• Title/Summary/Keyword: 절제의 미

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유의의(儒醫) 개념정립과 장개빈(張介賓);유의적개념정립여장개빈(儒醫的槪念定立與張介賓)

  • Seong, Ho-Jun
    • Journal of Korean Medical classics
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    • v.20 no.1
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    • pp.125-136
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    • 2007
  • 본연구장이송대이후유의적성립화의이투과명대적대표적유의장개빈(本硏究將以宋代以後儒醫的成立和意而透過明代的代表的儒醫張介賓), 진행검시의론화의덕지중유학이론적투영과정화전개(進行檢詩醫論和醫德之中儒學理論的投影過程和展開). 송대이후유학적인산생유의적지중칭지위인술적개념(宋代以後儒學的仁産生儒醫的之中稱之爲仁術的槪念), 효화인성위의학적존립목적(孝和仁成爲醫學的存立目的). 저래원재어유학구유적도덕적생명의(這來源在於儒學具有的道德的生命議), 이차이생명도덕적해석위중심(而且以生命道德的解釋爲中心), 해석형기적문제(解釋形氣的問題). 생리적변화촉진심성변화적촉발(生理的變化促進心性變化的觸發), 심성적부중절조성병리(心性的不中節造成病理). 유의문장유학적절욕양생적의미전이도의학(儒醫們將儒學的節欲養生的意味轉移到醫學), 이차장욕구화감정절제주장적성리학화의학재어일개구조지중상통(而且將欲求和感情節制主張的性理學和醫學在於一個構造之中相通). 유학적추구시인간화자연이급사회적도덕주체적확립(儒學的追求是人間和自然以及社會的道德主體的確立), 이차전개장개빈이급유의문적유학이상(而且展開張介賓以及儒醫們的儒學理想). 유의적의의부지재어장의학적과학기술문제(儒醫的意義不只在於將醫學的科學技術問題), 장유추인간생명적도덕적의의(將類推人間生命的道德的意義), 재어의학적문화화도덕적해석적가능성(在於醫學的文化和道德的解釋的可能性).

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The Concept of Beauty and Aesthetic Characteristics in Daesoon Thought (대순사상의 미(美) 개념과 미학적 특징)

  • Lee, Jee-young;Lee, Gyung-won
    • Journal of the Daesoon Academy of Sciences
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    • v.37
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    • pp.191-227
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    • 2021
  • In this study, values of truth and good are expressed in the form of beauty, and truth and good are analyzed from an aesthetic point of view. This enables an assessment of how truth is expressed and presented as an "aesthetic" in Daesoon Thought. Therefore, an approach to faith in Daesoon Jinrihoe (大巡眞理會) can be presented via traditional aesthetics or theological aesthetics that reflect on sense experience, feelings, and beauty. The concept of beauty in Daesoon Thought which focuses on The Canonical Scripture appears in keywords used in Daesoon Thought such as divine nature (神性), the pattern of Dao (道理), the singularly-focused mind (一心), and relationships (關係). Therein, one can find sublimation, symmetry, moderation, and harmony. The aesthetic features of Daesoon Thought, when considered as an aesthetic system can formulate thinking regarding the aesthetics of 'Reordering Works of Heaven and Earth' (天地公事), the aesthetics of Mutual Beneficence (相生), and the aesthetics of healing. The Reordering Works of Heaven and Earth contain a record of the Supreme God visiting the world as a human being. The realization that the human figure, Kang Jeungsan (1871-1909), is the Supreme God, Sangje (上帝), is the shocking aesthetic motif and theological starting point of the Reordering Works of Heaven and Earth. Mutual Beneficence can be seen aesthetically as indicating the sociality of mutual relations, and there is an aesthetic structure of Mutual Beneficence in the harmony and unification of those relations. Healing can be said to contain the sacred sublimation of Sangje, and moderation is a form of beauty that makes humans move toward Quieting the mind and Quieting the body (安心·安身), the Dharma of Presiding over Cures (醫統), and the ultimate value of healing, which is the end point of the Cultivation (修道) wherein one realizes that the ideals of humankind and the aesthetics of healing bestow the spiritual pleasures of a beautiful and valuable life. The aesthetic characteristics of Daesoon Thought demonstrate an aesthetic attitude that leads to healing through Sangje's Holy Works and the practice of Mutual Beneficence (相生) which were performed when He stayed with us to vastly save all beings throughout the Three Realms that teetered on the brink of extinction. It is not uncommon to see a beautiful woman and remark she is like a goddess (女神) or female immortal (仙女). Likewise, beautiful music is often praised as "the sound of heaven." That which fills us with joy is spoken of as "divine beings (神明)" of God. God is a symbol of beauty, and the world of God can be said to be the archetype of beauty. Experience of beauty guides our souls to God. The aesthetic experience of Daesoon Thought is a religious experience that culminates in emotional, intellectual, and spiritual joy, and it is an aesthetic experience that recognizes transcendent beauty.

Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer (조기유방암에서 유방보존치료와 유방전절제술의 치료결과 및 실패양상 비교)

  • Kim Yeon-Sil;Yoon Sei-Chul;Chung Su-Mi;Ryu Mi-Ryeong;Jung Sang-Sul;Choi Ihl-Bohng
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.115-123
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    • 2004
  • Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

Role of Postoperative Conventional Radiation Therapy in the Management of Supratentorial Malignant Glioma - with respect to survival outcome and prognostic factors - (천막상부 악성 신경교종에서 수술 후 방사선 치료의 역할 - 생존율과 예후인자 분석 -)

  • Nam Taek Keun;Chung Woong Ki;Ahn Sung Ja;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.389-398
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    • 1998
  • Purpose : To evaluate the role of conventional postoperative adjuvant radiotherapy in the management of supratentorial malignant glioma and to determine favorable prognostic factors affecting survival. Materials and Methods : From Sep. 1985 to Mar. 1997, the number of eligible patients who received postoperative radiotherapy completely was 69. They ranged in age from 7 to 66 years (median, 47). Forty-two (61$\%$) patients were glioblastoma multiforme and the other 27 (39$\%$) were anaplastic astrocytoma. Twenty patients (29$\%$) had Karnofsky score equal or more than 80 preoperatively. Forty-three patients (62$\%$) had symptom duration equal or less than 3 months. Twenty-four patients (35$\%$) had gross total resection and forty patients(58$\%$) had partial resection, the remaining five patients (7$\%$) had biopsy only. Radiotherapy dose ranged from 50.4 Gy to 61.2 Gy (median, 55.8; mode, 59.4) with fraction size of 1 8 Gy-2.0 Gy for 33-83 days(median, 48) except three patients delivered 33, 36, 39 Gr, respectively with fraction size of 3.0 Gy due to poor postoperative performance status. Follow-up rate was 93$\%$ and median follow-up period was 14 months. Results : Overall survival rate at 2 and 3 years and median survival were 38$\%$, 20$\%$, and 16 months for entire patients; 67$\%$, 44$\%$, and 34 months for anaplastic astrocytoma; 18$\%$, 4$\%$, and 14 months for glioblastoma multiforme, respectively (p=0.0001). According to the extent of surgery, 3-year overall survival for gross total resection, partial resection, and biopsy only was 38$\%$, 11$\%$, and 0$\%$, respectively (p=0.02) The 3-year overall survival rates for patients age 40>, 40-59, and 60< were 52$\%$, 8$\%$, and 0$\%$, respectively (p=0.0007). For the variate of performance score 80< vs 80>, the 3-year survival rates were 53$\%$ and 9$\%$, respectively (p=0.008). On multivariate analysis including covariates of three surgical and age subgroups as above, pathology, extent of surgery and age were significant prognostic factors affecting overall survival. On another multivariate analysis with covariates of two surgical (total resection vs others) and two a9e (50> vs 50<) subgroups, then, pathology, extent of surgery and performance status were significant factors instead of age and 3-year cumulative survival rate for the five patients with these three favorable factors was 100$\%$ without serious sequela. Conclusion : We confirmed the role of postoperative conventional radiotherapy in the management of supratentorial malignant glioma by improving survival as compared with historical data of surgery only. Patients with anaplastic astrocytoma, good performance score, gross total resection and/or young age survived longest. Maximum surgical resection with acceptable preservation of neurologic function should be attempted in glioblastoma patients, especially in younger patients. But the survival of most globlastoma patients without favorable factors is still poor, so other active adjuvant treatment modalities should be tried or added rather than conventional radiation treatment alone in this subgroup.

