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Radiotherapy for Early Glottic Carinoma (조기 성문암 환자에서의 방사선치료)

  • Kim, Won-Taek;Nam, Ji-Ho;Kyuon, Byung-Hyun;Wang, Su-Gun;Kim, Dong-Won
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.295-302
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    • 2002
  • Purpose : The Purpose of this study was to establish general guidelines for the treatment of patients with early glottic carcinoma (T1-2N0M0), by assessing the role of primary radiotherapy and by analyzing the tumor-related and treatment-related factors that have an influence on the treatment results. Materials and Methods : This retrospective study was composed of 80 patients who suffered from early glottic carcinoma and were treated by primary radiotherapy at Pusan National University Hospital, between August 1987 and December 1996. The distribution of patients according to T-stage was 66 for stage T1 and 14 for stage T2. All of the patients were treated with conventional radical radiotherapy using a 6MV photon beams, a total tumor dose of $60\~75.6\;Gy$ (median 68.4 Gy), administered in 5 weekly fractions of $1.8\~2.0\;Gy$. The overall radiation treatment time was from 40 to 87 days, median 51 days. All patients were followed up for at least 3 years. Univariate and multivariate analysis was done to identify the prognostic factors affecting the treatment results. Results : The five-years survival rate was $89.2\%$ for all patients, $90.2\%$ for T1 and $82.5\%$ for T2. The local control rate was $81.3\%$ for all patients, $83.3\%$ for T1 and $71.4\%$ for T2. However, when salvage operations were taken into account, the ultimate local control rate was $91.3\%,\;T1\;94.5\%,\;T2\;79.4\%$, reprosenting an increase of $8\~12\%$ in the local control rate. The voice preservation rate was $89.2\%,\;T1\;94.7\%,\;T2\;81.3\%$. Fifteen patients suffered a relapse after radiotherapy, among whom 12 patients underwent salvage surgery. We included T-stage, tumor location, total radiation dose, fraction size, field size and overall radiation treatment time as potential prognostic factors. T-stage and overall treatment time were found to be statistically significant in the univariate analysis, but in the multivariate analysis, only the over-all treatment time was found to be significant. Conclusion : The high cure and voice preservation rates obtained when using a procedure, comprising a combination of radical radiotherapy and salvage surgery, may make this the treatment of choice for patients with early glottic carcinoma. However, the prognostic factors affecting the treatment results must be kept in mind, and more accurate treatment planning and further optimization of the radiation dose are necessary.

Radiation Therapy in Elderly Skin Cancer (노령의 피부암에서 방사선치료)

  • Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.113-117
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    • 2008
  • Purpose: To evaluate the long term results(local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. Material and Methods: The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma(10 patients), basal cell carcinoma(3 patients), verrucous carcinoma(1 patient) and skin adnexal origin carcinoma(1 patient). The most common tumor location was the head(13 patients). The mean tumor diameter was 4.9 cm(range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from $50{\sim}80$ Gy(mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. Results: The local control rates were 100%(15/15). In addition, the five year disease free survival rate(5YDFS) was 80% and twelve patients(80%) had no recurrence and skin cancer recurrence occurred in 3 patients(20%). Three patients have lived an average of 90 months($68{\sim}120$ months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. Conclusion: The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin cancer in elderly patients who achieved a good survival rate and few minor complications.

Effects of Hemorrhage on the Electroencephalograms in Dogs Anesthetized with Ketamine, Propofol and Isoflurane (출혈이 Ketamine, Propofol, Isoflurane 마취견의 뇌파에 미치는 영향)

