• Radiation Oncology Journal
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• v.19 no.3
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• pp.237-244
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• 2001

Purpose : To assess the tolerance, complete response rate, bladder preservation rate and survival rate in patients with muscle-invading bladder cancer treated with selective bladder preservation protocol. Method and Materials : From October 1990 to June 1998, twenty six patients with muscle-invading bladder cancer (clinical stage T2-4, N0-3, M0) were enrolled for the treatment protocol of bladder preservation. They were treated with maximal TURBT (transurethral resection of bladder tumor) and 2 cycles of MCV chemotherapy (methotrexate, crisplatin, and vinblastine) followed by $39.6\~45\;Gy$ pelvic irradiation with concomitant cisplatin. After complete urologic evaluation (biopsy or cytology), the patients who achieved complete response were planed for bladder preservation treatment and treated with consolidation cisplatin and radiotherapy (19.8 Gy). The patients who had incomplete response were planed to immediate radical cystectomy. If they refused radical cystectomy, they were treated either with TURBT followed by MCV or cisplatin chemotherapy and radiotherapy. The median follow-up duration is 49.5 months. Results : The Patients with stage T2-3a and T3b-4a underwent complete removal of tumor or gross tumor removal by TURBT, respectively. Twenty one out of 26 patients $(81\%)$ successfully completed the protocol of the planned chemo-radiotherapy. Seven patients had documented complete response. Six of them were treated with additional consolidation cisplatin and radiotherapy. One patient was treated with 2 cycles of MCV chemotherapy due to refusal of chemo-radiotherapy. Five of 7 complete responders had functioning tumor-free bladder. Fourteen patients of incomplete responders were further treated with one of the followings : radical cystectomy (1 patient), or TURBT and 2 cycles of MCV chemotherapy (3 patients), or cisplatin and radiotherapy (10 patients). Thirteen patients of them were not treated with planned radical cystectomy due to patients' refusal (9 patients) or underlying medical problems (4 patients). Among twenty one patients, 12 patients $(58\%)$ were alive with their preserved bladder, 8 patients died with the disease, 1 patient died of intercurrent disease. The 5 years actuarial survival rates according to CR and PR after MCV chemotherapy and cisplatin chemoradiotherapy were $80\%\;and\;14\%$, respectively (u=0.001). Conclusion : In selected patients with muscle-invading bladder cancer, the bladder preservation could be achieved by MCV chemotherapy and cisplatin chemo-radiotherapy. All patients tolerated well this bladder preservation protoco. The availability of complete TURBT and the responsibility of neoadjuvant chemotherapy and chemoradiotherapy were important predictors for bladder preservation and survival. The patients who had not achieved complete response after neoadjuvant chemotherapy and chemoradiotherapy should be immediate radical cystectomy. A randomized prospective trial might be essential to determine more accurate indications between cystectomy or bladder preservation.

• Korean Journal of Poultry Science
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• v.35 no.3
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• pp.291-302
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• 2008

To acquire essentially necessary basic data to establish feeding system by verifying appropriate dietary energy and protein level for the growth of commercial slow growing broiler chicks within the country, two experiments were conducted for 5 weeks. One day old, 1,404 male and female broiler chicks were used for the experiments, and 26 chicks were placed at each pen. The energy level of feed was maintained about 3,000 or 3,100 kg/kcal for whole breeding period of 5 weeks, and protein content was adjusted about 20, 21, and 22% during the first two weeks and the content was adjusted to 18, 19, 20, 21, and 22% from the 3 to 5 weeks old of the experiment. The categories of body weight and feed intake amount were monitored to calculate the productivity and blood sampling was conducted for the analysis at the end of each experiment. Experiment 1:Although the productivity by the ME content difference during $0{\sim}2$ weeks did not have significant difference and the body weight increase by the difference of CP content and feed intake amount did not have much difference, the feed requirement rate was statistically improved in CP 21 and 22% treatment groups compared to the CP 20% group (P<0.05). The feed ME 3,100 kcal/kg treated group during $3{\sim}5$ weeks after starting the experiment revealed to show improved feed requirement rate (P<0.05). Within the period of experiment, the CP 22% treated group resulted to show significant body weight increase compared to the groups treated with low levels of CP (P<0.05) and the feed requirement rate was improved in high CP treated group compared to low CP treated groups, but the feed intake amount did not show significant difference between treated groups. During the experiment period, the body weight increase and feed requirement rate revealed to interact between ME and CP (P<0.05). During the whole experiment period of the 5 weeks, the feed requirement rate was improved in ME 3,100 kcal/kg treated group than the groups treated with ME 3,000 kcal/kg, and the CP (20) 18% treatment groups resulted to show higher values than other treatment groups (P<0.05). Body weight increase was high in CP (22) 22% treated groups than those of CP (21) 21% and (20) 18% treated groups, and the interaction between ME and CP was found at body weight increase and feed requirement rate (P<0.05). Although blood albumin and total cholesterol levels were elevated in ME 3,100 kcal/kg treated group than ME 3,000 kcal/kg treated group, but neutral fat content was reduced (P<0.05). On the other hand, the total cholesterol content was increased in CP (22) 21% treated group than CP (22) 20% and CP (20) 18% treated groups (P<0.05). Experiment 2: The body weight increase in 0-2 weeks was higher in ME 3,100 kcal/kg treated group than ME 3,000 kcal/kg treated group, and it was highly improved in CP 22% treated group than CP 20% treated group by showing the interaction between CP and ME (P<0.05). The significant improvement of feed requirement rate was observed in CP 21% and 22% treated groups compared to CP 20% treated group (P<0.05). The productivity between the growth period from 3 to 5 weeks of age and whole growth period resulted to show no significant difference. Although no difference was observed in blood composition between treated groups, the interaction of ME and CP on cholesterol content was accepted at the range of P<0.05). Therefore, it is considered that the appropriate dietary protein level within feed for the physiology of growing broiler chicks was 22% or more for the first two weeks and protein level of 21% or 20% from 3 to 5 weeks old for the maximization of productivity. Even if the energy level within feed had some partial effects on the productivity, but did not show consistency. So, further experiments needto be conducted by differentiating the energy level.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.59-67
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• 1992

