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The Results of Definitive Radiation Therapy and The Analysis of Prognostic Factors for Non-Small Cell Lung Cancer (비소세포성 폐암에서 근치적 방사선치료 성적과 예후인자 분석)

  • Chang, Seung-Hee;Lee, Kyung-Ja;Lee, Soon-Nam
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.409-423
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    • 1998
  • Purpose : This retrospective study was tried to evaluate the clinical characteristics of patients, patterns of failure, survival rates, prognostic factors affecting survival, and treatment related toxicities when non-small cell lung cancer patients was treated by definitive radiotherapy alone or combined with chemotherapy. Materials and Methods : We evaluated the treatment results of 70 patients who were treated by definitive radiation therapy for non-small cell lung cancer at the Department of Radiation Oncology, Ewha Womans University Hospital, between March 1982 and April 1996. The number of patients of each stage was 2 in stage I, 6 in stage II, 30 in stage III-A, 29 in stage III-B, 3 in stage IV. Radiation therapy was administered by 6 MV linear accelerator and daily dose was 1.8-2.0 Gy and total radiation dose was ranged from 50.4 Gy to 72.0 Gy with median dose 59.4 Gy. Thirty four patients was treated with combined therapy with neoadjuvant or concurrent chemotherapy and radiotherapy, and most of them were administered with the multi-drug combined chemotherapy including etoposide and cisplatin. The survival rate was calculated with the Kaplan-Meier methods. Results : The overall 1-year, 2-year, and 3-year survival rates were 63$\%$, 29$\%$, and 26$\%$, respectively. The median survival time of all patients was 17 months. The disease-free survival rate for 1-year and 2-year were 23$\%$ and 16$\%$, respectively. The overall 1-year survival rates according to the stage was 100$\%$ for stage I, 80$\%$ for stage II, 61$\%$ for stage III, and 50$\%$ for stage IV. The overall 1-year 2-year, and 3-year survival rates for stage III patients only were 61$\%$, 23$\%$, and 20$\%$, respectively. The median survival time of stage III patients only was 15 months. The complete response rates by radiation therapy was 10$\%$ and partial response rate was 50$\%$. Thirty patients (43$\%$) among 70 patients assessed local control at initial 3 months follow-up duration. Twenty four (80$\%$) of these 30 Patients was possible to evaluate the pattern of failure after achievement of local control. And then, treatment failure occured in 14 patients (58$\%$): local relapse in 6 patients (43$\%$), distant metastasis in 6 patients (43$\%$) and local relapse with distant metastasis in 2 patients (14$\%$). Therefore, 10 patients (23$\%$) were controlled of disease of primary site with or without distant metastases. Twenty three patients (46$\%$) among 50 patients who were possible to follow-up had distant metastasis. The overall 1-year survival rate according to the treatment modalities was 59$\%$ in radiotherapy alone and 66$\%$ in chemoirradiation group. The overall 1-year survival rates for stage III patients only was 51$\%$ in radiotherapy alone and 68$\%$ in chemoirradiation group which was significant different. The significant prognostic factors affecting survival rate were the stage and the achievement of local control for all patients at univariate- analysis. Use of neoadjuvant or concurrent chemotherapy, use of chemotherapy and the achievement of local control for stage III patients only were also prognostic factors. The stage, pretreatment performance status, use of neoadjuvant or concurrent chemotherapy, total radiation dose and the achievement of local control were significant at multivariate analysis. The treatment-related toxicities were esophagitis, radiation pneunonitis, hematologic toxicity and dermatitis, which were spontaneously improved, but 2 patients were died with radiation pneumonitis. Conclusion : The conventional radiation therapy was not sufficient therapy for achievement of long-term survival in locally advanced non-small cell lung cancer. Therefore, aggressive treatment including the addition of appropriate chemotherapeutic drug to decrease distant metastasis and preoperative radiotherapy combined with surgery, hyperfractionation radiotherapy or 3-D conformal radiation therapy for increase local control are needed.

