• Title/Summary/Keyword: 임상특성

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Conservative Surgery and Primary Radiotherapy for Early Bresst Cancer: Yonsei Cancer Center Experience (조기 유방암에서 보존적 수술후 방사선치료: 연세암센터 경험)

  • Suh Chang Ok;Lee Hy De;Lee Kyung Sik;Jung Woo Hee;Oh Ki Keun;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.337-347
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    • 1994
  • Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation in 1991 and treated one hundred and fourty patients during the next three years. Purpose : To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five Patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results : Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven Patients were N0 and 27 patients were Nl. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occured at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation pneumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer is Proven to be safe and comfortable treatment method without any major complication. Long-term follow up is needed to evaluate our treatment results in terms of loco-regional control rate, survival rate, and cosmetic effect.

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Type 2 Diabetes Mellitus in Children (소아연령에서의 2형 당뇨병의 임상적 고찰)

  • Park, Jee Min;Yoo, Eun Gyong;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.646-653
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    • 2002
  • Purpose : The incidence of type 2 diabetes mellitus in children has been increasing worldwide recently, which is thought to be related to the increasing prevalence of obesity. We investigated to evaluate the incidence and the characteristics of type 2 diabetes mellitus in children and also analysed the relationship between intrauterine growth retardation and type 2 diabetes mellitus. Methods : We investigated 25 children diagnosed as type 2 diabetes mellitus between March 1990 and December 2000. The analysis was performed retrospectively with medical records based on the clinical characteristics and laborotory findings. Results : Incidence of type 1 and type 2 diabetes mellitus in children has been increasing since 1990. We demonstrated an increase in the percentage of type 2 diabetes mellitus children from 5.3% in 1990 to 21.0% in 2000. Sixty eight percent of patients(17/25) were classified as obese group. Initial symptoms at first visit were polyuria, polydipsia and polyphagia 48%(12/25), asymptomatic glycosuria 40% (10/25), weight loss 8%(2/25) and obesity 4%(1/25). The mean age at diagnosis was $12.9{\pm}1.8$ years. 64%(16/25) of patients had positive family history of type 2 diabetes mellitus. Autoanti-bodies were positive in 18.1%(4/22) of patients. Twenty eight percent (7/25) of patients had an associated disease and two patients had fatty liver in association with obesity. Treatment consisted of diet, exercise, education and oral hypoglycemic agents. Three patients were treated with insulin as well as oral hypoglycemic agents because of poor blood glucose control. Long-term diabetic complications occurred in 4 patients. Intrauterine growth retardtion was found in 34.6%(9/25); 88.9% (8/9) of these patients were non-obese group. Conclusion : The increase in the incidence of type 2 diabetes mellitus in children is thought to be related to the increasing prevalence of obesity. The non-obese group of patients might be associated with intrauterine growth retardation.

Dose distribution at junctional area abutting X-ray and electron fields (X-선과 전자선의 인접조사에서 접합 조사면에서의 선량분포)

  • Yang, Kwang-Mo
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.1
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    • pp.91-99
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    • 2004
  • Purpose : For the head and neck radiotherapy, abutting photon field with electron field is frequently used for the irradiation of posterior neck when tolerable dose on spinal cord has been reached. Materials and methods : Using 6 MV X-ray and 9 MeV electron beams of Clinac1800(Varian, USA) linear accelerator, we performed film dosimetry by the X-OMAT V film of Kodak in solid water phantom according to depths(0 cm, 1.5 cm, 3 cm, 5 cm). 6 MV X-ray and 9 MeV electron(1Gy) were exposes to 8cm depth and surface(SSD 100cm) of phantom. The dose distribution to the junction line between photon($10cm{\times}10cm$ field with block) and electron($15cm{\times}15cm$ field with block) fields was also measured according to depths(0 cm, 0.5 1.5 cm, 3 cm, 5 cm). Results : At the junction line between photon and electron fields, the hot spot was developed on the side of the photon field and a cold spot was developed on that of the electron field. The hot spot in the photon side was developed at depth 1.5 cm with 7 mm width. The maximum dose of hot spot was increased to $6\%$ of reference doses in the photon field. The cold spot in the electron side was developed at all measured depths(0.5 cm-3 cm) with 1-12.5 mm widths. The decreased dose in the cold spot was $4.5-30\%$ of reference dose in the electron field. Conclusion : When we make use of abutting photon field with electron field for the treatment of head and neck cancer we should consider the hot and cold dose area in the junction of photon and electron field according to location of tumor.

