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Results of Breast Conserving Surgery and Subsequent Postoperative Radiotherapy for Cases of Breast Cancer (유방암에서 유방보존수술 및 수술 후 방사선치료의 결과)

  • Chie, Eui-Kyu;Kim, Kyu-Bo;Choi, Jin-Hwa;Jang, Na-Young;Han, Won-Shik;Noh, Dong-Young;Im, Seock-Ah;Kim, Tae-You;Bang, Yung-Jue;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.26 no.3
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    • pp.142-148
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    • 2008
  • Purpose: We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by postoperative radiotherapy.Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months. Results: The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival. Conclusion: This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.

Evaluation of Butyltin Compounds and its Distribution Among Seawater, Sediment and Biota from the Kwangyang Bay (광양만내 유기주석화합물의 해수, 퇴적물, 생물중 농도 및 분포 상관관계)

  • KIM Gue Yoong;PARK Mi-Ok
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.34 no.4
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    • pp.291-298
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    • 2001
  • Seawater, sediment and biota in the Kwangyang Bay were analyzed by gas chromatography/quartz furnace atomic absorption spectroscopy (GC-QFAAS) to investigate concentrations and distribution pattern of butyltin compounds (TBT, DBT, MBT) during February, April and July, 1996, Marine biota analyzed were Tapes japcnicus and Crassostrea gigas. The concentrations of tributyltin (TBT) in seawater were in the range of ND-15.7 ng/L for the surface and ND-68.5 ng/L for the bottom. The highest concentration of TBT in seawater was detected in April for the both, surface and bottom water. The maximum value of $TBT_{(bottom)}/TBT_{(surface)}$, 3.6 in April showed the increased input of TBT from the surface water in April compared to February (2.1) and July (0.9). The concentrations of TBT in the sediment were in the range of ND-8.5 ng/g dry wt. The highest concentration of TBT in the sediment was measured in July, This result seems to attributed to the removal of TBT from water column via sorption onto particulate matters to the relatively undisturbed underlying sediment and increased input of TBT by increased fluxes of detritus of marine plankton after spring bloom, in July. The mean values of partitioning coefficient ($K_d$) of TBT between seawater and sediment were $3.0\times10^3$(February), $7.4\times10^3$(April) and $9.4\times10^3$(July). The concentrations of TBT in biosamples were in the range of ND-93.30 ng/g dru wt. (T. japonicus) and ND-138.53 ng/g dry wt. (C. gigas). The seasonal variation of TBT contents in biota was remarkable. The $K_d$ (biological concentration factor) was $7-41\times10^3$ for T. japonicus. and $5-34\times10^3$ for C. gigas. The measured TBT concentrations in seawater in the study area was sufficient to cause the imposex of shellfish and to retard the growth of aquatic organisms including oyster upon chronic exposure.

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Postoperative Stability and Occlusal Plane Alternation by Orthognathic Surgery of Skeletal Class III Malocclusion with Anterior Open Bite (전치부 개교를 동반한 골격성 III급 부정교합 환자의 악교정 수술 후 교합평면의 변화와 안정성에 관한 연구)

  • Shin, Soo-Jung;Hwang, Byung-Nam;Lee, Jung-Keun;Rhee, Seung-Hoon
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.113-127
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    • 1999
  • The purpose of this study is to investigate the stability of counterclockwise rotation of mandible by sagittal split ramus osteotomy to correct the skeletal Class III malocclusion with anterior open bite. Twenty five skeletal Class III open bite patients(mean age 20.6 years) who were treated by the sagittal split ramus osteotonues with rigid fixation were examined in this study. Cephalometric radiographs were taken for each Patients Preoperative(T1), ewly Postoperative(T2), and late postoperative Period(T3). Mean postoperative period was 8.0 months. Cephalometric analysis was done and data from T1, T2, and T3 were analyzed statistically by Paired t-test and Pearson correlation analysis. The following results were obtained. 1. Mandibular plane angle decreased $2.9^{\circ}$ and mandibular occlusal plane angle related to SN Plane decreased $2.7^{\circ}$ after orthognathic surgery(T2). At 6 months after orthognathic surgery(T3), mandibular plane angle increased $1.0^{\circ}$, but mandibular occlusal plane angle did not changed. 2. The amount of horizontal relapse long time after orthognathic surgery(T3) was 1.6 mm at B point and it was $22\%$ of the total posterior movements. There was no vertical relapse in the anterior facial height. 3. The related factor with horizontal relapse at late postoperative period was mandibular plane angle(p<0.01). The related factors with decreasing posterior facial height were amount of mandibular setback(p<0.01), increasing of mandibular ramus height(p<0.01), and decrease of the mandibular plane angle during operation(p<0.01). 4. There was no relationship between the amount of changes in mandibular occlusal plan angle during operation and the amount of relapse after surgery.