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Surgical Treatment of Dermatofibrosarcoma Protuberans of the Chest Wall (흉벽의 융기피부섬유육종의 수술적 치료)

  • Cho, Hyun-Min;Kim, Young-Jin;Lee, Tae-Yeon;Lee, Chan-Kyu;Seok, June-Pill;Lee, Yong-Hae
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.790-792
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    • 2010
  • A 77-year-old man presented with a huge protruding mass on the left anterior chest wall. The tumor was resected and diagnosed as dermatofibrosarcoma protuberans (DFSP). DFSP is an uncommon, intermediate-grade mesenchymal cutaneous tumor which extends deep into subcutaneous tissue and may invade through the fascial planes and into muscle but rarely metastasize. Histologically, DFSP is composed of spindle cells arranged in an irregularly whorled or storiform pattern. The histological diagnosis can be confirmed with immunohistochemical staining for CD34. We report a case of DFSP. The tumor was completely excised and the chest wall was reconstructed using latissimus dorsi muscle flap and skin graft.

Causes of Under-staging in Patients with Gastric Cancer That was Proven to be Unresectable after a Laparotomy - Correlation with CT Findings (비절제 위암의 원인분석-전산화단층촬영(CT) 소견을 중심으로)

  • Yoon, Hyuk-Jin;Shin, Jung-Hye;Kim, Gab-Chul;Yu, Wan-Sik;Chung, Ho-Young
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.263-269
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    • 2006
  • Purpose: The aim of this study was to investigate the causes of under-staging in patients with advanced gastric cancer that was proven to be unresectable after a laparotomy. Materials and Methods: We retrospectively analyzed 25 gastric cancer patients who had undergone a diagnostic laparotomy between 2001 and 2005. For the preoperative evaluation, spiral CT and multidetector-row CT were performed. We analyzed the clinicopathologic features of patients and compared the image findings and the results of surgery. The causes of under-staging were divided into 3 groups; patient factor, CT factor, and interpretation factor. Results: Grossly, there were 12 cases of Borrmann type-III tumors and 13 cases of Borrmann type-IV tumors. The most frequent histologic type was poorly differentiated adenocarcinomas (8 cases) and signet ring cell carcinomas (7 cases). There were 13 cases of adjacent organ invasion, and the pancreas was the most frequently invaded organ (9 cases). There were 17 cases of peritoneal metastasis, and 3 cases of distant lymph node metastasis. For the cause of under-staging, there were four cases of patient factor, 19 cases of interpretation factor, and 9 cases of CT factor. In three cases, the cause of under-staging could not be identified. Conclusion: CT interpretation factor was the most frequent cause of under-staging in the preoperative diagnosis with gastric cancer patients. Therefore, more cautious CT interpretation is necessary to avoid unnecessary laparotomies in gastric cancer patients.

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Vitamin C Promoted Liver Regeneration Following Partial Hepatectomy-induced Hepatic Injury in Senescence Marker Protein-30-deficient Mice (비타민 C 투여는 간 부분절제술에 의한 간 재생을 촉진 시킴)