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The Monitoring on Plasticizers and Heavy Metals in Teabags (침출용 티백 포장재의 안전성에 관한 연구)

  • Eom, Mi-Ok;Kwak, In-Shin;Kang, Kil-Jin;Jeon, Dae-Hoon;Kim, Hyung-Il;Sung, Jun-Hyun;Choi, Hee-Jung;Lee, Young-Ja
    • Journal of Food Hygiene and Safety
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    • v.21 no.4
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    • pp.231-237
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    • 2006
  • Nowadays the teabag is worldwide used for various products including green tea, tea, coffee, etc. since it is convenient for use. In case of outer packaging printed, however, there is a possibility that the plasticizers which is used for improvement in adhesiveness of printing ink may shift to inner tea bag. In this study, in order to monitor residual levels of plasticizers in teabags, we have established the simultaneous analysis method of 9 phthalates and 7 adipates plasticizers using gas chromatography (GC). These compounds were also confirmed using gas chromatography-mass spectrometry (GC-MSD). The recoveries of plasticizers analyzed by GC ranged from 82.7% to 104.6% with coefficient of variation of $0.6\sim2.7%$ and the correlation coefficients of each plasticizer was $0.9991\sim0.9999$. Therefore this simultaneous analysis method was showed excellent reproducibility and linearity. And limit of detection (LOD) and limit of quantitation (LOQ) on individual plasticizer were $0.1\sim3.5\;ppm\;and\;0.3\sim11.5\;ppm$ respectively. When 143 commercial products of teabag were monitored, no plasticizers analysed were detected in filter of teabag products. The migration into $95^{\circ}C$ water as food was also examined and the 16 plasticizers are not detected. In addition we carried out analysis of heavy metals, lead (Pb), cadmium (Cd), arsenic (As) and aluminum (Al) in teabag filters using ICP/AES. $Trace\sim23{\mu}g$ Pb per teabag and $0.6\sim1718{\mu}g$ Al per teabag were detected in materials of samples and Cd and As are detected less than LOQ (0.05 ppm). The migration levels of Pb and Al from teabag filter to $95^{\circ}C$ water were upto $11.5{\mu}g\;and\;20.8{\mu}g$ per teabag, respectively and Cd and As were not detected in exudate water of all samples. Collectively, these results suggest that there is no safety concern from using teabag filter.

Comparison of Growth Characteristics, Forage Productivity and Quality between Italian Ryegrass and Synthetics Derived from Interspecific and Intergeneric Hybrids and Ecotypes (이탈리안 라이그라스와 종.속간 잡종 및 생태형 유래 합성종간의 생육특성, 수량성 및 사료가치 비교)

  • Choi, G.J.;Lim, Y.W.;Lim, Y.C.;Sung, B.R.;Kim, M.J.;Kim, K.Y.;Park, G.J.;Kim, S.R.
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.22 no.4
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    • pp.265-272
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    • 2002
  • Forage breeding laboratory of National Livestock Research Institute, R.D.A. has made interspecific hybrids of Lolium multiflorum $\times$ L. pratensis and intergeneric hybrids of Lolium $\times$ Festuca since 1984, and has collected ecotypes of Italian ryegrass since 1991. Growth characteristics of these hybrids and ecotypes were researched, and then these clone lines were named. Among these clone lines, the several clones that have polen fertility, high cold-tolerance, and similar heading time were used for making synthetics, Naehan 6, 7, 8, 9, with polycrossing method in 1997. Field experiments were carried out to compare the mophological and agronomical characteristics and forage productivity and quality of the synthetics with those of Italian ryegrass varieties, Barmultra and Hwasan 101. in Suwon and Yonchun from 1999 to 2000. Heading time of the synthetics were 22th to 24th May that belong to late-mature types to be similar to that of Barmultra and Hwasan 101 in Suwon. The synthetics were 101 to 106 c3n in plant length, medium or thick in thickness of stem, dark peen in leaf color, broad and long in flag leaf, strong in lodging resistance, and excellent in regrowth. Winter survivals of the synthetics were no different from that of Barmultra or Hwasan 101 in Suwon, but better than that of Barmultra or Hwasan 101 in Yonchun where was -10 to -12$^{\circ}C$ of minimum average air temperature in January or February. Dry matter(DM) yields of the synthetics were similar to DM 8,238kg per ha of Barmultra in Suwon, but in Yonchun, were more 7 to 13% than DM 7,291kg per ha of Barmultra. Forage qualities, IVDMD, ADF, NDF and TDN of the synthetics were lower than those of Hwasan 101, but higher than those of Barmultra.