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Lead Pollution and Lead Poisoning among Children in China

  • Zheng, Yuxin
    • Proceedings of the Korean Environmental Health Society Conference
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    • 2003.06a
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    • pp.24-25
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    • 2003
  • Lead is ubiquitous in the human environment as a result of industrialization. China's rapid industrialization and traffic growth have increased the potential for lead emissions. Lead poisoning in children is one of the most common public health problems today, and it is entirely preventable. Children are more vulnerable to lead pollution and lead in their bodies can affect their nervous, circulatory, and digestive systems. Children are exposed to lead from different sources (such as paint, gasoline, and solder) and through different pathways (such as air, food, water, dust, and soil). Although all children are exposed to some lead from food, air, dust, and soil, some children are exposed to high dose sources of lead. Significant sources of lead for China's children include industrial emissions (often close to housing and schools), leaded gasoline, and occupational exposure that occurs when parents wear lead-contaminated clothing home from work, burning of coal for home heat and cooking, contaminated food, and some traditional medicines. To assess the blood lead level in children in China, a large-scale study was conducted in 19 cities among 9 provinces during 1997 to 2000. There were 6502 children, aged 3-5 years, were recruited in the study The result indicates that the mean blood lead level was 8.83ug/dl 3-5 year old living in city area. The mean blood lead level of boys was higher than that of girls (9.1l ug/dl vs 8.73ug/dl). Almost 30 percent childrens blood lead level exceeded 10ug/dl. The average blood lead level was higher than that of in 1985 (8.83ug/dl vs 8.lug/dl). An epidemiological study was carried on the children living around the cottage industries recycling the lead from battery. Nine hundreds fifty nine children, aged 5-12 years, living in lead polluted villages where the lead smelters located near the residential area and 207 control children live in unpolluted area were recruited in the study. The lead levels in air, soil, drinking water and crops were measured. The blood lead and ZnPP level were tested for all subjects. The results show that the local environment was polluted. The lead levels both in the air and crops were much higher than that of in control area. In the polluted area, the average blood level was 49.6ug/dl (rang 19.5-89.3ug/dl). Whereas, in the unpolluted area, the average blood level was 12.4ug/dl (rang 4.6-24.8ug/dl). This study indicates that in some countryside area, some cottage industries induce seriously lead pollution and cause children health problem. For the introducing of unleaded gasoline in some large cities, such as Beijing and Shanghai, the blood lead level showed a declined trend since 1997. By 2000, the use of leaded gasoline in motor vehicles has been prohibited in China. The most recent data available show that levels of lead in blood among children in Shanghai decreased from 8.3ug/dl in 1997 to 7.6ug/dl in 1999. The prevalence rate of children lead poisoning (blood lead >10ug/dl) was also decreased from 37.8% to 24.8%. In children living in downtown area, the blood lead level reduced dramatically. To explore the relationship between gene polymorphisms and individual susceptibility of lead poisoning, a molecular epidemiological study was conducted among children living in lead polluted environment. The result showed that the subjects with ALAD2 allele has higher ZPP level, and the subjects with VDR B allele has larger head circumference than only with b allele. In the present study, we demonstrated that ALAD genotypes modify lead effects on heme metabolism and VDR gene variants influence the skull development in highly exposed children. The polymorphism of ALAD and VDR genes might be the molecular inherited factor modifying the susceptibility of lead poisoning. Recently, Chinese government pays more attention to lead pollution and lead poisoning in children problem. The leaded gasoline was prohibited used in motor vehicles since 2000. The government has decided to have a clampdown on the high-polluted lead smelters for recycling the lead from battery in countryside. It is hopeful that the risk of lead poisoning in children will be decreased in the further