From March 1979 through December 1986, 124 patients with early stage carcinoma of the uterine cervix received curative radiation therapy. According to FIGO classification, 35 patients were stage IB and 89 were stge II A. In stage IB, five year locoregional control, five year disease free survival, and five year overall survival was $79.0\%$, $76.4\%$ and $81.8\%$, respectively. In stage II A, five year locoregional control, five year disease free survival, and five year overall survival were $78.0\%$, $66.8\%$, and $72.1\%$, respectively. To identify prognostic factors, pretreatment parameters including age, ECOG performance status, number of pregnancies, history of diabetes mellitus and hypertension, histology, size and shape of primary tumor, CT findings and blood parameters were retrospectively analyzed in terms of locoregional control, disease free survival and overall survival using univariate analysis and multivariate analysis. In univariate analysis, tumor size on physicai examination and rectal invasion on CT significantly affected locoregional control, disease free survival and overall survival. Parametrial involvement on CT was a significant prognostic factor on locoregional control and disease free survival. Hemoglobin level affected disease free survival and overall survival. Histology and age were significant prognostic factors on locoregional control. In multivariate analysis excluding CT finding, tumor size on physical examination was a significant factor in terms of locoregioal control and overall survival. Hemoglobin level was significant in terms of disease free survival. In multivariate analysis including CT, histology was a prognostic factor on locoregional control and disease free survival. Hemoglobin level and rectal invasion on CT were significant factors on locoregional control.

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.179-184
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• 2014

Purpose: We investigated the safety and efficacy of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. Methods: A retrospective review was conducted on patients who underwent PICC at the hospice-palliative division of KEPCO (Korea Electric Power Corporation) Medical Center between January 2013 and December 2013. All PICCs were inserted by an interventional radiologist. Results: A total of 30 terminally ill cancer patients received the PICC procedure during the study period. Including one patient who had had two PICC insertions during the period, we analyzed a total of 31 episodes of catheterization and 571 PICC days. The median catheter life span was 14.0 days (range, 1~90 days). In 25 cases, catheters were maintained until the intended time (discharge, transfer, or death), while they were removed prematurely in six other cases (19%; 10.5/1000 PICC days). Thus, the catheter maintenance success rate was 81%. Of those six premature PICC removal cases, self-removal due to delirium occurred in four cases (13%; 7.0/1000 PICC days), and catheter-related blood stream infection and thrombosis were reported in one case, each (3%; 1.8/1000 PICC days). Complication cases totaled eight (26%; 14.1/1000 PICC days). The time to complication development ranged from two to 14 days and the median was seven days. There was no PICC complication-related death. Conclusion: Considering characteristics of terminally ill cancer patients, such as a poor general condition, vulnerability to trivial damage, and a limited period of survival, PICC could be a safe intravenous procedure.