  • Yoon, In-Sub;Jang, Hwan-Soo;Lim, Jae-Hyun;Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.539-546
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    • 2009
  • The effect of hemorrhage on the electroencephalogram(EEG) was investigated in fifteen mixed-breed dogs anesthetized with ketamine, propofol and isoflurane. Animals were randomly allocated to three groups (n = 5) by anesthetic agents; group 1 (ketamine 5 mg/kg, IV), group 2 (propofol $156\;{\mu}g$/kg/min, IV) and group 3 (isoflurane 2.0% end-tidal concentration). Medetomidine ($40\;{\mu}g$/kg, IM) was used in all dogs as a preanesthetic agent. Recording electrode for EEG was positioned at CZ. EEG, heart rate, systolic/diastolic blood pressure, $pCO_2$, $pO_2$ and blood pH were measured before anesthesia, after anesthesia and after every bleedings. Three bleedings were accomplished by drawing blood through the femoral artery catheter at a rate of 7 ml/kg (10% of total blood volume) for 10 minutes. In the course of hemorrhage, a systolic/diastolic pressure continuously decreased in all groups. The $pCO_2$ values and heart rates were increased in all groups. The $pO_2$ values were most significantly increased in group 1 compared with those in other groups. The pH values were not significantly changed. On statistical analysis of EEG, there was no significant changes in group 1 and 3. But in group 2, band 3, 4 and 7 were significantly altered after 2nd and 3rd bleeding. Power alterations of band 3, 4 and 7 were thought to be related with hemorrhage over 20% of total blood volume in group 2. In conclusion, the regulation of infusion rate would be considered when a dog, anesthetized with propofol, bleed over 20% of total blood volume.

Detection of Osteomyelitis Using a Tc-99m Labeled Antigranulocyte Antibody Immunoscintigraphy (Tc-99m 표지 항과립구항체 면역신티그라피를 이용한 골수염의 진단)

  • Kang, Won-Jun;Chung, June-Key;Yeo, Jeong-Seok;Hong, Mee-Kyoung;Jeong, Jae-Min;Lee, Dong-Soo;Lee, Sang-Hoon;Choi, In-Ho;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.344-353
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    • 1998
  • Purpose: The purpose of this study was to evaluate the diagnostic accuracy of Tc-99m labeled antigranulocyte antibody immunoscintigrapy in the diagnosis of osteomyelitis and compare with the results of triphasic bone scan. Materials and Methods: The study population was 39 patients (22 male, 17 female) who had uncertain diagnoses of osteomyelitis. Fifteen patients had history of orthopedic surgery, and 5 had previous fracture. One milligram of monoclonal antibody against NCA-95 was labeled with 370 MBq of Tc-99m, injected intravenously, and 4 hour images were obtained. Triphasic bone scan images were obtained in 30 patients. The final diagnosis was confirmed by bacteriologic culture, biopsy or long term clinical follow up. Results: Twenty one patients were confirmed to have osteomyelitis (1 acute, 20 chronic). Eighteen patients were without osteomyelitis. Antigranulocyte antibody immunoscintigraphy had a sensitivity of 71% (15/21), and a specificity of 89% (16/18), while the sensitivity and specificity of triphasic bone scan was 93% (13/14) and 38% (6/16), respectively. Antigranulocyte antibody scan showed higher specificity of 100% (11/11) in comparison with 33% (3/9) of triphasic bone scan in patients with history of orthopedic surgery or fracture. Conclusion: Antigranulocyte antibody immunoscintigraphy is more specific than that of triphasic bone scan and may be helpful in patients with history of surgery or fracture. However, sensitivity is lower than triphasic bone scan in the detection of chronic osteomyelitis.

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The Role of Endoscopy for Tumorous Conditions of the Upper Gastrointestinal Tract in Children (내시경으로 진단된 소아 상부 위장관의 종양성 질환에 대한 고찰)

