• Radiation Oncology Journal
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• v.26 no.4
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• pp.213-221
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• 2008

Purpose: The objective of this retrospective study was to identify predictive factors for the complete pathologic response and tumor downstaging after preoperative concurrent chemoradiotherapy for locally advanced rectal cancer. Materials and Methods: Between the years 2000 and 2008, 39 patients with newly diagnosed rectal cancer without prior evidence of distant metastasis received preoperative concurrent chemoradiotherapy followed by surgery. The median radiation dose was 50.4 Gy (range, $45{\sim}59.4\;Gy$)). Thirty-eight patients received concurrent infusional 5-fluorouracil and leucovorin, while one patient received oral capecitabine twice daily during radiotherapy. Results: A complete pathologic response (CR) was demonstrated in 12 of 39 patients (31%), while T-downstaging was observed in 24 of 39 patients (63%). N-downstaging was observed in 18 of 28 patients (64%), with a positive node in the CT scan or ultrasound. Two patients with clinical negative nodes were observed in surgical specimens. The results from a univariate analysis indicated that the tumor circumferential extent was less than 50% (p=0.031). Moreover, the length of the tumor was less than 5 cm (p=0.004), while the post-treatment carcinoembryonic antigen (CEA) levels were less than or equal to 3.0 ng/mL (p=0.015) and were significantly associated with high pathologic CR rates. The univariate analysis also indicated that the adenocarcinoma (p=0.045) and radiation dose greater than or equal to 50 Gy (p=0.021) were significantly associated with high T-downstaging, while a radiotherapy duration of less than or equal to 42 days (p=0.018) was significantly associated with N-downstaging. The results from the multivariate analysis indicated that the lesser circumferential extent of the tumor (hazard ratio [HR] 0.150; p=0.028) and shorter tumor length (HR, 0.084; p=0.005) independently predicted a higher pathologic CR. The multivariate analysis also indicated that a higher radiation dose was significantly associated with higher T-downstaging (HR, 0.115; p=0.025), while the shorter duration of radiotherapy was significantly associated with higher N-downstaging (HR, 0.028; p=0.010). Conclusion: The circumferential extent of the tumor and its length was a predictor for the pathologic CR, while radiation dose and duration of radiotherapy were predictors for tumor downstaging. Hence, these factors may be used to predict outcomes for patients and to develop further treatment guidelines for high-risk patients.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.293-299
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• 2000

Purpose :We conducted a prospective non-randomized clinical study to evaluate the efficacy and toxic of the preoperative concurrent chemoradiotherapy for locally advanced unresectable rectal cancer. Materials and Methods: Between January 1995 and June 1998, 37 conecutive patients with locally unresectable advanced rectal cancer were entered into the study. With 3- or 4- fields technique, a total of 45 Gy radiation was delivered on whole pelvis, followed by 5.4 Gy boost to the primary tumor in some cases. Chemotherapy was done at the first and fifth week of radiation with bolus i.v. 5-Fluorouracil (FU) 370$\~$450 mg/m$^{2}$, days 1$\~$5, plus Leucovorin 20 mg/m$^{2}$, days 1$\~$5. OF 37 patients, 6 patients did not receive all planned treatment course (refusal in 4, disease progression in 1, metastasis to lung in 1). Surgical resection was undergone 4$\~$6 weeks after preoperative concurrent chemoradiotherapy. Results :Complete resection rate with negative margins was 94$\%$ (29/31). Complete response was seen in 7 patients (23$\%$) clinically and 2 patients (6$\%$) pathologically. Down staging of tumor occured in 21 patients (68$\%$). Treatment related toxicity was minimal except grade III & IV leukopenia in 2 patients, respectively. Conclusion : Preoperative concurrent chemoradiotherapy in locally advanced rectal cancer was effective in inducing down staging and complete resection rate. Treatment related toxicity was minimal. Further follow up is on-going to determine long term survival following this treatment.

• Radiation Oncology Journal
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• v.24 no.1
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• pp.21-29
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• 2006

Purpose: This study explored the anal sphincter-saving rate and down-staging rate after preoperative chemoradiotherapy for treating lower rectal cancer. We also explored the prognosis of the patients who refused surgery after preoperative chemoradiotherapy. Materials and Methods: Thirty seven patients with histologically proven lower rectal cancer who underwent preoperative chemoradiotherapy were retrospectively analyzed. In each case, the tumor location was 0 to 5 em from the anal verge, and curative resection of the cancer with performing a sphincter-saving procedure was not feasible before chemoradiotherapy. In each case, the staging examinations, including biopsy, were done before starting radiotherapy and this was repeated at 1 month after radiation therapy. Results: After chemoradiotherapy, among the 37 included patients, 56.8% and 32.4% were downstaged to the T stage and N stage, respectively, when comparing the postradiotherapy stage with pre-radiotherapy stage. Twenty five patients underwent complete resection of cancer at 6 weeks after radiotherapy: eleven, eight and six patients underwent abdominoperineal resection, low anterior resection and local excision, respectively. The sphincter-saving rate among the 24 completely resected cases was 54.2%. Twelve patients refused surgery after radiotherapy. Among 6 patients who refused surgery with biopsy-proven complete remission after chemoradiotherapy, 5 patients were alive without disease at a median follow up period of 31 months, and only 1 patient had local failure. Conclusion: For lower rectal cancer, a high sphincter-saving rate was accomplished with preoperative chemoradiotherapy. The prognosis of the patients who refused surgery with biopsy proven complete remission after chemoradiotherapy was good and these patients need to be kept under close surveillance.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.04a
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• pp.189-189
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• 1994

