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Responses and Toxicities of Risk-adapted Chemotherapy in Pediatric Intracranial Germ Cell Tumors (소아 두개 내 생식 세포종에서 위험군에 따른 화학요법의 치료 반응 및 독성)

  • You, Dong Kil;Lee, Soo Hyun;Yoo, Keon Hee;Sung, Ki Woong;Lim, Do Hoon;Shin, Hyung Jin;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.186-190
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    • 2005
  • Purpose : The purpose of this study was to evaluate the responses and toxicities of risk-adapted chemotherapy in pediatric intracranial germ cell tumors(IC-GCT). Methods : Fourteen patients who were diagnosed as IC-GCT from October 2002 to December 2003 received chemotherapy as an initial treatment modality. The low risk(LR) group was defined as follows : Pure germinoma and normal AFP level. Beta-hCG level 50 mIU/mL or less. The others belonged to the high risk(HR) group. Chemotherapy was composed of cisplatin, cyclophosphamide, etoposide and vincristine. Double doses of cisplatin and cyclophosphamide was used in HR patients. Results : Pathologic confirmation was done in all but one. Median age at diagnosis was 11.6 yr (1.2-18.7 yr), and nine patients belonged to the HR group. Tumor markers were normalized after chemotherapy in all patients whose tumor markers had been elevated. Four LR patients(80 percent) and seven HR patients(77.8 percent) showed complete response(CR) at the end of chemotherapy. An additional two of the three patients with partial response(PR) achieved CR after radiation therapy (RT), and the remaining one relapsed before RT. Four LR and all HR patients experienced infectious episodes that required hospitalization. Four of the nine HR patients(44.4 percent) suffered from tinnitus, three of whom developed sensorineural hearing loss. All but one are surviving, event-free, with a median follow-up of 13.9 mo(8.1-22.3 mo). Conclusion : Risk-adapted cisplatin-based chemotherapy was effective even in HR patients, but regimen modification seems to be necessary to avoid an unacceptably high toxicity rate.

Recovery of Copper, Reuse of $TiO_2$, and Assessment of Acute Toxicity in the Photocatalytic Oxidation of Cu(II)-EDTA (Cu(II)-EDTA 광촉매 산화반응에서의 구리회수, $TiO_2$ 재사용 및 처리수 독성평가)

  • Yang, Jae-Kyu;Choi, Bong-Jong;Lee, Seung-Mok
    • Journal of Korean Society of Environmental Engineers
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    • v.27 no.8
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    • pp.844-851
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    • 2005
  • The purpose of this study was to determine feasibility of application of regenerated or recycled $TiO_2$ on the successive treatment of Cu(II)-EDTA. The recovery of copper, the reuse of $TiO_2$ and the assessment of acute toxicity was studied in the total eight successive photocatalytic reactions. Aqueous solution of $10^{-4}\;M$ Cu(II)-EDTA was treated using an illuminated $TiO_2$ at pH 6 in a circulating reactor. Two different procedures were applied in the reuse of $TiO_2$: i) recycle of $TiO_2$ without acid wash ii) regeneration of $TiO_2$ with acid wash to remove adsorbed copper in a previous experiment. The averaged decomplexation rate constant($k'_{obs}$) of Cu(II)-EDTA in recycle of $TiO_2$ without acid wash was approximately 45% less than that in regeneration of $TiO_2$ with acid wash. Removal of Cu(II) was near complete after 180 minutes in the total eight successive photocatalytic reactions using the regenerated $TiO_2$ after acid wash. In contrast, removal of Cu(II) was minimum at total fifth successive photocatalytic oxidation using the recycled $TiO_2$ without arid wash. The recovered $TiO_2$ was approximately 86% in average in each procedure. The recovered Cu(II) was 67.9% in average. The acute relative toxicity of the treated water rapidly declined at an initial reaction time up to 60 minutes but little declination was observed after 60 minutes due to little degradation of DOC. Relative toxicity of treated water using the recycled $TiO_2$ without acid wash we some what well correlated with the concentration of dissolved Cu(II). From this work, it is suggested that Cu(II)-EDTA can be effectively treated using an integrated cyclic photocatalytic oxidation with recovery of $TiO_2$ and Cu(II).

