• Title/Summary/Keyword: Disease Location

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Comparing Concurrent Chemoradiotherapy to Chemotherapy Alone for Locally Advanced Unresectable Pancreatic Cancer (절제 불가능한 췌장암의 동시 항암화학 방사선 요법과 항암화학 단독 요법의 비교)

  • Park, Jeong-Hoon;Kim, Woo-Chul;Kim, Hun-Jung;Gwak, Hee-Keun
    • Radiation Oncology Journal
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    • v.27 no.2
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    • pp.64-70
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    • 2009
  • Purpose: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced unresectable pancreatic cancer. However, the introduction of gemcitabine and the recognition of a benefit in patients with advanced disease stimulated the design of trials that compare chemotherapy alone to concurrent chemoradiation. Therefore, we evaluated role of CCRT for locally advanced unresectable pancreatic cancer. Materials and Methods: We carried out a retrospective analysis of treatment results for patients with locally advanced unresectable pancreatic cancer between January 2000 and January 2008. The radiation was delivered to the primary tumor and regional lymph nodes with a 1~2 cm margin at a total dose of 36.0~59.4 Gy (median: 54 Gy). The chemotherapeutic agent delivered with the radiation was 5-FU (500 mg/$m^2$). The patients who underwent chemotherapy alone received gemcitabine (1,000 mg/$m^2$) alone or gemcitabine with 5-FU. The follow-up period ranged from 2 to 38 months. The survival and prognostic factors were analyzed using Kaplan-Meier method and log-rank test, respectively. Results: Thirty-four patients received concurrent chemoradiotherapy, whereas 21 patients received chemotherapy alone. The median survival time was 12 months for CCRT patients, compared to 11 months for chemotherapy alone patients (p=0.453). The median progression-free survival was 8 months for CCRT patients, compared to 5 months for chemotherapy alone patients (p=0.242). The overall response included 9 partial responses for CCRT and 1 partial response for chemotherapy alone. In total, 26% of patients from the CCRT group experienced grade 3~4 bowel toxicity. In contract, no grade 3~4 bowel toxicity was observed in the chemotherapy alone group. The significant prognostic factors of overall survival were lymph node status, high CA19-9, and tumor location. Conclusion: The response rate and progression-free survival were more favorable in the CCRT group, when compared with the chemotherapy alone group. Therefore, radiation therapy seems to be an effective tool for local tumor control.

An Epidemiologic Study of Metastatic Bone Tumor (전이성 골종양의 역학적 연구)

  • Kim, Jae-Do;Lee, Duk-Hee;Park, Jeong-Ho;Son, Young-Chan;Hong, Yonng-Gi;Son, Jeong-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.38-44
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    • 1995
  • Metastatic bone tumor is the most common bone tumor and 32.5% of all primary malignant tumors are eventually metastasize to bone. Metastatic bone tumor has been more frequently encountered disease in the orthopedic fields due to the greater longevity of life of the patients with primary visceral cancers by major advances in early detection, diagnosis, and surgical/radiotherapeutic/chemotherapeutic treatment of primary and metastatic lesions. Therefore, the epidemiologic data about the incidences and the patterns of bone metastasis is important. We reviewed 417 patients who were diagnosed and treated for metastatic bone tumor at Kosin University Medical Center from 1985 to 1993 to analyse the primary lesion, age and sex distributions, location of bone metastasis, patterns of metastasis according to the primary. The results were as follows : 1. The common origin of bone metastasis were lung(29.5%), stomach(15.3%), breast(11.3%), unknown(7.7%), cervix(5.3%), liver(4.8%) in order of frequency. 2. There were 251 men and 166 women and their mean age was 54.8 years and the peak age incidence was in 6th decades. Most cases(85.3%) were occured beyond 5th decades. 3. The preferred sites of metastatic deposits were spine(64.0%), pelvis(40.5%), rib(38.8%), femur(36.7%), skull(21.1%), humerus(13.9%), scapula(13.0%) in order of frequency. In the spine, thoracic(42.1%), lumbar(39.1%), cervical(13.2%), sacral(5.6%) vertebrae were involved in order of frequency. 4. Multiple bone metastases were more common(73.1%) than single metastasis(26.9%). 5. In the lung cancer, the peak age incidence was 6th decades, and the preferred sites of bone metastasis were spine, pelvis, femur. 6. In the stomach cancer, the peak age incidence was 6th decades, and the preferred sites of bone metastasis were spine, femur, pelvis. 7. In the breast cancer, the peak age incidence was 5th decades, and the preferred sites of bone metastasis were spine, rib, pelvis. 8. In the bone metastasis with unknown primary site, the peak age incidence was 7th decades, the preferred sites of bone metastasis were spine, femur, pelvis, and the common histologic types were adenocarcinoma and squamous cell carcinoma.