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Variations in Soil-to-Red Pepper Transfer Factors of Radionuclides with Time of Their Application and Fruit Harvest (고추 재배시 방사성 핵종 처리 및 열매수확 시기에 따른 토양-작물체간 전이계수의 변이)

  • Choi, Yong-Ho;Lee, Won-Yun;Lim, Kwang-Muk;Park, Doo-Won;Lee, Myung-Ho;Lee, Chang-Woo;Lee, Hyun-Duk;Lee, Jeong-Ho
    • Journal of Radiation Protection and Research
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    • v.22 no.3
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    • pp.171-181
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    • 1997
  • A mixed solution of $^{54}Mn$, $^{60}Co$, $^{85}Sr$ and $^{137}Cs$ was applied to the soil of culture boxes in a greenhouse 2 days before transplanting red pepper and at 3 different times during its growth for investigating transfer factors ($m^2/kg-dry$) for its green and red fruits. Transfer factors varied with radionuclide, application time and harvest time by factors of about $20{\sim}100$. They decreased mostly in the order of $^{85}Sr>^{54}Min>^{60}Co>^{137}Cs$ while $^{54}Mn$ and $^{60}Co$ was higher than $^{85}Sr$ when time lapse between application and harvest was short. Transfer factors of $^{85}Sr$ and $^{137}Cs$ at the last application were lower than those at the previous one by factors of $3{\sim}20$ depending on harvest time. Variations in $^{54}Mn$ and $^{60}Co$ transfer factors with application time after transplanting were comparatively low. Transfer factors of $^{54}Mn$, $^{60}Co$ and $^{85}Sr$ mixed with topsoil before transplanting were up to $3{\sim}9$ times higher than those for the application onto soil surface 2 days after transplanting while there was no difference in $^{137}Cs$. The present results can be referred to in estimating root-uptake concentrations of the radionuclides in red pepper fruit and taking proper measures for its harvest and consumption at the event of an accidental release during the growing season of red pepper.

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Rotating Shift and Daytime Fixed Work Schedules as a Risk Factor for Depression in Korean Police Officers (순환교대근무와 주간고정근무 경찰공무원의 우울감에 미치는 요인에 대한 연구)

  • Bae, Seung-Min;Lee, Yu-Jin;Kim, Seog-Ju;Cho, In-Hee;Kim, Jong-Hoon;Koh, Seung-Hee;Cho, Seong-Jin
    • Sleep Medicine and Psychophysiology
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    • v.17 no.1
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    • pp.28-33
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    • 2010
  • Objectives: Working at other times than the regular day shift has been reported to be a stressor associated with health consequences and mental disorders as well as disturbance of sleep. In current study, we aimed at investigating the relationship between work schedule, sleep quality and depression among police officers. Methods: Eleven hundreds and forty five police officers (male: 1040, female: 105) completed questionnaires of basic socio-demographic data, Pittsburgh Sleep Quality Index (PSQI), Korean Scale of Occupational Stress (KOSS), Impact of Event Scale - Revised (IES-R) and Center for Epidemiologic Study-Depression (CES-D). Results: After controlling for age, sex and educational level, score of CES-D was correlated positively with the score of KOSS, PSQI and IES-R on partial correlation analysis (r=-0.077; p=0.009, r=0.262; p<0.000 and r=0.421, p<0.000, respectively). Logistic regression analysis revealed that female sex, age, the score of KOSS and IES-R and schedule of rotating shift work predicted higher score than 16 score of CES-D significantly in total subjects (p=0.023, p=0.015, p=0.000, p=0.000 and p=0.022, respectively). Conclusion: Current result suggested that not only female sex, age, higher occupational stress and impact of event scale but also rotating shift work schedule might be related to depression among police officers.

