrel dogs, closed-chest CPR (CCCPR, n=4) and open-chest CPR (OCCPR, n=5) were compared with respects to hemodynamics, restoration of spontaneous circulation(ROSC), and survival. Ventricular fibrillation-cardiac arrest (VF-CA) was induced by electrical shock in all animals. After 4 minutes of cardiac arrest, basic life support (BLS) was applied for 15 minutes and followed by advanced life support (ALS). ALS was maintained until achi ving ROSC but not longer than 30 minutes regardless of the recovery. Resuscitation procedures in either group were standardized by adopting the protocol of American Heart Association. Result: Prearrest baseline hemodynamic data was not different between two groups. During resuscitation, substantially higher systolic pressure was maintained in OCCPR group than in CCCPR group (45$\pm$15 vs. 33$\pm$11 mmHg during BLS, 83$\pm$36 vs. 44$\pm$15 mmHg during ALS; p=NS). Mean pulmonary arterial pressure went up to the level of mean systemic arterial pressures in CCCPR group and to half of that in OCCPR group, and had kept higher in CCCPR group throughout CPR (32$\pm$10 vs. 22$\pm$4 mmHg during BLS and 32$\pm$15 vs. 24$\pm$10 mmHg during ALS; p=NS). ROSC was obtained in 4 of 5 dogs receiving open-chest CPR and 2 of 4 closed-chest CPR. Prolonged survival was noted in all dogs in OCCPR group (6 to 1440 hours) but not in CCPR group (p<.05). Conclusion: These findings indicate that open-chest CPR can be more effective t maintain hemodynamics during cardiac arrest and to obtain restoration of spontaneous circulation and survival. Further experiment will be designed to compare heart-lung bypass CPR with open-chest CPR.

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Comparison of quality of 30:2 vs. 2:30 CPR in manikins (심폐소생술 방법 변화에 따른 quality 비교 - 30:2와 2:30 비교분석실험 -)

  • Uhm, Tai-Hwan;Yoou, Soon-Kyu;Choi, Hea-Kyung;Jung, Ji-Yeon
    • The Korean Journal of Emergency Medical Services
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    • v.14 no.3
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    • pp.71-81
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    • 2010
  • Purpose: To minimize an interruption in chest compression, reduce the hands-off time, the American Heart Association has recommended the ratio of chest compression to ventilation ratio to 30:2 from 2005 CPR guideline to 2010 CPR guideline. However, current studies have shown that the hands-off time was > 10 seconds with that method. For this reason, we devised new CPR method that a ventilation to chest compression ratio of 2:30 to reduce pt assessment time and skipped the assessment step of carotid artery pulse would be a more effective way to reduce the hands-off time & the time to set the CPR. According to the more detailed purpose are listed below. 1) We would like to confirm efficiency of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 to reduce the hands-off time & the time to set the CPR. 2) We would like to evaluate possibility of increasing for chest compression accuracy of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 3) We would like to evaluate possibility of increasing for ventilation accuracy of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 Methods: According to 2005 American Heart Association Guidelines, 60 paramedic students(20 students X freshmen, sophomore, junior) performed 5 cycles of 3~ chest compressions : 2 ventilations after A, B, C evaluation with Laerdal Resusci R Anne SkillReporters. After 5 minutes rest, the 60 students performed 5 cycles of 2 ventilations : 30 chest compressions after A, B evaluation with the manikins between 13 and 17 September 2010. The short reports including speed & accuracy of chest compression, respiratory, CPR cycle were gained from the manikins. Hands-off times were measured by assistants. Results: Recently, the importance of high quality CPR was emphasized in order to perform the CPR faster and more accurate. To find out improving the conventional CPR method, we switch the procedure of the compression and the ventilation. By switching the procedure back and forth, we are able to compare the effectiveness of CPR between two type of CPR method which are 2:30 and 30:2 methods. 2:30 is that the breaths is delivered twice, first and perform 30 compressions while 30:2 perform 30 compressions first and give 2 breaths followed by the ABC method. Also, we verify the effectiveness of the hands off time, compression accuracy of the compression through the comparison of the two procedure as mentioned earlier. Consequently research verified that 2:30 is the efficient by providing faster set up delivering more accurate chest compression. Conclusion: 2:30 can minimize a time delay from cardiac standstill until starting the chest compression. In addition, hands-off time which is an interruption in chest compression can be shortened by 2:30 method, which result to effective oxygenation of coronary artery & maintenance of the bloodstream. Once again, performing the 2:30 method provide lessen hands off time and increase the accuracy of the chest compression.

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