  • Han, Seon Young;Hwang, Meeyul;Kim, Ah-Young;Lee, Eun-Mi;Lee, Eun-Joo;Lee, Myeong-Mi;Sung, Soo-Eun;Kim, Sang-Hyeob;Jeong, Kyu-Shik
    • Journal of Life Science
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    • v.25 no.3
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    • pp.336-344
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    • 2015
  • The capacity for liver regeneration involves a variety of nutritional factors. Vitamin C has multiple metabolic and antioxidant functions. In this study, we investigated the role of vitamin C in liver regeneration following hepatectomy in senescence marker protein (SMP)-30 knockout (KO) mice. Partial hepatectomy was performed by resecting the median and left lateral lobes of mice. Vitamin C accelerated liver recovery in SMP30 KO mice treated with vitamin C (KV). The livers of the KV mice exhibited lower levels of aspartate aminotransferase and lower injury than those of the KO mice. Increased type II transforming growth factor-β receptor (TGF-βRII)-mediated regeneration signaling was accompanied by HGF and cMet in the KV but not the KO mice. Consistent with this, the expression of cell cycle regulatory proteins, including cyclin D1 and proliferating cell nuclear antigen (PCNA), increased rapidly in the KV mice. Enhanced activation of ERK and GSK-3β proteins and a significantly increased number of binuclear hepatocytes were also detected in the livers of the KV mice. Moreover, the KV mice synthesized the highest levels of albumin. These data suggest that treating SMP30 knockout mice with vitamin C resulted in earlier recovery and liver regeneration by activation of the regeneration system.

The Results of Palliative Radiation Therapy in Patients with Unresectable Advanced Pancreatic Cancer (절제 불가능한 췌장암의 고식적 방사선치료 결과)

  • Ryu, Mi-Ryeong;Yoon, Sei-Chul;Kim, Yeon-Sil;Chung, Su-Mi
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.243-247
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    • 2006
  • $\underline{Purpose}$: To evaluate the treatment results and prognostic factors of palliative radiation therapy in the patients with unresectable advanced pancreatic cancer. $\underline{Materials\;&\;Methods$: Thirty-seven evaluable patients with unresectable advanced pancreatic cancer who were treated by palliative radiation therapy for pain relief at the Department of Radiation Oncology, Kangnam St. Mary's hospital, the Catholic University of Korea between March 1984 and February 2005 were analysed retrospectively. There were 22 men and 15 women. Age at diagnosis ranged from 30 to 80 (median 57) years. Twelve patients (32.4%) had liver metastases and 22 patients (59.5%) had lymph node metastases. Radiation therapy was delivered to primary tumor and regional lymph nodes with $1{\sim}2\;cm$ margin, and total dose was $3,240{\sim}5,580\;cGy$ (median 5,040 cGy). Chemotherapy with radiotherapy was delivered in 30 patients (81%) with 5-FU alone (21 patients) or gemcitabine (9 patients). The follow-up period ranged from 1 to 44 months. Survival and prognostic factors were analysed using Kaplan-Meier method and log-rank test respectively. $\underline{Results}$: Overall mean and median survival were 11 and 8 months and 1-year survival rate was 20%. Among 33 patients who were amenable for response evaluation, 7 patients had good response and 22 patients had fair response with overall response rate of 87.9%. Mild to moderate toxicity were observed in 14 patients with nausea, vomiting, and indigestion, but severe toxicity requiring interruption of treatment were not observed. Chemotherapy didn't influence the survival and symptomatic palliation, but the group containing gemcitabine showed a tendency of longer survival (median 12 months) than 5-FU alone group (median 5.5 months) without statistical significance (p>0.05). The significant prognostic factors were Karnofsky performance status and liver metastasis (p<0.05). Age, sex, tumor location, lymph node metastasis, and CA 19-9 level did not show any prognostic significance (p>0.05). $\underline{Conclusion}$: Radiation therapy was effective for symptomatic palliation in the patients with unresectable advanced pancreatic cancer and would play an important part in the survival benefit with gemcitabine or other targeted agents.

