• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3941-3944
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• 2013

Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.

• Radiation Oncology Journal
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• v.33 no.3
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• pp.179-187
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• 2015

Purpose: The purpose of this study was to investigate the predictable value of pretreatment $^{18}F$-fluorodeoxyglucose positron emission tomography-computed tomography ($^{18}F$-FDG PET-CT) in radiotherapy (RT) for patients with hepatocellular carcinoma (HCC) or portal vein tumor thrombosis (PVTT). Materials and Methods: We conducted a retrospective analysis of 36 stage I-IV HCC patients treated with RT. $^{18}F$-FDG PET-CT was performed before RT. Treatment target was determined HCC or PVTT lesions by treatment aim. They were irradiated at a median prescription dose of 50 Gy. The response was evaluated within 3 months after completion of RT using the Response Evaluation Criteria in Solid Tumors (RECIST). Response rate, overall survival (OS), and the pattern of failure (POF) were analyzed. Results: The response rate was 61.1%. The statistically significant prognostic factor affecting response in RT field was maximal standardized uptake value (maxSUV) only. The high SUV group (maxSUV ${\geq}5.1$) showed the better radiologic response than the low SUV group (maxSUV < 5.1). The median OS were 996.0 days in definitive group and 144.0 days in palliative group. Factors affecting OS were the %reduction of alpha-fetoprotein (AFP) level in the definitive group and Child-Pugh class in the palliative group. To predict the POF, maxSUV based on the cutoff value of 5.1 was the only significant factor in distant metastasis group. Conclusion: The results of this study suggest that the maxSUV of $^{18}F$-FDG PET-CT may be a prognostic factor for treatment outcome and the POF after RT. A %reduction of AFP level and Child-Pugh class could be used to predict OS in HCC.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.225-232
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• 2011

Purpose: This study was designed to retrospectively evaluate the postsurgical initial stability of the Le Fort I osteotomy with posterior impaction and rigid internal fixation for the correction of mandibular prognathism with midface deficiency. Particular attention was paid to the magnitude and direction of the initial postsurgical change. Methods: 20 healthy patients with mandibular prognathism and midface deficiency participated in this study. All patients underwent Le Fort I osteotomy with posterior impaction and mandibular setback BSSO by one surgeon. Preoperative (T0), immediate postoperative (T1) and follow-up period (T2) cephalograms were taken and analyzed. Change between T0~T1 and T1~T2 was measured and analyzed. Results: Between T0~T1, significant differences were observed in all measurements except the ANS point and mandibular plane angle. Between T1~T2, only the occlusal plane angle was significantly changed. No significant changes were found in all other measurements. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.338-346
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• 2018

Crossed occlusion can be treated either by overdenture and telescopic denture or by placing an implant at the edentulous area to reestablish the support on the occlusion. If alveolar bony support is sufficient and an the environment where an implant is inserted is favorable to restoring the masticatory and aesthetic function of a patient, the implant-supported fixed prosthesis can provide more definitive occlusal support and more aid for other oral functions. In this case report, a patient with a severe residual alveolar bone resorption following the extraction of teeth and who had a crossed occlusion was treated with sinus bone graft and alveolar bone augmentation in order to place the implants at prosthetically position. The definitive restoration was made to reflect the patient's occlusal and aesthetic function using the CAD/CAM double scanning method. Finally, the treatment had the masticatory and aesthetic function adequately restored, which is reported here.

• Journal of the Korean School Mathematics Society
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• v.13 no.3
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• pp.459-483
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• 2010

This study aims to develop materials related to math education for the aged and to identify the effects of application as part of active measures to the aging society with its growing elderly population which is one of the greatest changes in our society. In this purpose, the necessity and objectives for development of materials of 'Silver Math' as education for the aged are explained. Developing and disseminating materials with a role as a program for intelligent needs and physical and spiritual health of the aged presents standards for development of more systemic and meaningful educational materials at this point of time when the importance of education of the aged increases to help the old enjoy qualitatively successful lives in later years in the perspective of lifelong education. Also it aims to present standards of contents and requirements in learning that are adequate and meaningful to old learners at the actual learning sites where education takes place only in terms of making good use of spare time while at the same time suggesting plans of teaching and learning as well as conditions for learning environment. Next, the effectiveness of 'Silver Math' are explored by applying developed materials to the aged. materials of 'Silver Math' for the aged with contents that are appropriate to the definitive and cognitive level of the aged are presented. The developed materials for mathematical activities are divided into 'computation of basic numbers' for those wishing to learn calculation and concepts of numbers, 'active math' that corresponds to definitive factors of old learners, facilitates leisure time through mathematical activities, and Improves communication abilities through cooperative learning among learners, and 'math with thinking power' to solve simple calculation problems by applying to various actual situations.