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The Clinical Characteristics in Patients with Lung Cancer Under 45 Years of Age (45세 이하 약년자 폐암 94례의 임상적 특징)

  • Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Han, Sung-Beom;Jeon, Young-Jun;Hyun, Dae-Sung;Lee, Sang-Chae;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.550-560
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    • 2002
  • Background : Lung cancer is the leading cause of cancer-related mortality in both men and women. Although most cases of lung cancer occur in the sixty to eight decades of life, 5 to 10% are diagnosed at a young age. There are characteristic features in young patients with lung cancer that differ from those in older patients with lung cancer. The purpose of this study was to determine if the basal characteristics and survival in young patients with lung cancer differed from those of old patients. Methods : We retrospectively reviewed the medical records of 94 young patients who were under 45 years of age and compared them with 1,728 old patients (= 46 years of age) in 4 medical schools at Daegu, between August 1986 and July 1995. Results : Significantly more female patients and adenocarcinomas were found in the young patients group. when compared to the old patients. Cough and sputum were the most frequent presenting symptom in both age groups. This was followed by chest discomfort, dyspnea and hemoptysis. The rates of smoking was significantly lower in the young patients. There was no statistical difference in the severity of the disease in terms of staging between the two age groups. Young patients received treatment more frequently than the older patients. The location of the primary tumors was equally frequent in both the upper and lower lobe. However, the survival was bettrer in the young patients(median survival time, 67.3 weeks), when compared to the old patients (median survival time, 26.8 weeks) (p<0.05). Conclusion : Females and adenocarcinoma patients were predominant in young patients with lung cancer. The young patients appeared to have significantly better prognosis.

Outcome of Tumor Prosthetic Reconstruction in Osteosarcoma Patient (골육종 환자에서 종양 대치물을 이용한 재건술의 치료결과)

  • Kim, Jae-Do;Kim, Cheung-Kue;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.79-86
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    • 2011
  • Purpose: Modular tumor prosthesis is the most popular recontructive modality after resection of malignat tumor in extremity. Complications and survival of tumor prosthesis reconstruction are well-known. however, reports on the long-term outcome of tumor prosthesis in osteosarcoma patientss are scarece. Materials and Methods: In 158 cases as diagnosed as osteosarcoma from feburary 1989 to December 2006 in a single cancer center. We retrospectively reviewd 48 osteosarcoma patients who under went tumor prosthetic reconstruction. Mean follow up preiod was 75.6 months (range; 60 to 179 months). There were 28 males, 20 females and mean age was 22.4 years (range; 11-71). Pathologic subtypes were conventional central osteosarcoma in 46 cases and periosteal in 2 cases. The location of the tumor was proximal tibia (26 cases), distal femor (20 cases), femor diaphysis (1 case), and tibia diaphysis (1 case). In 41 cases built-up-type tumor prosthesis have been used and 7 cases expansion-type tumor prosthesis have been used. We used Musculoskeletal tumor society (MSTS) grading system to asses post operation function, and we analyzed survival rate of patient and tumor prosthesis and complication. Results: The overall survival rate was 77.7% and disease free survival rate was 68.9%. The survival rate of tumor prosthesis was 73%, in last follow up tumor prosthesis has been removed in 12 cases. All of them, 17 complications occurred, which included infection in 16 cases, Periprosthetic Fracture and Loosening of tumor prosthesis in 4 cases, articular instability in 4 cases. MSTS functional score was 74.1% in post operation. Conclusion: In long term follow up result, Primary tumor prosthesis -a reconstruction method after a wide extensional resecion of a bone tumor- can be a effective treatment method in asepect of survival rate, functional assesment and complication.