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.170-178
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• 2014

Purpose: Delirium is a common and serious neuropsychiatric complication among terminally ill cancer patients. We investigated risk factors related to the development of delirium among hospice care patients. Methods: Between May 2011 and September 2012, we included patients who were mentally alert and had no psychiatric disease or drug addiction at the hospice ward of two local hospitals. Among them, participants who had been diagnosed with delirium by two doctors according to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-4th edition) criteria were grouped as Delirium Group. We analyzed results of psychometric and other laboratory tests performed at the time of patient's admission - psychometric tests included cognitive function (mini-mental status examination, MMSE), depression (Beck Depression Inventory, BDI), anxiety, and insomnia (Insomnia Severity Index, ISI). Logistic regression analysis was used to compare delirium and the related factors. Cox's proportional hazard model was performed using significant factors of logistic regression analysis. Results: Of the 96 patients who met the inclusion criteria, 41 (42.7%) developed delirium. According to the logistic regression analysis, primary cancer site, cognitive impairment (MMSE < 24), depression ($BDI{\geq}16$), and insomnia ($ISI{\geq}15$) were significant factors related to delirium. Among the four factors, depression (OR 5.130; 95% CI, 2.009~13.097) and cognitive impairment (OR 5.130; 95% CI, 2.009~13.097) were found significant using Cox's proportional hazard model. Conclusion: The development of delirium was significantly related to depression and cognitive impairment among patients receiving hospice care. It is necessary to carefully monitor depression and cognitive function in hospice care.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.35-43
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• 2003

Purpose :To analyze the survival period, prognostic factors and complications of patients having undergone high-dose-rate intraluminal brachytherapy (HDR-ILB) as a salvage radiation therapy, while having a catheter, for percutaneous transhepatic billary drainage (PTBD), inserted due to biliary obstruction caused by a secondary malignant biliary tumor Methods and Materials : A retrospective study was performed on 24 patients having undergone HDR-ILB, with PTBD catheter Insertion, be)ween December 1992 and August 2001. Their median age was 58.5, ranging from 35 to 82 years. The primary cancer site were the stomach, gallbladder, liver, pancreas and the colon, with 12, 6, 3, 2 and 1 cases, respectively. Eighteen patients were treated with external beam radiation therapy and HDR-lLB, while slx were treated with HDR-lLB only. The 4otal external beam, and brachytherapy radiations dose were 30$\~$61.2 and 9$\~$30 Gy, with median doses of 50 and 15 Gy, respectively. Results : Of the 24 patients analyzed, 22 died during the follow-up period, with a median survival of 7.3 months. The 6 and 12 months survival rates were 54.2 (13 patients) and 20.8$\%$ (5 patients), respectively. The median survivals for stomach and gailbladder cancers were 7.8 and 10.2 months, respectively, According to the unlvariate analysis, a significant factor affecting survival of over one year was the total radiation dose (over 50 Gy) (o=0.0200), with all )he patients surviving more than one year had been Irradiated with more than 50 Gy. The acute side effects during the radiation therapy were managed with conservative treatment. During the follow-up period, 5 patients showed symptoms of cholangltis due to the radiation therapy Conclusion :An extension to the survival of those patients treated with HDR-ILB is suggested compared to the median historical survival of 4hose patients treated with external biliary drainage. A boost radiation dose could be effectively given, by performing HDR-lLB, which is a prognostic factor In addition, the acute complications of radiation therapy were effectively controlled by conservative management, and It could be regarded as a safe treatment.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.2
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• pp.129-136
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• 2009

Purpose: To determine optimal imaging time for diagnostic I-123 whole body scan in the follow-up of patients with differentiated thyroid cancer(DTC), we compared the image quality of 6- and 24-hour images of the same subjects. Materials and Methods: Four hundred ninety-eight patients(M:F = 55:443, Age $47.6{\pm}12.9$ years) with DTC who had undergone total thyroidectomy and I-131 ablation therapy underwent diagnostic whole body scanning 6 hour and 24 hour after oral ingestion of 185 MBq(5 mCi) of I-123. Serum thyroglobulin measurement and ultrasonography of the neck were performed at the time of imaging. In 40 patients underwent additional I-131 therapy, post-therapy I-131 images were obtained and compared with diagnostic I-123 images. Results: In 440 patients(88.4%), 6- and 24-hour diagnostic I-123 images were concordant, and 58 patients(11.6%) showed discordant findings. Among 58 discordant patients, 31 patients showed abnormal tracer uptake on only 6-hour image, which turned out false-positive findings in all cases. In 12 patients with positive findings on only 24-hour image, remnant thyroid tissue(4 patients) and cervical lymph node metastasis(3 patients) were presented. Among 40 patients underwent additional I-131 therapy, 6-hour and 24-hour images were discordant in 13 patients. All 5 patients with abnormal uptake on only 6-hour image revealed false-positive results, whereas most of 24-hour images were concordant with post-therapy I-131 images. Conclusion: I-123 imaging at 24-hour could reduce false-positive findings and improve diagnostic accuracy, compared with 6-hour image in the follow-up of patient with DTC.