  • Kim, Hye Young;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.31-40
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    • 2005
  • Purpose: This study aimed to provide, as a basic material, the experiences of endoscopy in diagnosis and treatment of tumorous conditions in the upper gastrointestinal tract in children. Methods: The objects were 26 patients diagnosed as having tumorous conditions in the upper gastrointestinal tract among 1,283 patients who underwent upper gastrointestinal endoscopic examination at the Department of Pediatrics, Pusan National University Hospital, from January 1994 to July 2004 retrospectively. The characteristics of patients, the chief complaints for endoscopic examination, the sorts of tumors diagnosed, the endoscopic findings of tumors, and the treatment of tumors were analysed. Results: 1) Eleven male and fifteen female were included, whose mean age was $6.93{\pm}4.02years$. 2) The chief complaints for endoscopic examination were abdominal pain (80.7%), vomiting or nausea (30.8%), and gastrointestinal beeding (30.7%) in order. 3) Six cases of ectopic pancreas, five cases of sentinel polyp, three cases of papilloma and vallecular cyst, two cases of Brunner's gland hyperplasia and gastric submucosal tumor, one case of gastrointestinal stromal tumor, duodenal intramural hematoma, T cell lymphoma, lipoma, and Peutz-Jeghers syndrome were diagnosed by endoscopy with or without biopsy. 4) The location of tumors was in the pharynx (19.2%), esophagus (7.7%), gastro-esophageal junction (23.0%), stomach (30.7%) and duodeneum (26.9%). 5) The size of tumors was less than 10 mm in 53.8%, 10~20 mm in 26.9%, more than 20 mm 19.2%. 6) Treatments for tumors included resection by laser, surgical resection, endoscopic polypectomy with a forcep or snare, and observation 7) There was no significant complication. Conclusion: Various and not a few tumors were found in the upper gastrointestinal tract. The endoscopy was accurate, effective, and safe means for diagnosis and treatment of those lesions in children.

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The Changes of Intestinal Normal Flora in Neonates for Seven Days Postnatally (정상 신생아의 대변에서 생후 1주일 동안 장내세균총의 변화)

  • Sung, Nam-ju;Lee, Seung Gue;Kim, Me Jin;Kim, Young Ho;Yang, Seung;Hwang, Il Tae;Jung, Ji A;Lee, Hae Ran;Kim, Jae-Seok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.162-168
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    • 2006
  • Purpose: Microbial colonization of the intestine begins just after birth and development of the normal flora is a gradual process. The first bacteria colonizing the intestine in newborns are Staphylococcus, Enterobacteriaceae and Streptococcus. For several days after birth, the number of Bifidobacterium spp. increase. The aim of this study was to investigate the changes of microflora for seven days postnatally in neonatal stool. Methods: Fifteen neonates (breast : formula : mixed feeding 1 : 8 : 6, vaginal delivery : cesarean section 3 : 12) who were born at the Kangdong Sacred Heart Hospital, Hallym University were enrolled. First meconium and stools of postnatal 1-, 3-, and 7-day were innoculated. Blood agar plates for total aerobes, trypton bile X-glucuronide agar for E. coli, phenylethyl alcohol agar for gram positive anaerobes, MRS agar for Lactobacillus spp., bifidobacterium selective agar for Bifidobacterium spp. and cefoxitin-cycloserine-fructose agar for Clostridium difficile were used in the general incubator ($CO_2$ free incubator), $CO_2$ incubator or the anaerobic chamber for 48 or 72 hours at $37^{\circ}C$ and then colony forming units were counted. Results: No microflora was identified in the first meconium. Total aerobes, E. coli, and gram positive anaerobes were significantly increased with advancing postnatal days. In only one baby, Lactobacillus acidophilus was detected $2{\times}10^5CFU/g$ in the seven-day stool. Bifidobacterium spp. was detected in two babies. Clostridium difficile was not detected during the seven days. There were no significant differences in the bowel flora depending on the delivery pattern and feeding method. Conclusion: This study shows many changes in the intestinal normal flora in neonatal stool during seven days postnatally. If these findings are confirmed with larger studies, the data may be preliminary findings to support use of probiotics in neonates.