• Parasites, Hosts and Diseases
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• v.51 no.6
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• pp.633-636
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• 2013

Angiostrongylus cantonensis is a parasitic nematode that needs to develop in different hosts in different larval stages. Freshwater snails, such as Pomacea canaliculata, are the intermediate host, and rats are the definitive host. Periodic shedding of the cuticle (moulting) is an important biological process for the survival and development of the parasite in the intermediate and definitive hosts. However, there are few studies on the cuticle alterations between different stages of this parasite. In this study, we observed the ultrastructural appearance and changes of the cuticle of the 2nd/3rd stage larvae (L2/L3) and the 3rd/4th stage larvae (L3/L4) using a scanning electron microscope. We also first divided L2/L3 into late L2 and early L3. The late L2 lacked alae, but possessed a pull-chain-like fissure. Irregular alignment of spherical particles on the cuticle were noted compared to the L3. Alae appeared in the early L3. The old cuticle turned into a thin filmlike structure which adhered to the new cuticle, and spherical particles were seen regularly arranged on the surface of this structure. Regular rectangular cavities were found on the surface of L3/L4. The caudal structure of L3/L4 was much larger than that of L3, but caudal inflation, such as seen in L4, was not observed. These results are the first to reveal the ultrastructural changes of the cuticle of A. cantonensis before and after moulting of L2/L3 and L3/L4.

• Radiation Oncology Journal
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• v.24 no.4
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• pp.217-222
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• 2006

$\underline{Purpose}$: This study evaluated the results of definitive radiation therapy and the prognostic factors that affect survival rates for T2N0 glottic cancer patients. $\underline{Materials\;and\;Methods}$: Thirty patients with T2N0 glottic cancer who were treated with definitive radiation therapy at our institution between September 1986 and June 2004 were retrospectively reviewed. All patients were pathologically confirmed as having squamous cell carcinoma and were staged as AJCC T2N0. The age of the patients ranged from 39 to 79 (median 62) years and all were male. A total dose of $66{\sim}70\;Gy$ (median 66 Gy) was delivered with a 6-MV linear accelerator in $6.5{\sim}7$ weeks. The median follow-up period was 63 months. $\underline{Results}$: The actuarial disease-free survival rate for the entire group of the patients was 79% at 5 years. The five-year disease-free survival rates for patients without and with subglottic extension were 90% and 56%, respectively (p=0.03). However, anterior commissure involvement, supraglottic extension, and impaired cord mobility were not statistically significant prognostic factors. The five-year disease-free survival rates for patients with and without concurrent chemotherapy were 86% and 69%, respectively (p=0.47). $\underline{Conclusion}$: Subglottic extension can be considered a poor prognostic factor for T2N0 glottic cancer.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.179-184
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• 2001