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Chemical Composition and Antioxidative Activity of Kiwifruit in Different Cultivars and Maturity (제주산 참다래의 품종 및 숙도에 따른 화학성분과 항산화 활성)

  • Oh, Hyun-Jeong;Jeon, Si-Bum;Kang, Hye-Young;Yang, Young-Jun;Kim, Seong-Cheol;Lim, Sang-Bin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.3
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    • pp.343-349
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    • 2011
  • The chemical composition and antioxidative activity of kiwifruit varieties in Jeju, such as Jecy Gold (Actinidia chinensis var. 'Jecy Gold'), Halla Gold (A. chinensis var. 'Halla Gold'), Jecy Sweet (A. deliciosa var. 'Jecy Sweet') and Hwabuk 94 (A. deliciosa var. 'Hwabuk 94') were investigated. The crude protein, crude lipid, and pH showed no differences among variety and maturity whereas the moisture contents showed differences among the variety and maturity. Jecy Sweet in mature stage showed the highest values in soluble solid, crude protein, crude lipid, and crude ash. The changes in chemical components of kiwifruit by maturity stage were as follows: during ripening, the glucose and the fructose contents increased considerably with the decrease of sucrose content. Potassium, phosphorus, sodium, and magnesium were estimated as the major minerals in kiwifruit and Jecy Sweet contained the highest amounts of potassium and magnesium. At maturity stage, ascorbic, malic and lactic acid were increased with the decrease of citric acid content. The polyphenol contents were 26.81~56.10 ${\mu}g/g$ and 8.64~26.45 ${\mu}g/g$, respectively, in immature and mature fruits. During ripening, the polyphenol content was decreased. The DPPH radical scavenging activity of methanol extracts were 84.47~89.37% and 43.94~76.96% at 500 ppm, respectively, in immature and mature fruits. The immature varieties of kiwifruit have a high DPPH radical scavenging activity. Therefore the chemical composition and physiological activity of kiwifruit was affected by variety and maturity.

Stress distribution following face mask application using different finite element models according to Hounsfield unit values in CT images (CT상의 HU 수치에 따른 상악골 전방견인 효과의 유한요소 분석)

  • Chung, Dong-Hwa
    • The korean journal of orthodontics
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    • v.36 no.6
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    • pp.412-421
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    • 2006
  • Objective: The result of finite element analysis depends on material properties, structural expression, density of element, and boundar or loading conditions. To represent proper elastic behavior, a finite element model was made using Hounsfield unit (HU) values in CT images. Methods: A 13 year 6 month old male was used as the subject. A 3 dimensional visualizing program, Mimics, was used to build a 3D object from the DICOM file which was acquired from the CT images. Model 1 was established by giving 24 material properties according to HU. Model 2 was constructed by the conventional method which provides 2 material properties. Protraction force of 500g was applied at a 45 degree downward angle from Frankfort horizontal (FH) plane. Results: Model 1 showed a more flexible response on the first premolar region which had more forward and downward movement of the maxillary anterior segment. Maxilla was bent on the sagittal plane and frontal plane. Model 2 revealed less movement in all directions. It moved downward on the anterior part and upward on the posterior part, which is clockwise rotation of the maxilla. Conclusion: These results signify that different outcomes of finite element analysis can occur according to the given material properties and it is recommended to use HU values for more accurate results.

Psychosocial Impact of Chronic Orofacial Pain (만성 구강안면통증의 사회심리적 영향)