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Conversion of Fermented Feed by Basidiomycetes (담자균(擔子菌)을 이용(利用)한 발효(醱酵) 사료(飼料)에 관한 연구(硏究))

  • Hong, Jae-Sik;Kim, Joong-Man;Jeong, Jin-Chul;Lee, Tae-Kyu;Kim, Dong-Han;Kim, Myung-Kon;Lee, Keug-Ro
    • The Korean Journal of Mycology
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    • v.13 no.3
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    • pp.157-168
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    • 1985
  • To investigate nutritive values of a feed fermented with basidiomycetes, among the isolated strains, Lyophyllum decastes (Fr.) Sing. was found with the greatest enzyme productivity and rapid mycelial growth in rice straw medium. Optimum temperature, pH and moisture content for mycelial growth and enzyme production of the strain were $25{\sim}30^{\circ}C,\;pH\;4.0{\sim}7.0\;and\;70{\sim}75\;%$, respectively. Fifteen days of culture were required for the highest enzyme productivity. Among the sub-materials added, $30{\sim}40\;%$ of rice bran and $10{\sim}20\;%$ of defatted perilla seeds were effective for the enzyme production, but caused a reduced mycelial growth. The greatest effect of an addition of inorganic salts was obtained with $0.36{\sim}0.72\;%\;of\;(NH_4)_2HPO_4$. When 40 mesh or smaller rice straw and steam treatment at $0.5\;kg/cm^2$ were used, the mycelial growth decreased, whereas the enzyme production increased. The mycelial growth and enzyme production increased when $Ca(OH)_2$ was used as the alkali treatment, but decreased with increasing concentration of NaOH. As the fermentation proceeded, the amounts of ash, reducing sugar and total nitrogen increased, but cellulose, lignin and pentosan decreased. When the rice straw was treated with alkali, the amounts of ash, total nitrogen and lignin decreased, but reducing sugar and cellulose increased. At higher NaOH concentration, the variation become greater. The in vitro dry matter digestibility of the products increased from 55.03 % at the beginning of the fermentation to 62.72 % at 45 days after fermentation. The most effective alkali treatment on the digestibility of rice straw was KOH followed by NaOH. However, the digestibility increased with increasing concentration of NaOH. The digestibility of pretreated with alkali increased after fermentation as well.

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Studies on Dairy Farming Status, Reproductive Efficiencies and Disorders in New Zealand (II) A Survey on Reproductive Efficiencies and Disorders in Palmerston North Area (뉴질랜드 (Palmerston North) 의 낙농 현황과 번식 및 번식장해에 관한 연구 (II) Palmerston North 지역의 낙농 번식현 황과 번식장해에 관한 조사)

  • 김중계;맥도날드
    • Korean Journal of Animal Reproduction
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    • v.24 no.1
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    • pp.19-33
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    • 2000
  • Eighty dairy farms (38 farms responded) in Palmerston North area of New Zealand were questioned by mail questionnaire on: 1) general characteristics, 2) milk yield and feed supplementary, 3) reproductive efficiencies (12 questions) and 4) reproductive disorders (12 questions) from February to July, 1998. Among those 4 items, the reproductive efficiencies (3) and disorders (4), various diseases and culling rates were surveyed and analyzed for Korean dairy farmers (especially in Cheju island) and compared with New Zealand. The results are as follows: 1. Fifteen farms in 38 dairy farms relied entirely on artificial insemination, the rest of 23 dairy farms (60.5%) raised 5∼6 bulls to increase conception rate. The dairy farmers in Palmerston North used artificial insemination from Oct 4th to Dec 10th for 42.8 days, and then used bulls from that point to coming Jan 10th for 41.4 days. The submission rate within 3, 6 and 10 weeks following the initiation of AI season was 84.7, 93.9 and 97.9% respectively. 2. The average age of heifers at the first estrus, pregnancy and calving was 11.0, 18.0 and 24.7 months respectively, and an average 1.4 estrus cycles were required for conception. The intervals of estrus recurrence and the following conception after calving were 38 and 68 days respectively. 3. Among inseminated cows, calving, abortion and empty cow was 90.9, 1.6 and 7.4% respectively. Calving rate decreased according to increasing farm size, while the number of empty cows decreased. 4. Stillbirth, retained placenta and delivery abnormalities were 5.3, 3.7 and 5.5% respectively, not different depend on herd size. 5. The incidence of milk fever, grass tetany, and ketosis was 3.6, 3.0 and 1.0%, respectively. The delivery abnormality and mastitis treated with medicine were 3.1 and 6.7%, but decreased according to farm size. Lameness was 8.6% on average, but over 10% in farms which has more than 400 milking cows. 6. Among the culled cows (15.5% of the total), those culled due to an old age, lameness and other diseases were 2.9, 1.8 and 4.3% respectively and those culled due to low milk production, reproductive abnormality reduced with farm size. 7. Compared with the data collected in Korea, the reproductive efficiency was better, and lameness, metabolic problem and culling rate were higher in New Zealand