Identification of Quantitative Trait Loci Associated with Anthracnose Resistance in Chili Pepper (Capsicum spp.) (고추 탄저병 저항성 관련 양적형질 유전자좌 분석)

  • Kim, Su;Kim, Ki-Taek;Kim, Dong-Hwi;Yang, Eun-Young;Cho, Myeong-Cheoul;Jamal, Arshad;Chae, Young;Pae, Do-Ham;Oh, Dae-Geun;Hwang, Ju-Kwang
    • Horticultural Science & Technology
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    • v.28 no.6
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    • pp.1014-1024
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    • 2010
  • Pepper ($Capsicum$ spp.) anthracnose caused by $Colletotrichum$ $acutatum$ is a destructive disease susceptible to areas where chili peppers are grown. $Capsicum$ $baccatum$ var. $pendulum$ (Cbp) is resistant to anthracnose and has actively been used for interspecific hybridization for the introgression of resistance gene(s) into cultivated chili peppers. The goals of this study were to determine the inheritance of resistance to anthracnose within $Capsicum$ $baccatum$ and to map quantitative trait loci (QTLs) for the anthracnose resistance. A genetic mapping population consisting of 126 $F_2$ plants derived from a cross between $Capsicum$ $baccatum$ var. $pendulum$ (resistant) and $Capsicum$ $baccatum$ 'Golden-aji' (susceptible) was used for linkage mapping. The linkage map was constructed with 52 SSRs, 175 AFLPs, and 100 SRAPs covering 1,896cM, with an average interval marker distance of 4.0cM. Based on this map, the number, location, and effect of QTLs for anthracnose resistance were studied using plants inoculated in the laboratory and field. A total of 19 quantitative trait loci (2 major QTLs and 16 minor QTLs) were detected. Two QTLs ($An8.1$, $An9.1$) showed 16.4% phenotypic variations for anthracnose resistance after wounding inoculation. In addition, five minor QTL loci ($An7.3$, $An7.4$, $An4.1$, $An3.1$, $An3.2$) showed a total of 60.73% phenotypic variations of anthracnose resistance in the field test. Several significant QTLs were also detected and their reproducibility was confirmed under different inoculation conditions. These QTLs are now being confirmed with different breeding populations. Markers tightly linked to the QTLs that are reliable under different environmental conditions will help to determine the success of marker-assisted selection for anthracnose -resistant breeding programs in chili pepper.

Incidence and magnitude of out-of-pocket payment and factors influencing them in Industrial Accident Compensation Insurance (산재환자의 진료비 본인부담 발생 및 크기와 이에 영향을 미치는 요인)

  • Park, Bo-Hyun;Lee, Tae-Jin;Lim, Wha-Young
    • Health Policy and Management
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    • v.20 no.1
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    • pp.103-124
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    • 2010
  • Objectives: The out-of-pocket payment (OOP) of the Industrial Accident Compensation Insurance (IACI) in Korea was investigated empirically in terms of its incidence, magnitude and factors influencing them. Methods: The subjects were sampled with stratified, randomized methods among medical institutions of which the number of monthly IACI claims exceeded its median as of May 2008. Out of 204 institutions selected, 118 institutions (57.8%) responded to this survey. A total of 24,826 episodes(2,457 inpatient and 22,369 outpatient episodes) were included in this analysis. The incidence and magnitude of OOP of IACI were calculated by characteristics of institution as well as patient. Factors that affected the incidence and magnitude of OOP were investigated through multi-level analysis. Results: The overall incidence of OOP of IACI was 9.9% (25.6% for inpatient and 8.2% for outpatient) and the percentage of OOP among total expenditures was 8.3% on average (7.6% for inpatient and 26.8% for outpatient); 25.2% at traditional oriental medicine hospitals, 9.5% at general hospitals and 2.5% at the industrial-accident-designated medical institutions. The incidence of OOP of IACI was influenced by hospital size, ownership, longer duration of designation (over 5 years) and length of stay. On the other hand, its magnitude was influenced by medium-sized hospital, public hospital, location of large city and length of stay. Extra charges for upper grade room which accommodates less than 4 patients and treatment by specialists were the leading contributors to the magnitude of OOP of IACI. Conclusion: The incidence and magnitude OOP of IACI varied in institution type and were influenced by both institutional and patient's factors. In order to achieve the goal of Industrial Accident Compensation Insurance, appropriate level of compensation, that is, no incidence of OOP, for accident and disease of workers, it is necessary to take measures to reduce incidence and magnitude of OOP.