Q-35의 일회 및 반복투여 연구결과, 자타학 증상은 단지반복투여 피험자에서 중등도의 두통(1예)과 설사(3예)가 관찰되었으나 이들 설사증례는 장내 세균총 검사상 복감염에 의한 것이 아니었다. Q-35 투여 후 Q-EEG 및 평행기능의 장애 등은 관찰되지 않았으며 임상화학 검사상 반복투여 3예에서 SGOT, SGPT의 경미한 상승을 보였으나 이러한 변화는 정상 범위내에서의 변화이었다. Q-35의 반복투여에 따라 투약 3일에서 8일에 걸처 장내세균총은 일부 호기성 및 혐기성 세균총의 감소를 보였으나 투약종료 10일 후에는 투약전 상태로 회복되었다. Q-35는 투여량의 약 70 % 가 24시간 뇨중으로 배설되었으며 일회 및 반복투여의 결과 용량의존적인 동태양상은 관찰할 수 없었다. 50 mg에서 400 mg까지 일회 투여시 5.6-7.1 시간의 혈장반감기를 보였으며, 반복투여 시험에서는 평균 5.6 $\pm$ 0.7 시간의 반감기를 보였다. Q-35는 타액내로 신속히 이행되었으며 타액내 AUC는 혈장 AUC의 약 75 %에 해당하였고, 식사에 의해 약간의 흡수속도지연(Cmax 0.4 시간지연)과 공복시에 비해 82 %의 상대적 생체이용율을 보였다.

• Korean Journal of Clinical Pharmacy
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• v.17 no.1
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• pp.1-5
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• 2007

A computerized chemotherapy order system (CCOS) was developed to improve the accuracy and efficiency of prescriptions for pharmacy medication scheduling at a teaching hospital, Asan Medical Center, Seoul, Korea. We evaluated the system by comparing prescriptions before and after the implementation of the system and by analyzing the effects of the system on dosing accuracy (only against 5-FU), prescription change, overdoses above maximum limit and medication disposal in non computerized program group (control group) and CCOS group. In terms of dosing accuracy, prescription error rate (%) was significantly decreased in CCOS groups compared with the control group. The rate of prescription changes was also significantly decreased in CCOS groups. Regarding overdoses above maximum limit, we found that there was no prescription order exceeding the dosage limit in CCOS groups in contrast to significant overdoses in control group. In terms of medication disposal, there was no significant difference between 2 groups. We suggest that the computerized chemotherapy order system for chemotherapy may bean important and useful tool for minimizing prescribing errors in the hospitals.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1055-1058
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• 2002

뇌종양 치료성적은 점차 향상되고 있지만 백혈병 등 다른 소아암에 비해 향상 속도가 느리다. 하지만, 근래 MRI, PET scan 등 neuro-imaging 기술의 발달, 뇌종양의 분자유전학적 연구, 외과 수술 방법의 진전, 치료방사선요법의 다양화 등 많은 분야에서 꾸준한 발전을 보이고 있다. 그리고 여러 가지 신약개발에 의한 제 1, 제 2상의 약제시험, antiangiogenesis 약제의 임상시험, gene therapy 등의 연구가 활발하게 진행되고 있으므로, 이에 따른 환자의 치료 성적도 향상될 것으로 기대하고 있다. 외국에서는 여러 대학이 함께 참여하여 작성한 공동의 치료 protocol에 의한 치료가 활발하게 진행되어 생존율을 높이는데 반해, 우리나라에서는 아직까지 각 기관의 협조체제가 구축되지 못한 형편이다. 하지만 금년에 처음으로 여러 대학에서 임상각과가 참석하는 한국소아 뇌종양연구회가 탄생되어 우리나라 뇌종양 환아들의 치료 protocol 개발에 기여할 것을 기대하고 있다. 뇌종양 치료 후 생존하는 아이들을 위한 정밀한 추적관찰이 필수사항인데 여기에 소아과 의사들의 역할은 클 것으로 사료된다. 지능장애, 부적절한 대인관계, 사회적응의 어려움, 치료 후 발생한 내분비계통의 후유증 그리고 2차 암의 발생 등의 정확한 진단 및 치료가 소아과 의사들의 몫으로 남는다. 또한, 이러한 장애가 있는 환아들이 사회에 잘 적응하도록 하기 위해서는 재활교육에 대한 사회적인 관심과 그에 적절한 지원제도의 확립이 절실히 요구된다. 이 점에 있어서도 소아과 의사들의 관심과 지원이 필요하다.