Effect of Sand Extraction on Meiobenthic Community of Jangbong-do in the Eastern Yellow Sea of Korea (서해 주문도 연안 사질 조하대에서의 해사채취가 중형저서동물 군집에 미치는 영향 연구)

  • Kang, Teawook;Min, Won-Gi;Hong, Jae-Sang;Kim, Dongsung
    • Korean Journal of Environmental Biology
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    • v.32 no.2
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    • pp.138-152
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    • 2014
  • The objective of the study survey was to determine the effect of marine sand extraction on community composition and rate of recolonization of the meiobenthos following cessation of mining activities. Because of meiobenthic distribution in nature, high abundance, intimate association with sediments, fast reproduction, benthic larva period, sensitivity to pollution and rapid life histories, meiobenthos are widely regarded as ideal organisms to study the potential ecological indicator of natural and anthropogenic stresses. The community structure of meiobenthos was studied at seven stations within sandy tidal and sub tidal zones in Jangbongdo in the Yellow Sea, Korea from Aug. 2006 to Dec. 2007. Meiobenthic samples were collected by three core samples, with a 3.6 cm in diameter, from each sediment sample taken with a Smith-McIntyre Grab. It was found that sand mining often causes complete removal of the sediment and the damage to the habitats of meiobenthos. This study in the effect showed that sand mining resulted in a reduction in total abundance and biomass of meiobenthos in mining area. The finding of this study further showed that initial restoration of abundance and biomass within one year of the cessation of sand mining.

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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Preliminary Results of Management for Primary CNS Lymphoma (원발성 중추신경계 림프종의 치료에 관한 예비적 결과)

  • Ahn, Seung-Do;Chang, Hye-Sook;Choi, Eun-Kyong
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.79-82
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    • 1993
  • From October 1989 to March 1992, ten patients diagnosed as primary central nervous system (CNS) lymphoma were treated with radiation therapy at Asan Medical Center. To obtain pathologic diagnosis, five patients had stereotactic biopsy and the others underwent craniotomy & tumor removal. According to the classification by International Working Formulation, seven of 10 patients showed diffuse large cell types and the remaining 3 had diffuse mixed cell types. Computed tomographic scans of the brain disclosed solitary (6 cases) or multiple (4 cases) intracranial lesions. All patients received 4000 cGy/20 fx to the whole brain followed by an additional 2000 cGy/10 fx boost to the primary lesion. Six patients with initial cerebrospinal fluid (CSF involvement were treated with whole brain irradiation and intrathecal Methotrexate (IT-MTX) chemotherapy. One of them received an additional spinal irradiation after 3 cycles of IT-MTX chemotherapy because of MTX induced arachnoiditis. One patient received 3 cycles of systemic chemotherapy prior to rodiation therapy and one received 5 cycles of salvage chemotherapy for recurrence. With a median follow up time of 8 months, all patients were followed from 7 to 26 months. Radiologically seven patients showed complete remission and the remaining three showed partial remission at one month after radiotherapy. The 1 and 2 year survival rate was $86{\%}\;and\;69{\%}$ respectively. Until now, two patients expired at 7 and 14 months. These patients developed extensive CSF seeding followed by local failure. Considering initial good response to radiation therapy and low incidence of extraneural dissemination in primary CNS lymphoma, we propose to increase total tumor dose to the primary lesion by hyperfractionated radiotherapy or stereotactic radiosurgery. For the patients with CSF involvement at diagnosis, we propose craniospinal irradiation with IT MTX chemotherapy.

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Postoperative Radiotherapy for Low Grade Glioma of the Brain (뇌 신경교종의 수술 후 방사선치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.79-84
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    • 2000
  • Purpose : To evaluate the effectiveness and tolerance of postoperative e지ernai beam radiotherapy for patients with low grade glioma of the brain and define the optimal radiotherapeutic regimen. Materials and Methods : Between June, 1985 and May, 1998, 72 patients with low grade gliomas were treated with postoperative radiotherapy immediately following surgery. Median age was 37 years with range of 11 to 76 years. Forty one patients were male and 31 patients were female with male to female ratio of 1.3:1. Of those patients, 15 underwent biopsy alone and remaining 57 did subtotal resection. The distribution of the patients according to histologic type was as follows: astrocytomas-42 patients (58$\%$), mixed oligodendrogliomas-19 patients (27$\%$), oiigodendrogliomas-11 patients (15$\%$). Two patients were treated with whole brain irradiation followed by cone down boost and remaining 70 patients were treated with localized field with appropriate margin. Ail of the patients were treated with conventional once a day fractionation. Most of patients received total tumor dose of 5000 $\~$ 5500 cGy. Results : The overall 5 and 7 year survival rates for entire group of 72 patients were 61$\~$ and 50$\~$. Corresponding disease free survival rates for entire patients were 53$\~$ and 45$\~$, respectively. The 5 and 7 year overall survival rates for astrocytomas, mixed oligodendrogiiomas, and oligodendrogiiorras were 48$\%$ and 45$\%$, 76$\%$ and 56$\%$, and 80$\%$ and 52$\%$, respectively. Patients who underwent subtotal resection showed better survival rates than those who did biopsy alone. The overall 5 year survival rates for sub total resection patients and biopsy alone patients were 57$\%$ and 43$\%$, respectively. Forty six patients who were 40 years or younger survived batter than 26 patients who were 41 years or older (overall survival rate at 5 years, 69$\%$ vs 45$\%$). Although one patient was not able to complete the treatment because of neurological deterioration, there was no significant treatment related acute toxicities. Conclusion : Postoperative radiotherapy was safe and effective treatment for patients with low grade gliomas. However, we probably need prospective randomized trial to define optimal treatment timing and schedule for low grade gliomas and select patient group for different treatment philosophies.