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The Resting and Exercise Related Oxygen Desaturation as the Associated Factor for Sleep Related Oxygen Desaturation in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 수면 중 산소포화도 감소에 대한 예측인자로서 안정시 및 운동시 산소포화도)

  • Shin, Chang-Jin;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.231-238
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    • 1999
  • Background: Nocturnal hypoxemia occurs in patients with chronic obstructive pulmonary disease(COPD) and the detection and treatment of nocturnal hypoxemia should be part of the management of COPD patients. We performed this study to evaluate the factors influencing to sleep related arterial oxygen desaturation($SaO_2$) in patients with COPD. Methods: Resting and exercise cardiopulmonary function test, polysomnography, and $SaO_2$ during resting, exercise and sleep were measured in 12 patients with COPD. Results: The $SaO_2$ fell twice as much during sleep as during maximal exercise($13.1{\pm}9.3%$ fall in nocturnal $SaO_2$ vs. $6.4{\pm}3.3%$, p<0.05). Fall in nocturnal $SaO_2$ was well correlated with mean exercise $SaO_2$(r=-0.78, p<0.05), minimum exercise $SaO_2$(r=-0.90, p<0.01), and resting $SaO_2$(Cr=-0.82, p<0.05). Lowest sleep $SaO_2$ was well correlated with mean exercise $SaO_2$(r=0.80, p<0.05), lowest exercise $SaO_2$(r=0.90, p<0.01), and resting $SaO_2$(r=0.84, p<0.05). Conclusion: Resting and exercise $SaO_2$ was well correlated with nocturnal $SaO_2$, but exercise study add no additional information to predicting the nocturnal oxygen desaturation in patients with COPD.

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The Early Prognosis of Burn Patients with Elevated Initial Arterial Carboxyhemoglobin Level (초기 동맥혈 Carboxyhemoglobin 농도가 높았던 화상 환자들의 예후지표에 관한 연구)

  • Choi, Chang Soon;Kim, Cheal Hong;Kim, Keun Sook;Lee, Tae-Yu;Chung, Youn Son;Eom, Kwang Seok;Park, Young Bum;Jang, Seung Hun;Kim, Dong Gyu;Park, Myung Jae;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Kim, Jong Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.188-197
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    • 2003
  • Background : Smoke inhalation injury is an important determinant of mortality in burn patients. The early detection of inhalation injury in burn patients is important because the incidence of respiratory failure after inhalation injury was known to be high, with hypoxemia, pneumonia, and prolonged ventilatory support being commonplace. Acute carbon monoxide poisoning was one feature of smoke inhalation. The purpose of our study were to investigate the clinical characteristics of burn patients whose initial arterial carboxyhemoglobin (COHb) level had been elevated, to assess the clinical impact of COHb for smoke inhalation injury. Methods : Among 1,416 burn patients had been admitted at our institution from August 1, 2001 to July 31, 2002, 39 patients whose initial arterial COHb level have been more than 5% were included. We compared clinical scoring system for inhalation injury, percent total body surface area (%TBSA) burn, initial chest X-ray findings, APACHE II scores and SAPS II scores between survivors (n=27) and non-survivors (n=12) retrospectively. Results : COHb level were 9.7(5.71% and 10.3(8.81% in survivors and in non-survivors (p>0.05). Mean %TBSA burn of survivors and non-survivors were $16.6{\pm}17.8%$ and $60.7{\pm}28.8%$ (p<0.001). We did not find any difference in clinical scoring system, initial chest X-ray findings in survivors and in non-survivors. But %TBSA burn, APACHE II and SAPS II scores were high in non-survivors than in survivors significantly. Important factors associated with death were %TBSA burn, APACHE II scores, SAPS II scores, and the most important factor in predicting mortality was %TBSA burn. Conclusion : Burn patients with elevated initial arterial COHb level showed poor prognosis, but further study may be performed to know that the effect of COHb on prognosis in burn patients accompanying smoke inhalation.