Historical Studies on the Characteristics of Jondeokjeong in the Rear Garden of Changdeok Palace (창덕궁 후원 존덕정(尊德亭)의 조영사적 특성)

  • Song, Suk-Ho;Sim, Woo-Kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.1
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    • pp.31-43
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    • 2014
  • The purposes for this research were to find the correct building background of Jondeokjeong(尊德亭) in the rear garden of Changdeok Palace(昌德宮) based on the historical facts for the area of Jondeokjeong and investigate the internal theory of construction through the metaphysical consideration. The results were as follows. 1. Building background of Jondeokjeong was related to Sohyunseja(昭顯世子) and Bongrimdaegun(鳳林大君) as forms of rear garden where was not built in the area of Jondeokjeong, bamboo pavilion, hexagonal pavilion, octagonal pavilion, etc. They were built two or three times after returning of Sohyunseja and Bongrimdaegun from China, and the area of Jondeokjeong was continuously developed by building Chunhyanggak(天香閣), Mangchunjeong(望春亭) and Cheoknoidang(滌惱堂) after Hyojong(孝宗) succeeded the royal authority of Hyunjong(顯宗) who was born in Shenyang(瀋陽) and hung a signboard of Jondeokjeong after then, etc. 2. Dazhengjeon(大政殿) of Shenyang Palace(瀋陽故宮, 1625) played the roles of major hall, Jeongjeon(正殿) which held national big events as a one-storied building with two piles of roof similar with Jondeokjeong (1644). Also, it was the building encountered when Sohyunseja and Bongrimdaegun participated in breakfasts held in the palace or banquets supervised by a king, so building background of Jondeokjeong was judged to be related with Dazhengjeon. 3. In consideration of characteristics which are shown commonly in Jondeokjeong and Dazhengjeon, relations of two buildings were verified and characteristics of Jondeokjeong were examined. First, dragon which is representatively symbolizing royal authority was formed. Therefore, Jondeokjeong was judged as a garden building which purposes were to obtain and train natural reasons, govern the nation and let people comfortable. Second, the purposes of sun dial, Ilyoungdae(日影臺) were judged to examine the accurate time and express appropriateness of the king. Third, Taechungmun(太淸門) around there is related to Samcheong(三淸) of Taoism and judged to be caused by floral wall and secular happiness accomplishment for king's longevity without disease. Fourth, for building style, one-stories pavilion of duplicated roof and building with only cylinder were to king's embodiment of supporting the sky and governing the nation.4) 4. By examining the differences between Jondeokjeong and Dazhengjeon, Jondeokjeong's own characteristics were considered. First, constructive characteristics of Jondeokjeong were changed by existing of pond and it was changed for characteristics, location and function of pavilion built in the garden while accepting oversea culture and embodied by absorbing to Joseon culture. Second, the appearance of the pond in Jondeokjeong was shown as the situation that half moon typed pond with the form of young moon is full by stream to the East. It was to express movement of moon which was always changed through the form of pond and stream of water iconographycally and it was considered as an imaginary environment method of the period.