• Journal of The Korean Society of Clinical Toxicology
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• v.8 no.1
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• pp.43-45
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• 2010

A 22-year-old woman was referred to our emergency department for the treatment of a chemical injury on her arm. She had accidentally spilled 99% trifluoroacetic anhydride (TFAA) over her left forearm during an organic chemistry experiment. She visited a primary care unit, and then she was referred to our hospital for inactivation of the released fluoride ions. Her skin lesions were different from those caused by hydrofluoric acid (HF) injury. The injured area showed painful whitish maculae and patchy areas with accentuated rim. No vesiculation and bulla formation was detected. We intradermally injected a 5% solution of calcium through a 24-gauge needle into the burned skin. After the injection, she complained of more severe pain. Although TFAA contains fluorine, it does not release free fluoride ions on contact with the skin, unlike HF. In fact, application of calcium gluconate for TFAA burns is not recommended. Rather, it should be avoided since it increases pain and local abscess formation.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.98-109
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• 2004

The lower limit of detection, precision, setting method of target value, reportable range determination, recovery, linearity, and comparison study with another equipment was evaluated for the Toshiba-120FR chemistry autoanalyzer which was newly introduced at the Daejeon Veteran Hospital in Dec. 2003. Nineteen kinds of test for AST, ALT, ALP, LDH, GGT, TP, ALB, GLU, T-cho, T-bil, TG, UA, CAL, IP, AMY, HDL-C, LDL-C, Cre and BUN were performed to evaluate the lower limit of detection, precision, setting method of target value, reportable range determination, recovery, linearity, and comparison study with other equipment according to the NCCLS guidelines(EP5-A, EP6-P, EP9-A). The Toshiba-120FR autochemical analyzer showed good precision for all tested items. The data concerning the lower limit of detection, precision(total CV 0.47%~3.65%), setting method of target value, reportable range determination, recovery(93%~111%), linearity($R^2=0.997{\sim}0.999$), and comparison study(r=0.977~0.999) with other equipment was acceptable for all tested items. The results of evaluation for the Toshiba-120FR autochemical analyzer showed that this equipment could be used as an alternative to other equipment.

• Proceedings of the Korean Institute of Surface Engineering Conference
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• 2018.06a
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• pp.22-22
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• 2018

의료기기는 사용목적과 사용 시 인체에 미치는 잠재적 위해성의 정도에 따라 4개의 등급으로 분류하며, 두 가지 이상의 등급에 해당되는 제품의 경우에는 가장 높은 등급으로 분류하게 된다. 의료기기 품목허가를 위해서는 기술문서를 작성하여야 하며, 이를 위해서는 기술문서 심사를 신청하는 절차를 이해하여야 한다. 의료기기 기술문서란 의료기기의 성능과 안전성 등 품질에 관한 자료로서 해당 품목의 원자재, 구조, 사용목적, 사용방법, 작용원리, 사용 시 주의사항, 시험규격 등이 포함되는 문서를 말하며, '의료기기 허가 신청서'와 '첨부자료(임상시험자료 포함)'로 구성되어 있다. 의료기기 품목허가 시 제출되는 기술문서를 통하여 해당 의료기기의 안전성 및 성능이 충분히 입증되어야 하며, 인체 삽입되는 표면처리 임플란트를 포함한 인체 접촉 의료기기의 안전성의 경우 '의료기기의 생물학적 안전에 관한 공통 기준규격'에 따라 평가 후 제조 수입품목 허가를 진행해야 한다. 또한 성능의 경우는 해당 규격 또는 자사의 기준 및 시험방법에 따른 성능에 관한 자료, 물리 화학적 특성에 관한 자료를 통하여 평가되어야 하며, 기허가 인증된 제품에 한 번도 사용되지 않은 원재료 또는 적용부위 및 적용방법이 달라 안전성 및 유효성 확인이 필요한 경우 임상시험에 관한 자료가 요구될 수 있다. 본 발표에서는 이러한 인체 삽입용 표면처리 임플란트의 전반적인 인허가 절차에 대해서 안내하고자 한다.

• Journal of Veterinary Clinics
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• v.22 no.2
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• pp.100-107
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• 2005

This study was carried out to investigate the physical and chemical properties of teat cup liners. The hardness of the liners was $50\~67$, and their fatigue to failure 38-1,185 cycles. The elongation and tensile strength of these liners were about $134 kgf/cm^2\;and\;473\%$, respectively. The infrared spectrum and the gas chromatogram revealed that the liner A was consisted of NR, SBR, and BR, with a composition ratio of 60:20:20 (part per hundred rubber). The raw rubber materials used for liners B to G, on the other hand, were NBR only. However, the liner H was made of silicon rubber. The thermogravimetric analysis showed that the liners tested in this study contained raw rubber material, carbon black, organic compounds and metallic compounds.