p16INK4a Promoter Hypermethylation in Sputum, Blood, and Tissue from Non-Small Cell Lung Cancer and Pulmonary Inflammation (비소세포폐암과 염증성 폐질환에서 가래와 혈액 및 조직에서 p16INK4a Promoter 과메틸화)

  • Kim, Jeong Pyo;Kim, Kyong Mee;Kwon, Soon Seog;Kim, Young Kyoon;Kim, Kwan Hyoung;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak;Ahn, Joong Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.160-170
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    • 2006
  • Background : The aberrant promoter hypermethylation of p16INK4a, as a tumor suppressor gene, is contributory factor to non-small cell lung cancer(NSCLC). However, its potential diagnostic impact of lung cancer is unclear. This study measured the level of $p16^{INK4a}$ promoter hypermethylation in the sputum and blood, and compared this with the level measured in the tissue obtained from NSCLC and pulmonary inflammation. Methods : Of the patients who visited the Our Lady of Mercy Hospital in Incheon, Korea for an evaluation of a lung mass and underwent blood, sputum, and tissue tests, 23patients (18 NSCLC, 5 pulmonary inflammation) were enrolled in this study. DNA was extracted from each sample and the level of p16INK4amethylation was determined using methylation-specific polymerase chain reaction. Results : $p16^{INK4a}$ methylation of the blood was observed in 88.9% (16 of 18) and 20.0% (1 of 5) of NSCLC and from pulmonary inflammation samples, respectively (P=0.008). Methylation of the sputum was observed in 83.3% (10 of 12) 80.0% (4 of 5) of NSCLC and pulmonary inflammation samples, respectively (P=1.00). Among the 8 NSCLC tissue samples, methylation changes were detected in 75.0% of samples (6 cases). Four out of seven tissue samples (57.1%) showed concordance, being methylated in both the blood and sputum. Conclusions : There was a higher level of $p16^{INK4a}$ methylation of the blood from NSCLC patients than from pulmonary inflammation. The tissue showed a high concordance with the blood in the NSCLC samples. These findings suggest that $p16^{INK4a}$ promoter hypermethylation of the blood can used to discriminate between NSCLC and pulmonary inflammation.

Spontaneous Resolution of Residual Pleural Thickening in Tuberculous Pleurisy (결핵성 흉막염 치료 후 잔여 흉막비후의 자연흡수)

  • Kyung, S.Y.;Kim, Y.J.;Lim, Y.H.;An, C.H.;Lee, S.P.;Park, J.W.;Jung, S.H.
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.69-76
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    • 2005
  • Background : Residual pleural thickening (RPT) is the most common complication of tuberculous pleurisy (TP), despite adequate anti-tuberculous chemotherapy. At the conclusion of treatment, 43-50% of patients present RPT, with its incidence varying according to the time of evaluation. To assess the spontaneous resolution of RPT, the RPT at the completion of treatment was compared with that at the final follow-up. The factors related to the development of RPT after the completion of treatment were also studied. Methods : The medical records of sixty four patients, diagnosed with TP between March 2001 and June 2003, were retrospectively. The RPT was measured at the completion of treatment and at the time of the final follow-up and the degree and frequency of RPT compared between the two measurements. Each time, the patients were divided into two groups: those with and without RPT. The clinical characteristics and the radiographic and pleural fluid findings of the two groups were compared. Results : Thirty six (56%) and 27 patients had RPT at the completion of treatment and at the time of the final follow-up, respectively (median follow up period: 8 months). Spontaneous resolution of the RPT was found in 9 patients (24%), and had decrease below 10mm in 15 (42%) during the follow-up period after treatment. The patients were initially divided into two groups: 36 and 27 patients with and without RPT, respectively. There was no predicting factor of RPT, with the exception of the presence of CRP, between the two groups. The patients were also separated into two groups at the time of final visit: 27 and 37 patients with and without RPT, respectively. The patients with RPT were found to have a lower total WBC count in pleural fluid. Conclusion : 57% of patients with RPT were found to have spontaneous resolution of the residual pleural thickening after completion of the chemotherapy. The time of evaluation for RPT and its predicting factors were decided after adequate follow-up, irrespective of the completion of treatment.