  • Yang, Dong-Hyo;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.397-407
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    • 2009
  • The aim of the study was to evaluate psychosocial impact of non-dental chronic orofacial pain (OFP) on daily living using the graded chronic pain (GCP) scale. It is also investigated the clinical profile such as demographics, event related to initiation of OFP and prior treatments for patients. During previous 6 months since September 2008, 572 patients (M:F=1:1.5, mean age=34.7 years) with non-dental OFP attended university-based specialist orofacial pain clinic (Dankook University Dental Hospital, Cheonan) to seek care although 63% of them already experienced related treatment for their OFP problem. They visited the most frequently general dental practitioner and orthopedic doctors due to their pain problem and medication was the most commonly employed modality. Most of the patients (89.2%) had TMD and the most common related event to initiation of their pain was trauma, followed by dental treatment. Almost half of the patients (46%) suffered from chronic pain(${\geq}6\;M$) and 40% of them exhibited relatively high disability due to chronic OFP. GCP pain intensity and disability days were significantly different for age and diagnosis (p<0.05) but not for gender and duration. GCP grades were affected by all the factors including gender, age, pain duration and diagnosis.(p=0.000) Female gender, elders, and long lasting pain were closely related to high disability. The patients with neuropathic Pain and mixed OFP rather than TMD were graded as being highly disabled. Conclusively, a considerable percentage of chronic OFP patients reports high pain-related disability in their daily, social and work activity, which suggest a need for psychosocial support and importance of earlier referral for appropriate diagnosis and tailored management.

A histomorphometric study on the effect of surface treatment on the osseointegration (티타늄 임플란트의 표면처리가 골유착에 미치는 영향에 관한 조직형태계측학적 연구)

  • Choi, Woong-Jae;Cho, In-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.4
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    • pp.445-456
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    • 2009
  • Statement of problem: Many studies have been conducted to improve the primary stability of implants by providing bioactive surfaces via surface treatments. Increase of surface roughness may increase osteoblast activity and promote stronger bonding between bone and implant surface and it has been reported that bioactive surface or titanium can be obtained through alkali and heat treatment. Purpose: The purpose of this study was to evaluate the stability of alkali and heat treated implants via histomorphometric analysis. Material and methods: Specimens were divided into three groups; group 1 was the control group with machined surface, the other groups were treated for 24 hours in 5 M NaOH solution and heat treated for 1 hour at $600^{\circ}C$ in the atmosphere (group 2) and vacuum (group 3) conditions respectively. Surface characteristics were analyzed and fixtures were implanted into rabbits. The specimens were histologically and histomorphometrically compared according to healing periods and change in bone composition were analyzed with EPMA (Electron Probe Micro Analyzer). Results: 1. Groups treated with alkali and heat showed increase of oxidization layer and Na ions. Groups 2 which was heat treated in atmosphere showed significant increase of surface roughness (P<.05). 2. Histomorphometric analysis showed significant increase in BIC (bone to implant contact) according to increase in healing period and there was significant increases in groups 2 and 3 (P<.05). 3. BA(bone area) ratio showed similar results as contact ratio, but according to statistical analysis there was significant increase according to increase in healing period in group 2 only (P<.05). 4. EPMA analysis revealed no difference in gradation of bone composition of K, P, Ca, Ti in surrounding bone of implants according to healing periods but groups 2 and 3 showed increase of Ca and P in the initial stages. Conclusion: From the results above, it can be considered that alkali and heat treated implants in the atmosphere have advantages in osseointegration in early stages and may decrease the time interval between implantation and functional adaptation.

Microbial Safety and Quality of Fresh Carrot Juice Prepared with Different Environmentally-Friendly Washing Methods (친환경 세척제의 처리 방법을 달리하여 착즙한 당근 주스의 미생물 안전성 및 품질)

  • Lim, Sang-Wook;Choe, Da-Jeong;Kang, Min-Jung;Kim, Jong-Hyun;Kim, Myo-Jeong;Kim, Min-Ju
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.10
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    • pp.1225-1233
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    • 2017
  • The aim of this study was to evaluate the microbial inhibitory activity and physicochemical quality of fresh carrot juice prepared with different environmentally-friendly washing methods during low temperature storage. Individual and combined treatments with sodium bicarbonate (baking soda, $NaHCO_3$) and citric acid were applied to carrots for 10 min. Tap water and 50 ppm of sodium hypochlorite (NaOCl) were used as the control. Combined treatment of 1% $NaHCO_3$ and 1% citric acid significantly reduced total aerobic counts and coliforms. In addition, combined treatment of 1% $NaHCO_3$ and 1% citric acid inhibited microbial growth for 7 days at $4^{\circ}C$ and $10^{\circ}C$ in a shelf-life study. There were no significant differences among the sanitizers in terms of $^{\circ}Brix$, acidity, pH, and color. Changes in physicochemical quality were not significantly different by sanitizer but were affected by storage temperature. These results indicate that washing with combined treatment of 1% $NaHCO_3$ and 1% citric acid is an effective method to inhibit the microbial population and maintain physicochemical quality. Therefore, combined treatment of 1% $NaHCO_3$ and 1% citric acid can be effectively used to sanitize and prepare carrot juice without affecting other properties.