Treatment Outcome of Postoperative Radiotherapy in Extrahepatic Bile Duct Cancer (간외담관암의 수술 후 방사선치료 성적)

  • Choi, Young-Min;Cho, Heung-Lae
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.27-34
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    • 2003
  • Purpose : To evaluate the efficacy of radiotherapy, and the factors affecting survival in patients of extrahepatic bile duct cancer, by analyzing the results of postoperative radiotherapy Materials and Methods : Between October 1991 and July 2001, 21 patients with extrahepatic bile duct cancer, who received radiotherapy after a radical resection, were retrospectively reviewed. The patients' ages ranged from 39 to 75 years, with a median of 61 years, and a male to female ratio of 16 to 5. The numbers of patients with proximal and distal bile duct cancer were 14 and 7, respectively. From the postoperative pathological examination, 19 of the patients were found to have microscopic residues, and 7 to be lymph node positive. Patients with AJCC stages I, II and III were 10, 10 and 1, respectively. The total radiation dose administered was 4,500$\~$6,300 cGy, with a median dose of 5,040 cGy. The follow up period was 20$\~$81 months, with a median of 57.5 months. Results : The overall and disease free survival rates at 3 and 5 years were 41.0 and 29.3$\%$, and 41.6 and 29.7$\%$, respectively. The influences of age, sex, tumor location, differentiation, microscopic residue, neural invasion, 7 and N stage, the stage itself, the dose of radiation and chemotherapy, on survival were evaluated. The T stage and the stage itself were found to be significant from a univariate analysis (p<0.05), but the degree of significance was limited by the small number of patients. A recurrence occurred in 12 patients (57.1$\%$), 5 in locoregional sites, 4 in distant sites and 3 in a combination of locoregional and distant sites, and the sites of distant metastasis were the liver, 6, and the bone, 1 Grade 2 or 3 acute leucopenias occurred in 2 patients and grade 2 chronic peptic ulcers occurred in 4, who were all recovered by conservative management. Conclusion : Postoperative radiotherapy is feasigbls in extrah데atic bile duct cancer, with tolerable toxicity, but prospective studies, with a large patient enrollment, are needed for the evaluation of the effects of postoperative radiotherapy and the related prognostic factors.

Neuropsychological Mechanism of Delusion (망상의 신경심리학적 기전)

  • Lee, Sung-Hoon;Kim, Dong-Wha;Park, Yun-Zo;Park, Hae-Jung;Shin, Yoon-Sik
    • Sleep Medicine and Psychophysiology
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    • v.7 no.1
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    • pp.60-66
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    • 2000
  • Objectives: The Psychopathology of schizophrenia was expected to be related with focal dysfunction of brain while schizophrenia is recognized and studied as the brain disease. Authors studied correlation between neuropsychological tests and delusion which is representative symptom of schizophrenia in patients with head trauma and psychiatric patients in order to explore the functional localization of brain in delusional symptom. Methods: Halstead Reitan Neuropsychological Test Battery and Korean Weschler Intelligent Scale and Minnesota Multiphasic Personality Inventory(MMPI) were administered to one hundred ninteen patients consisted of sixty nine psychiatric patients and fifty patients with brain damage. We tested correlation between results of neuropsychological tests and delusional scale made from twenty four items related with delusion in MMPI. T-test between eighteen higher delusion scorers and twenty one lower scorers was examed in psychiatric group. Results: In brain damage group, signigicant correlations were found in the tests related with function of frontal lobe such as category test, trail making AB test, tactual performance test, digit symbol test and fingertip number writing test, and significant correlations were also noted in the tests related with function of left temporal and parietal lobes such as information, comprehension, vocabulary, similarities and speech sound perception test. The tests related with the function of right hemisphere such as tactual performance test location, picture completion and performance, and the tests related with subcortical function such as arithmetic, digit span, attention, digit symbol test, digit symbol and trail making AB test were signigicantly corelated with delusional scale too. In psychiatric group there were significant difference of delusional score in the tests related with function of left hemisphere such as vocabulary, vocable IQ, comprehension and language, and in the tests related with subcortical function such as N 120 voltage, digit symbol and arithmetic. Conclusions: Delusion seems to be related with function of frontal lobe, left hemisphere and subcortex in both groups. Right hemisphere may be also partially related with delusion.

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The Reconstruction with Extracorporeal Irradiated Autograft for Osteosarcoma of Extremities (사지 골육종에서 체외 방사선 조사를 이용한 재건술)

  • Kim, Jae-Do;Lee, Gun-Woo;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.1-7
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    • 2010
  • Purpose: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. Materials and Methods: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. Results: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. Conclusion: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.