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The Results of Radiation Therapy of Limited Stage Small Cell Lung Cancer (국한된 페소세포암의 방사선 치료성적)

  • Kim Sung Hwan;Choi Byung Ok;Gil Hak Joon;Yoon Sei Chul;Bahk Yong Whee;Shinn Kyung Sub;Kim Hoon Kyo;Lee Kyung Sik
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.97-102
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    • 1993
  • A retrospective analysis of various characteristics in 32 limited stage small cell lung cancer patients treated at the Department of Therapeutic Radiology in Kangnam St. Mary's Hospital, Catholic University Medical College from April 1983 to September 1991, was carried out to identify factors which had prognostic significance for survival from initiation of radiation therapy. There were 26 men and 6 women. Median age was 63 years (range: 24-78 years). The follow up duration was 1.5 to 44 months (median: 9 months). External radiation therapy was done with daily 160-180 cGy,5 fraction/week, total of 1000-6660 cGy (median: 4500 cGy) to the mediastinum by 6 MV linear accelerator. Of 32 Patients, 27 ($84.4{\%}$) patients were treated with combined modality (chemotherapy plus radiation therapy), and 5 ($15.6{\%}$) patients were treated with radiation therapy only. Complete responders were 12 patients ($37.5{\%}$), partial responders were 11 ($34.4{\%}$), and no responders were 9($28.1{\%}$). Karnofsky performance status over 70 (p<0.04), chemotherapy regimen (CAV, PV, and CAV+PV) (p<0.04),6 or more cycles of chemotherapy (p<0.007), radiation therapy over 4500 cGy (p<0.03), and radiation therapy responder (CR+PR) (p<0.003) showed a significantly favorable influence on 1 year survival rate. Age (p=0.545), sex (p=0.666), presence of superior vena cava syndrome (p=0.719), prophylactic cranial irradiation (p=0.217), and radiation therapy duration (p=0.491) had no effect on survival. Radiation induced side effects were transient esophagitis in 11 ($34{\%}$), general weakness in 9($28{\%}$), gastrointestinal symptoms in terms of nausea, vomiting and indigestion in 5 ($15{\%}$) and leukopenia in 1 ($3{\%}$).

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Early Results of Coronary Bypass Surgery in Patients with Severe Left Ventricular Dysfunction (심한 좌심실 기능저하를 동반한 환자에서의 관상동맥 우회로 조성수술의 조기성적)

  • 정윤섭;김욱성
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.383-389
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    • 1997
  • From March, 1992 to March, 1996, a total of 279 patients underwent coronary bypass surgery at the Sejong General Hospital, Puchon. We selected 22 patients with severe left ventricular(LV) dysfunction from them. The criteria were the presence of global or segmental abnormalities of left ventricular contraction and LV ejection fraction(EF) less than 35% based on biplane LV angiography by planimetry method. The mean age of 17 male and 5 female patients was 60$\pm$5.6years(range:47~73 years). All had the anginas, which were Canadian class II in 6, class 111 in 12 and class IV in 4. All patients except one had the history of previous myocardial infarction more than once. Seven of them had the symptoms and signs of congestive heart failure, such as dyspnea on excertion and increased pulmonary vascular markings. Their mean LVEF was 29.4$\pm$4 5%(range : 18~35%) and mean LV end-diastolic pressure was 18.7 $\pm$8. 2mmHg(range:10~42mmHg). 21 patients had 3 vessel-disease and 1 had 2 vessel-disease. Complete revascularization was tried with the use of 16 internal mammary arteries and 60 sapheuous veins and 3 radial arteries grafts. The mean number of distal anastomosis was 3.5$\pm$ 1.1. Concomitantly, one mitral valvuloplasty and annuloplasty was performed in the patient with moderate mitral regurtigation. The hospital mortality was 4.5%. During the follow-up, there were 3 late deaths. Of 18 survivors, 2 patients were lost in follow-up 24 and 27 month respectively after operation and the remaining 16 patients have bcen followed up with an average of 30.4 $\pm$ 13.4 months.15 patients had improvement with respect to angina but 8 patients still have the continuing or progressing heart failure. The 1-year, 2-year and 3-year actuarial survival rate was 85.2, 69.1, 46.1%, respectively. This study indicates that coronary artery bypass sur ery can be performed in the patients with severe LV dysfunction at acceptable risk but does not greatly contribute to the improvement of congestive heart failure.