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Genes of Wild Rice (Oryza grandiglumis) Induced by Wounding and Yeast Extract (상처와 효모추출물 처리조건에서 유발되는 야생벼 유전자 스크린)

  • Shin, Sang-Hyun;Im, Hyun-Hee;Lee, Jai-Heon;Kim, Doh-Hoon;Chung, Won-Bok;Kang, Kyung-Ho;Cho, Sung-Ki;Shin, Jeong-Sheop;Chung, Young-Soo
    • Journal of Life Science
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    • v.14 no.4
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    • pp.650-656
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    • 2004
  • Oryza grandiglumis (CCDD, 2n=48), one of the wild rice species, has been known to possess fungal-,bacterial-, and insect-resistance against sheath blight, rice blast, bacterial leaf blight and brown plant hopper (Nilaparvata lugens). To rapidly isolate differentially expressed genes responding to fungal and wounding stress, wounding and yeast extract were treated to O. grandiglumis for 24 hrs. Suppression subtractive hybridization (SSH) method was used to obtain differentially expressed genes from yeast extract and wounding treated plants. Seven hundreds and seventy six clones were obtained by subcloning PCR product, and colony array and screening were carried out using radio-isotope labeled cDNA probes prepared from the wounding and yeast extract treated plants. One hundred and fifteen colonies were confirmed as true positive ones. Average insert size of the clones were ranged from 400 bp to 700 bp and all the inserts were sequenced. To decide the identity of those clones, sequences were analyzed by sequence homology via GenBank database. The homology search result showed that 68 clones were matched to the genes with known function; 16 were related to primary metabolism, 5 to plant retrotransposons, 5 to defense related metallothionein-like genes. In addition to that, others were matched to various genes with known function in amino acid synthesis and processing, membrane transport, and signal transduction, so on. In northern blot analysis, induced expressions of ogwfi-161, ogwfi-646, ogwfi-663, and ogwfi-695 by wounding and yeast extract treatments were confirmed. The result indicates that SSH method is very efficient for rapid screening of differentially expressed genes.

ANTIMICROBIAL EFFECT OF ANTIBIOTICS AND ROOT CANAL CEMENTS ON THE PREDOMINANT PATHOGENIC ANAEROBIC MICROFLORA IN ROOT CANALS (근관내 주요 혐기성 병인균에 대한 수종 항생제와 근관충전용 세멘트의 항균효과에 관한 연구)