The Role of Lymphocyte Compartment and Cytokine in Coal Workers Pneumoconiosis (진폐증환자에서의 임파구 분획 및 싸이토카인의 역할)

  • Lee, Jung-Yeon;Yoo, Kwang-Ha;Ahn, Hae-Ryon;Kim, Sung-Ryul;Lee, Hae-Woon;Ahn, Cheol-Min;Kim, Hyung-Joong
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.241-250
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    • 2002
  • Background : Coal-worker's pneumoconiosis(CWP) is characterized by a chronic inflammatory lung reaction associated with macrophage accumulation in the alveolar spaces. CWP is usually divided into two stage : simple pneumoconiosis(SP) where there are a limited number of fibrotic lesions remain limited, with radiological opacities smaller than 1cm and progressive massive fibrosis(PMF), which is characterized by the development of a perifocal extensive fibrotic response of the lung and severe alterations in pulmonary function. In this study, the lymphocyte compartment and cytokine were evaluated by measuring the serum levels in the control, SP and PMF groups. Materials and Methods : The coal workers selected for this study were employees(patients?) of the Tae-Baek and Dong-Hae hospital. All were men, 45-76 years old and the mean duration of their exposure to coal dust was 23.2 years in the lymphocyte compartment and 24.3 years in the cytokine checked group. According to X-ray examination results, the patients were classified into either one of the SP, PMF categories. The normal controls examined were 26-70 years old men. The serum cytokine levels were estimated by using an end point enzyme immunoassay technique. Results : T lymphocyte, helper and suppressor T cells were highly related to pneumoconiosis in this study. A statistically significant decrease in the number of suppressor T lymphocytes was observed in the simple pneumoconiosis patients and at the same time, there was an increase in the lymphocyte index. Howevere, there was no statistically difference in the serum cytokines levels among the SP, PMF and control groups. Conclusion : T lymphocyte, helper T, and suppressor T cells may be highly related to the development of CWP compared to the control group particularly in the early stage of pneumoconiosis. The changes observed in the immunological system in patients with pneumoconiosis may lie at the bottom of the pathogenesis of fibrosis. Further study is needed to evaluate the lymphocyte compartment as a marker for pneumoconiosis development in the early stage.

Investigation on Korean Local Maize Lines VI. Use of a Korean Local Maize Line for Silage Production (재래종 옥수수 수집종에 대한 특성조사 제6보 청예를 위한 재래종 옥수수의 이용에 관한 연구)

  • Choe, B.H.;Park, J.S.;Kim, Y.R.;Chung, S.K.
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.26 no.3
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    • pp.251-256
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    • 1981
  • Silage yield and nutritional values of a locally collected Korean corn line with high tillering and earing characteristics were investigated at plant densities from 2778 to 8333 plants/ l0a. This line and a non-tillering and nonprolific corn as a check were grown at four plant densities and at three planting dates. The Korean local line abbreviated as MET had the highest dry matter per l0a. The highest dry matter of the MET line compared with the check hybrid was due to the highest dry leaf weight of the MET line. The highest dry leaf weight of the MET line was due to the increased number of tillers of the MET line. Other plant parts such as ear weight, kernel weight and cob weight of the MET line were lower than those of the check hybrid. The dry husk weight per l0a of the MET line was higher than that of the check hybrid, probably due to the increased number of ears in the MET line. The total embryo production per 10 a of the MET line was significantly higher than that of the check hybrid. The increased portion of embryo of the MET line is probably responsible for the higher TON values of the MET line. No interaction between variety x planting dates or planting density was found, indicating that the MET line and check hybrid were both the same in effects of planting dates and densities. Both line and hybrid showed the highest dry matter production when the planting density was high and planting dates was early. When silage was made from either MET line or check hybrid the nutritional values in terms of crude protein, crude fat, fiber, and ash contents of the MET line were similar to those of the check hybrid. But the TON of the MET line was higher than that of the check hybrid, while the OCP of the MET line lower than that of the check hybrid. Amino acid contents of the MET line were also comparable to those of the check hybrid, while lysine content of the MET line was 10% higher than that of the check hybrid.