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The Anticancer Effect and Mechanism of Photodynamic Therapy Using 9-Hydroxypheophorbide-a and 660 nm Diode Laser on Human Squamous Carcinoma Cell Line. (9-hydroxypheophorbide-a와 660 nm 다이오드 레이저를 이용한 광역학치료의 항암효과와 치료기전에 대한 연구)

  • Ahn, Jin-Chul
    • Journal of Life Science
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    • v.19 no.6
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    • pp.770-780
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    • 2009
  • A new photosensitizer, 9-Hydroxypheophorbide-a (9-HpbD-a), was derived from Spirulina platensis. We conducted a series of experiments, in vitro and in vivo, to evaluate the anticancer effect and mechanism of photodynamic therapy using 9-HpbD-a and 660 nm diode lasers on a squamous carcinoma cell line. We studied the cytotoxic effects of pheophytin-a, 9-HpbD-a, 9-HpbD-a red and 660 nm diode lasers in a human head and neck cancer cell line (SNU-1041). Cell growth inhibition was determined by using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction assay. The effects of 9-HpbD was higher than those of 9-HpbD-a red or pheophytin-a in PDT. We then tested the cytotoxic effects of 9-hydroxypheophorbide-a (9-HpbD-a) in vitro. The cultured SNU-I041 cells were treated with serial concentrations of 9-HpbD-a followed by various energy doses (0, 0.1, 0.5, 3.2 J/$cm^{2}$) and by various interval times (0, 3, 6, 9, 12 hr) until laser irradiation, then MTT assay was applied to measure the relative inhibitory effects of photodynamic therapy (PDT). Optimal laser irradiation time was 30 minutes and the cytotoxic effects according to incubation time after 9-HpbD-a treatment increased until 6 hours, after which it then showed no increase. To observe the cell death mechanism after PDT, SUN-I041 cells were stained by Hoechst 33342 and propidium iodide after PDT, and observed under transmission electron microscopy (TEM). The principal mechanism of PDT at a low dose of 9-HpbD-a was apoptosis, and at a high dose of 9-HpbD-a it was necrosis. PDT effects were also observed in a xenografted nude mouse model. Group I (no 9-HpbD-a, no laser irradiation) and Group II (9-HpbD-a injection only) showed no response (4/4, 100%), and Group III (laser irradiation only) showed recurrence (1/4,25%) or no response (3/4, 75 %). Group IV (9-HpbD-a + laser irradiation) showed complete response (10/16, 62.5%), recurrence (4/16, 25%) or no response (2/16, 12.5%). Group IV showed a significant remission rate compared to other groups (p<0.05). These results suggest that 9-HpbD-a is a promising photosensitizer for the future and that further studies on biodistribution, toxicity and mechanism of action would be needed to use 9-HpbD-a as a photosensitizer in the clinical setting.

Effect of Yearly Application of Straw and Nitrogen, Phosphate and Potassium Fertilizer on the Growth and Yield in Rice (생고(生藁) 및 삼요소(三要素)의 연속시용(連續施用)이 수도(水稻)의 생육(生育) 및 수량(收量)에 미치는 영향(影響))

  • Lee, Eun-Woong;Kwon, Y.W.
    • Applied Biological Chemistry
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    • v.8
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    • pp.51-59
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    • 1967
  • A split plot was laid out in 1965 for perennial application of straw by 500kg per 10 are, as main plot, and of chemical fertilizer in conventional way, as sub-plots. The sub-plot included the following 5 fertilizer treatments as (1) non-fertilized, (2) nitrogen-free, (3) phosphate-free (4) potassium-free, (5) completely fertilizer applied plots. Trends in the growth and yield of rice was observed at present experimental site in the first year, 1965, and second year, 1966, as follows: 1. Each treatmental plot showed nearly identical trends between the first and second year, in term of growth, yield and yield components. 2. Straw application deterred the initial growth at non-fertilized and nitrogen-free plots. But straw application raised the effective stem ratio and enlarged the values in yield components, finally to be resulted in the second year with significant difference. 3. Both phosphate and potassium did not much affected to plants for longer stem and larger number of tillers. 4. Effect of nitrogen, phosphate and potassium was recorded as investigated by previous research works. Phospate deficiency decreased maturing rate to a great extent. 5. Numerical index was calculated for the comparison of plots in yield, where the non-straw, completely fertilizer applied plot stands for 100. The indexes of the first and second year were as follows : at non-straw plot(indexes in the blank are from the first year trial); non-fertilized : 80.2(80.9), nitrogen-free: 83.6(89.4), phosphate-free : 89.4(93.1) and potassium-free plot: 93.5(102.4) at non-straw plot. On the other hand, indexes at straw applied plots were non-fertilized : 84.0(86.6), nitrogen-free 82.6(93.9), phosphate-free : 91.7(96.3), potassium-free: 103.2(102.0) and complete plot: 98.7(109.8).

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