• The Journal of the Petrological Society of Korea
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• v.2 no.2
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• pp.74-94
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• 1993

Metabasites and metapelites in the Mungyong area were intruded by Cretaceous granites with radius of 4-8 km. As the distance from granite body increases, the mineral assemblage of metabasite changes from amphibole + plagioclase through amphibole + plagioclase + epidote to amphibole + plagioclase + epidote + chlorite. The compositional variations of amphibole and plagioclase according to the change of metamorphic grade and bulk rock compositions are very complex. Towards the Mungyong Cretaceous granite body, the mineral assemblage of metapelite changes from chlorite+ muscovite(ch1orite zone) through biotite + chlorite + muscovite(biotite zone) to andalusite+biotite + muscovite${\pm}$chlorite or cordierite+ biotite+ muscovite${\pm}$chlorite(cordierite zone). The estimated metamorphic conditions of cordierite zone are 480~$580^{\circ}C$ 1.5-3.3 kb. The theoretical study on the thermal metamorphism caused by the Cretaceous granite with radius longer than 4 km in the Mungyong area suggests the followings: The degree of metamorphism is mainly determined not by the size of granite body but by the temperature of granite intrusion; The country rocks within 2 km from Cretaceous granite have undergone metamorphism with temperature higher than $500^{\circ}C$, which is consistent with the petrological study in the Mungyong area. Mungyong Cretaceous granite caused a low P/T thermal metamorphism to the country rocks; the amphibolite facies metamorphism to the country rocks within 1-2 km from the granite body and the epidote-amphibolite and greenschist facies metamorphism to the country rocks within 2-5 km.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.523-530
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• 2007

Background: A ThinPrep$^{(R)}$ Processor was developed to overcome the limitations of conventional cytology and is widely used to diagnose various cancers. This study compared the diagnostic efficacy of conventional cytology for lung cancer with that of the ThinPrep$^{(R)}$ cytology using the bronchial washing fluid. Methods: The bronchial washing fluid of 790 patients from Jan. 2002 to Dec. 2006, who were suspected of gaving a lung malignancy, was evaluated. Both ThinPrep$^{(R)}$ and conventional cytology were performed for all specimens. Result: Four hundred forty-six men and 344 women were enrolled in this study, and 197 of them were diagnosed with cancer from either a bronchoscopic biopsy or a percutaneous needle aspiration biopsy. ThinPrep$^{(R)}$ cytology showed a sensitivity, specificity, positive predictive value, negative predictive value and false negative error rate of 71.1%, 98.0%, 92.1%, 91.1%, 8.9%, respectively. The conventional cytology showed sensitivity, specificity, positive predictive value, nagative predictive value and false negative error rate of 57.9%, 98.0%, 90.5%, 87.5%, 12.5%, respectively. For central lesions, the sensitivity of conventional cytology and ThinPrep$^{(R)}$ were 70.1% and 82.8%, respectively. Conclusion: ThinPrep$^{(R)}$ cytology showed a higher sensitivity and lower false negative error rate than conventional cytology. This result was unaffected by the histological classification of lung cancer. Therefore, ThinPrep$^{(R)}$ cytology appears to be a useful method for increasing the detection rate of lung cancer in bronchial washing cytology test.

• Journal of Food Hygiene and Safety
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• v.25 no.3
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• pp.269-277
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• 2010

Selenium is an essential micronutrient for normal body function and functions as an essential constituent of selenoproteins. This study was carried out to investigate effect of selenium on the formation of colonic aberrant crypt foci (ACF) and tumor formation in a mouse model. Five-week old ICR mice were acclimated for one week and fed different selenium diet (0.02, 0.1, and 0.5 ppm) for 12 weeks. Animals received three intraperitoneal injections of azoxymethane (10 mg/kg B.W. in saline for 3 weeks), followed by 2% dextran sodium sulfate in the drinking water for a week. There were four experimental groups, including a normal control group and three different selenium levels groups. After sacrifice, the total numbers of aberrant crypt (AC) and ACF were measured in the colonic mucosa after methylene blue staining. The number of tumors was noted for tumor incidence. Liver selenium concentration was measured using ICP-AES method. Gutathione peroxidase (GPx) activity was determined using a GPx assay kit in the liver and colon. TUNEL assay and proliferating cell nuclear antigen (PCNA) staining were performed to examine the cell apoptosis and cell proliferation, respectively. Immunohistochemistry of $\beta$-catenin was also performed on the mucous membrane tissue of colon. The activity of GPx in the liver and colon was decreased in the selenium-deficient diet group while it was increased in the selenium-overloaded diet group. Apoptotic positive cells were increased in the selenium-overloaded diet group but decreased in the selenium-deficient diet group. PCNA staining area was decreased in the selenium-overloaded diet group. In addition, the $\beta$-catenin protein level in the selenium-deficient diet group was increased but decreased in the selenium-overloaded diet group. These results indicate that dietary selenium might exert a modulating effect on colon cancer by inhibiting the development of ACF and colon tumor formation in this mouse model.