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A Study on the IADL Affecting Subjective Health Index of the Aged in Some Area (일부지역(一部地域) 노인(老人)들의 주체적(主體的) 건강수준(健康水準)에 영향을 미치는 IADL에 관한 연구(硏究))

  • Kim, Keun-Jo;Park, Heung-Ki;Koon, Hyeok-Su;Bae, Soo-Chan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.1
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    • pp.29-50
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    • 2001
  • This research have been made to define how the IADL (Instrumental Activity of Daily Living) performance and the subjective health index of the Aged are affected by their residential circumstance, gender and age, and how deeply these two factors are related and interact. For the period of June 1 to July 31, 2000, we had conducted a questionnaire and direct interview with 693 persons over age sixty-five (65) in Daejon and in other adjacent area, grouping into three different residential types The Aged living at home, The Aged living at welfare facilities and The Aged living alone, and studied on how the IADL performance and the subjective health index of the Aged are influenced and interact as per their characteristics, daily activity and mentality. We had analyzed all the data obtained through this research by the method of : - analysis of frequency as per specific factors by SPSS 1O.0/PC+, - $x^2$ test, - t-test, - ANOVA, - multiple regression analysis by factors. The research concludes followings : a. It appears that the three (3) factors such as gender, age and residential circumstance of the Aged deeply affect the IADL performance and subjective health index of the Aged. (p<0.01) b. With regard to IADL performance of the Aged by the gender, it was analyzed that the female-Aged gains 23.8 point on average, which shows the performance of the female-Aged is less independent. (p<0.01). In addition, it was also found that the IADL performance is becoming less and less independent following their age increasing. In analyzing IADL performance by the residential type, it appears that the Aged living at welfare facilities gains the lowest 21.5 points and is least independent. It was also found that the Aged living at welfare facilities need some assistances from others for their performing IADL. (20-24 point) (p<0.001) c. With regard to the subjective health index of the all-Aged participated in this research, the analysis indicates 8.8 point and this is considered as a point of general standard (7-10 point). In analyzing this index by the gender, the female-Aged gains only 8.6 point which explains a lot of female-Aged consider they are not really healthy. (p<0.001) In analyzing this index by the residential type, the Aged living at welfare facilities and the Aged living alone gain the comparatively lower point, - respectively 8.4 point for the Aged living at welfare facilities and 8.8 point for the Aged living alone. The Aged living at these two residential types express they are obviously in a bad situation of health. (p<0.001) d. With regard to the factors affecting the IADL performance and the subjective health index of the Aged, it was analyzed that the IADL performance can largely be affected by the factors such as depression, frequency of going-out and age rising, and that the subject health index can also deeply be affected by depression, pain and by how much they are satisfied with their current living conditions. e. It was analyzed that the interacting between the IADL performance and the subjective health index is not that strong but even weak. As a result, we were able to conclude that the IADL performance is less independent in case of the female-Aged, the Aged living at welfare facilities, and following the age rising. As for the subjective health state the Aged themselves are aware of, we concluded that the female-Aged, the Aged living at welfare facilities and the Aged living alone, are more critical about their health. From this research, we were able to realize that, when the OMT (Orthopedic Manual Therapy) needed, the physical therapists are really required to have a correct and cautious understanding of the situation in which the aged persons are, and take care of them with more concerns and more improved treatment.

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Memory Organization for a Fuzzy Controller.