  • Bae, Kwang-Shik
    • Restorative Dentistry and Endodontics
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    • v.18 no.2
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    • pp.515-525
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    • 1993
  • The purpose of this study was to evaluate the susceptibility of anaerobic microorganisms to certain antibiotics and root canal cements. Prevotella intermedia(Bacteroides intermedius) ATCC 25611(serotype A), Fusobacterium nucleatum ATCC 25586, Actinomyces viscosus ATCC 15987 which are the predominant pathogenic anaerobes in dental root canals were cultured in BHI for 48 hours(Fig.1). After each $200{\mu}l$ of those broths with microorganisms was streaked on each surface of blood agar plate, 2 to 5 antibiotic discs which are impregnated with Tetrncycline, Erythromycin, Ampicillin, Clindamycin, or Vancomycin were applied on each surface of blood agar plate and cultured for 5 days anaerobically in the anaerobic chamber (Fig.2). 15 antibiotic discs for each kind of antibiotics and each species of microorganisms were tested. Also each kind of root canal cement tubes which include Zinc oxide eugenol cement, Zinc phosphate cement, Calcium hydroxide powder+DD.W., Calcium hydroxide paste(Pulpdent Tempcanal), or Vitapex(Table 1) were applied on the inoculated BAPs after $200{\mu}l$ of each experimental species of microorganisms was streaked on the surface of blood agar plates, and they were cultured for 5 days anaerobically in the anaerobic chamber(Fig.3). The sensitivity(antimicrobial effect) was determined by the diameter of the inhibition zone. The results are as follows: 1. The results of antibiotic susceptibility test(Table 2) 1) All of the tested antibiotics had antimicrobial activity with various degrees. 2) In Prevotella intermedia (old Bacteroides intermedius), the diameter of inhibition zone to Erythromycin($37.87mm{\pm}2.20$) was largest, those to Tetracycline($26.20mm{\pm}2.96$), Vancomycin($21.53mm{\pm}1.96$), Clindamycin($18.73mm{\pm}0.96$) was smaller than former orderly, and That to Ampicillin ($7.87mm{\pm}0.83$) was smallest. 3) In Actinomyces viscosus, the diameter of inhibition zone to Erythromycin($28.73mm{\pm}1.22$) was largest, those to Ampicillin($21.73mm{\pm}1.03$), Clindamycin($21.33mm{\pm}1.59$) was similarly next order, that to Vancomycin($19.00mm{\pm}1.96$) was smaller than Clindamycin, and that to Tetracycline($11.93mm{\pm}0.70$) was smallest. 4) In Fusobacterium nucleatum, the diameter of inhibition zone to Ampicillin($31.07mm{\pm}1.91$) was largest, that to Erythromycin($28.87mm{\pm}0.92$), Clindamycin($20.47mm{\pm}1.51$), Vancomycin ($16.73mm{\pm}0.96$), Tetracycline ($12.13mm{\pm}1.06$) are smaller than former orderly. 2. The results of root canal cements and pastes(Table 3) 1) The external diameter of tube is 4mm, so 4mm of the inhibition zone diameter means non-susceptable. Prevotella intermedia (old Bacteroides intermedius) was non-susceptable to Calcium hydroxide powder+D.D.W., Calcium hydroxide paste(pulpdent Tempcanal), and Actinomyces viscosus was non-susceptable to Zinc phosphate cement, Calcium hydroxide powder + D.D.W., Calcium hydroxide paste(pulpdent Tempcanal). 2) In Prevotella intermedia (old Bacteroides intermedius), the diameter of inhibition zone to Zinc oxide eugenol cement($13.67mm{\pm}3.30$) was largest, that to Vitapex($9.20mm{\pm}2.96$), Zinc phosphate cement($6.13mm{\pm}2.07$) was smaller than former. 3) In Actinomyces viscosus, the diameter of inhibition zone to Zinc oxide eugenol cement($17.40mm{\pm}5.20$) was largest and that to Vitapex($8.80mm{\pm}1.70$) was next order. 4) In Fusobacterium nucleatum, the diameter of inhibition zone to Vitapex($42.33mm{\pm}17.2$) was largest and those to Calcium hydroxide paste(Pulpdent Tempcanal)($14.47mm{\pm}3.72$) and Zinc oxide eugenol cement($8.93mm{\pm}2.71$), Zinc phosphate cement($8.20mm{\pm}2.27$), Calcium hydroxide powder+D.D.W.($5.53mm{\pm}2.10$)was next orderly. And then In Zinc oxide eugenol cement and Zinc phosphate cement group, two of fifteen samples showed no inhibition zone, in Calcium hydroxide powder + D.D.W. group, 8 of 15 samples showed no inhibition zone.

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