Objective: The role of chemotherapy in locally advanced head and neck cancer has been established in nasopharynx and larynx as definitive therapy and organ preserving therapy, respectively. Oral cavity cancers are relatively uncommon and local recurrence is the main cause of treatment failure. We planned this retrospective study to evaluate the role of neoadjuvant chemotherapy in locally advanced oral cavity cancer patients. Materials and Methods: From 1988 March to 2001 February, locally advanced, previously untreated oral cavity cancer patients who received neoadjuvant chemotherapy were examined. Chemotherapy had been done in the following patients: Histologically proven squamous cell or poorly differentiated carcinoma, stage 3 or 4, and performance state 0-2 patients. Chemotherapy regimen consisted of cisplatin and infusional 5-fluorouracil. Response was evaluated after 2 cycles and in case of no response, definitive local therapy was done; otherwise 3 cycles was done before local treatment. Results: 48 patients were treated and 47 patients were evaluable for responses. Complete response rate was 6.4%(3/47) and partial response 80.0%(38/47), scoring overall response rate of 87.2%. Median time to progression was 27.0 months (95% CI : 0-58months) and overall 5 year survival was 54.8%. 5-year disease-free survival in the patients in remission after local treatment was 51.9%. In multivariate analysis, contributing factor to the survival were response to neoadjuvant chemotherapy and local treatment modalities. Extensive surgery was done in 10 patients and 25 patents (52.1%) was followed up with preserved function. With median follow-up of 57.0 months, 19 recurrences were detected, most of which were local or regional type. Conclusion: Neoadjuvant chemotherapy followed by local treatment in oral cavity cancer showed high response rate and was thought to be effective therapeutic approach especially in view of organ preservation.

• Radiation Oncology Journal
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• v.29 no.3
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• pp.174-180
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• 2011

Purpose: To evaluate the radiotherapy treatment outcome of patients in stage IE and IIE nasal natural killer/T-cell lymphoma. Materials and Methods: From August 1999 to August 2009, 46 patients with stage IE and IIE nasal natural killer/T-cell lymphoma were treated by definitive radiotherapy and chemotherapy. 33 patients were treated with chemotherapy followed by radiotherapy (CT + RT) and they received 50.4 Gy in 28 fractions. 13 patients were treated with concurrent chemoradiotherapy (CCRT) and they received 40 Gy in 20 fractions. Results: The median follow-up period was 4.6-137.6 months (median, 50.2 months) for all patients. The 4-year overall survival was 68.6% and 4-year disease free survival (DFS) was 61.9%. The 4-year locoregional recurrence free survival was 65.0%, and 4-year distant metastasis free survival (DMFS) was 66.2%. For patients treated with CT + RT, 15 patients (45.5%) achieved complete response after chemotherapy, and 13 patients (39.4%) achieved partial response. 13 patients (81.8%) achieved complete response after radiotherapy, and 6 patients (18.2%) achieved partial response. For patients treated with CCRT, 11 patients (84.6%) achieved complete response, and one patient (7.7%) achieved partial response. In univariate analysis, presence of cervical lymph node metastasis was only significant prognostic factor for DFS and DMFS. Conclusion: This study did not show satisfactory overall survival rate and disease free survival rate of definitive radiotherapy and chemotherapy for stage IE and IIE nasal natural killer/T-cell lymphoma. For patients with cervical lymph node metastasis, further investigation of new chemotherapy regimens is necessary to reduce the distant metastasis.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6779-6782
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• 2015

Background: Chemoradiotherapy is an important treatment modality for lung cancers. The aim of this study was to investigate alterations in, as well as the interrelationship between, lung function and quality of life of patients receiving chemoradiotherapy due to locally advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) limited to the thorax. Materials and Methods: The study included patients receiving definitive chemoradiotherapy for lung carcinoma. The respiratory function of the patients was assessed by measuring forced expiratory volume in 1 s per unit (FEV1) and forced expiratory volume in 1s per unit of vital capacity (FEV1/VC) before, in the middle of and after treatment. During the study, EORTC QLQ C30 and LC13 questionnaires developed by the Committee of the European Organization for Research and Treatment of Cancer (EORTC) were employed to evaluate the quality of life on the same day as respiratory function tests (RFT). Findings: The study included 23 patients in total: 19 (82.6%) diagnosed with NSCLC and 4 (17.4%) with SCLC. The average percentage FEV1 was $55.6{\pm}21.8%$ in the pre-treatment period, $56.2{\pm}19.2%$ in the middle of treatment and $60.4{\pm}22%$ at the end of treatment. The improvement in functional scores, symptom scores and general health scores during treatment was not statistically significant (P= 0.568, P= 0.734, P= 0.680, P=0.757 respectively). Conclusions: Although this study showed an improvement in respiratory function and quality of life of patients during treatment with thoracic chemoradiotherapy, no statistically significant results were obtained. While evaluating the effectiveness of treatments for lung carcinoma, the effects of treatment on respiratory function and quality of life should be considered.