Clinicopathologic Evaluation of Gastric Polyps Remainding in the Stomach after a Gastrectomy (위 절제술 후 발생한 위 폴립의 임상 병리학적 특징)

  • Yoon, Ki-Young;Cho, Sung-Jin;Kim, Jeong-Hon;Kim, Young-Sik;Lee, Sang-Ho
    • Journal of Gastric Cancer
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    • v.5 no.3 s.19
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    • pp.169-173
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    • 2005
  • Background: Gastric polyps encompass a wide variety of lesions that most commonly arise from the gastric epithelium. However, coincidental gastric carcinomas have rarely been reported, being found in $1.5{\sim}2.1%$ of patients with hyperplastic polyps. The sizes and the pathologies of polyps seem to be important in the application of treatment. Therefore, it is necessary to classily gastric polypoid lesions after a gastrectomy. Materials and Methods: During a follow-up endoscopy study, 23 patients were found to have developed gastric polyps after a gastrectomy. Most of those polyps were removed by using an endoscopic polypectomy. We performed clinical and pathologic evaluations of the gastric polyps in the remainding in the stomach after a gastrectomy, Results: The mean age of the patients was 64.5 years old with the incidence of polyps remainding in the stomach after a gastrectomy increasing after the first year following the gastrectomy. The sizes of the polyps ranged from 0.3cm to 3.5cm in diameter and the numbers of polyps below 1.0cm were 19 (82.6%). The anastomotic site was the most prevalent place 10 (43.2%), followed by the cardia 6 (26.0%) and the body 4 (17.3%). Among 23 gastric polypoid lesions Yamada types of gastric polyps in the remainding in the stomach were as follows: 1 case in type I, 12 cases in type II, 9 cases in type III, 1 case in type IV. The pathologic diagnoses of the polyps were hyperplastic polyps in 6 cases, tubular adenomas in 2 cases and inflammatory polyps in 15 cases. Conclusion: Endoscopic polypectomy is believed to be important in assessing the precise diagnosis of gastric polyps remainding in the stomach. In this study, hyperplastic polyps were found to have no malignant potential, despite their sizes. As a result aggressive biopsy with a polypectomy of gastric polyp afier gastrectomy is recommended and frequent follow-up be performed.

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Primary Adenosquamous Carcinoma of the Stomach (위에서 발생한 선-편평세포암종)

  • Cho, Yong-Kwon;An, Ji-Yeong;Hong, Seong-Kweon;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.31-35
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    • 2006
  • Purpose: A primary adenosquamous carcinoma of the stomach is relatively rare, accounting for only about 0.5% of all gastric cancers. However, its histopathologic characteristics are still unclear, and the most appropriate form of therapy has not been established yet. Materials and Methods: We retrospectively reviewed the clinicopathologic features of 8 patients with pathologically confirmed primary adenosquamous carcinomas out of 8,268 patients who underwent gastric cancer surgery at Samsung Medical Center between September 1994 and December 2004. Results: The median age of the 8 patients was 49 ($41{\sim}69$) years, and the male : female ratio was 5 : 3. In 3 patients, the tumor was located at the mid body of the stomach, and in 5 patients, at the lower body or antrum. The tumor sizes were $2.5{\sim}8cm$. Seven patients showed metastases to the regional lymph nodes. The UICC stage distribution were: 5 stage II, 2 stage III, and 1 stage IV. In the stage IV patient, a palliative gastrojejunostomy was performed, and he died 5 months after surgery. Of the 7 patients who underwent a radical gastrectomy and adjuvant chemotheratpy, the median survival was 34 ($12{\sim}66$) months, 2 patients died of cancer recurrence, and 4 patients are being followed up without evidence of recurrence. Conclusion: As for an adenocarcinoma of the stomach, a radical gastrectomy including regional lymph node dissection and postoperative adjuvant therapy should be performed for appropriate treatment of an adenosquamous carcinoma of the stomach.

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