  • Jee, K.D.S.;Poluzzi, R.;Russo, B.
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 1993.06a
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    • pp.1041-1043
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    • 1993
  • Fuzzy logic based Control Theory has gained much interest in the industrial world, thanks to its ability to formalize and solve in a very natural way many problems that are very difficult to quantify at an analytical level. This paper shows a solution for treating membership function inside hardware circuits. The proposed hardware structure optimizes the memoried size by using particular form of the vectorial representation. The process of memorizing fuzzy sets, i.e. their membership function, has always been one of the more problematic issues for the hardware implementation, due to the quite large memory space that is needed. To simplify such an implementation, it is commonly [1,2,8,9,10,11] used to limit the membership functions either to those having triangular or trapezoidal shape, or pre-definite shape. These kinds of functions are able to cover a large spectrum of applications with a limited usage of memory, since they can be memorized by specifying very few parameters ( ight, base, critical points, etc.). This however results in a loss of computational power due to computation on the medium points. A solution to this problem is obtained by discretizing the universe of discourse U, i.e. by fixing a finite number of points and memorizing the value of the membership functions on such points [3,10,14,15]. Such a solution provides a satisfying computational speed, a very high precision of definitions and gives the users the opportunity to choose membership functions of any shape. However, a significant memory waste can as well be registered. It is indeed possible that for each of the given fuzzy sets many elements of the universe of discourse have a membership value equal to zero. It has also been noticed that almost in all cases common points among fuzzy sets, i.e. points with non null membership values are very few. More specifically, in many applications, for each element u of U, there exists at most three fuzzy sets for which the membership value is ot null [3,5,6,7,12,13]. Our proposal is based on such hypotheses. Moreover, we use a technique that even though it does not restrict the shapes of membership functions, it reduces strongly the computational time for the membership values and optimizes the function memorization. In figure 1 it is represented a term set whose characteristics are common for fuzzy controllers and to which we will refer in the following. The above term set has a universe of discourse with 128 elements (so to have a good resolution), 8 fuzzy sets that describe the term set, 32 levels of discretization for the membership values. Clearly, the number of bits necessary for the given specifications are 5 for 32 truth levels, 3 for 8 membership functions and 7 for 128 levels of resolution. The memory depth is given by the dimension of the universe of the discourse (128 in our case) and it will be represented by the memory rows. The length of a world of memory is defined by: Length = nem (dm(m)+dm(fm) Where: fm is the maximum number of non null values in every element of the universe of the discourse, dm(m) is the dimension of the values of the membership function m, dm(fm) is the dimension of the word to represent the index of the highest membership function. In our case then Length=24. The memory dimension is therefore 128*24 bits. If we had chosen to memorize all values of the membership functions we would have needed to memorize on each memory row the membership value of each element. Fuzzy sets word dimension is 8*5 bits. Therefore, the dimension of the memory would have been 128*40 bits. Coherently with our hypothesis, in fig. 1 each element of universe of the discourse has a non null membership value on at most three fuzzy sets. Focusing on the elements 32,64,96 of the universe of discourse, they will be memorized as follows: The computation of the rule weights is done by comparing those bits that represent the index of the membership function, with the word of the program memor . The output bus of the Program Memory (μCOD), is given as input a comparator (Combinatory Net). If the index is equal to the bus value then one of the non null weight derives from the rule and it is produced as output, otherwise the output is zero (fig. 2). It is clear, that the memory dimension of the antecedent is in this way reduced since only non null values are memorized. Moreover, the time performance of the system is equivalent to the performance of a system using vectorial memorization of all weights. The dimensioning of the word is influenced by some parameters of the input variable. The most important parameter is the maximum number membership functions (nfm) having a non null value in each element of the universe of discourse. From our study in the field of fuzzy system, we see that typically nfm 3 and there are at most 16 membership function. At any rate, such a value can be increased up to the physical dimensional limit of the antecedent memory. A less important role n the optimization process of the word dimension is played by the number of membership functions defined for each linguistic term. The table below shows the request word dimension as a function of such parameters and compares our proposed method with the method of vectorial memorization[10]. Summing up, the characteristics of our method are: Users are not restricted to membership functions with specific shapes. The number of the fuzzy sets and the resolution of the vertical axis have a very small influence in increasing memory space. Weight computations are done by combinatorial network and therefore the time performance of the system is equivalent to the one of the vectorial method. The number of non null membership values on any element of the universe of discourse is limited. Such a constraint is usually non very restrictive since many controllers obtain a good precision with only three non null weights. The method here briefly described has been adopted by our group in the design of an optimized version of the coprocessor described in [10].

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