The Result of the Surgical Treatment for Non-small Cell Lung Cancer (비소세포성 폐암의 외과적 치료에 대한 성적)

  • Park, Jin-Gyu;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.899-907
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    • 1997
  • Recently, primary lung cancer has increased markedly in incidence & prevalence in korea. Prom July 1979 to June 1996, 183 patients were diagnosed and operated for primary non-small cell lung cancer, and evaluated clinically. 1. There were 164 males and 19 females(M:P=8.6: 1), and the peak incidence of age was 50th and 60th decade of life(73.7%). 2. Most of symptoms were respiratory, whitch were cough(44.8%), chest pain(30.1%), dyspnea(20.8%), hemoptysis or blood tinged sputum(19.7%), sputum(15.3%), and asymptomatic cases were 12.0%. 3. Histopathologically, sguamous cell carcinoma was 68.9%, adenocarcinoma 19.7%, bronchioloalveol r cell carcinoma 2.2%, adenosguamous cell carcinoma 1.6%, and large cell carcinoma 7.7%. 4. In the operation, pneumonectomy was 41.0%, lobectomy 42.1%, bilobectomy 13.1%, stagmentectomy or wedge resection 1.6%, and explore tharacotomy 2.2%, and the overall resectability was 97.8%. 5. Postoperative complications were developed in 31.9%, and operative mortality was 1.6%. 6. In postoperative stagings, stage I was 38.3%, stage H 14.8%, stage llla 31.1%, and stage IIIb 15.8%. 7. The overall cumulative survival rates were 1 year 77.8%, 3 year 42.7%, and 5 year 39.5%. The 5 year survival rate according to stage were stage 153.0%, stage H 46.5%, stage I[la 28.2%, and stage IIIb 13.8%(p<0.05), according to operation method were lobectomy 45.0%, and pneumonectomy 30.3%(p<0.05), and according to mediastinal involvement were Nl 32.0%, and N2 11.1%(p<0.05). The 5 year survival rate according to histologic type were squamous cell carcinoma 43.1%, adenocarcinoma 23.3%, and large cell carcinoma 30.3 (p>0.05).

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Combined Treatment of Residual, Recurrent and Unresectable Gastric Cancer (수술후 잔존 위암, 재발성 위암 및 절제 불가능한 위암의 병용 요법)

  • Bae, Hoon-Sik
    • Radiation Oncology Journal
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    • v.8 no.1
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    • pp.85-93
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    • 1990
  • A series of 25 patients with residual, recurrent, and unresectable gastric cancer received various combination of surgery, radiotherapy (RT), chemotherapy (CT), and hyperthermia (HT). They were placed into 7 categories; 1) CT and HT-14 patients; 2) RT and HT-15 patients; 3) surgery, RT and HT-2 patients; 4) surgery, RT, HT and CT-1 patient; 5) RT, HT and CT -1 patient; 6) RT and CT-1 patient; 7) RT alone-1 patient. Three patients had curative resection. 21 patients received irradiation with tightly contoured portals to spare as much small bowel, kidney and marrow as possible. Hyperthermia was applied regionally once or twice a week for 23 patients using 8 MHz radiofrequency capacitive heating device (Thermotron RF-8). HT was given approximately 30 min after RT 7 patients were treated with CT: 4 patients received HT and concomitant Mitomycin-C; 3 patients received HT and sequential 5-FU+Adriamycin+Mitomycin-C. There was not any treatment related deaths. There was also no evidence of treatment related problems with liver, kidney, stomach, or spinal cord except only one case of transient diabetic ketoacidosis. The tumor response was evaluable in 22 patients. None achieved complete remission.11 ($50\%$) achieved partial remission. The response rate was correlated with total radiation dose and achieved maximum temperature. 9 of 14 ($64\%$) received more than 4000 cGy showed partial remission; especially, all 3 patients received more than 5500 cGy achieved partial response.8 of the 12 patients ($67\%$) who achieved maximal temperature more than $41^{\circ}C$ showed partial response in comparing with $25\%$ (2 of 8 patients, below $41^{\circ}C$). The numbers of HT, however, was not correlated with the response. 3 of the 25 patients ($12\%$) remain alive. The one who was surgically unresectable and underwent irradiation alone is in progression of the disease with distant metastases. The remaining two patients with curative resection are alive with free of disease, 24 and 35 months, respectively. The median survival by response are 11.5 months in responders and 4.6 months in non-responders.

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