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Role of Postoperative Conventional Radiation Therapy in the Management of Supratentorial Malignant Glioma - with respect to survival outcome and prognostic factors - (천막상부 악성 신경교종에서 수술 후 방사선 치료의 역할 - 생존율과 예후인자 분석 -)

  • Nam Taek Keun;Chung Woong Ki;Ahn Sung Ja;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.389-398
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    • 1998
  • Purpose : To evaluate the role of conventional postoperative adjuvant radiotherapy in the management of supratentorial malignant glioma and to determine favorable prognostic factors affecting survival. Materials and Methods : From Sep. 1985 to Mar. 1997, the number of eligible patients who received postoperative radiotherapy completely was 69. They ranged in age from 7 to 66 years (median, 47). Forty-two (61$\%$) patients were glioblastoma multiforme and the other 27 (39$\%$) were anaplastic astrocytoma. Twenty patients (29$\%$) had Karnofsky score equal or more than 80 preoperatively. Forty-three patients (62$\%$) had symptom duration equal or less than 3 months. Twenty-four patients (35$\%$) had gross total resection and forty patients(58$\%$) had partial resection, the remaining five patients (7$\%$) had biopsy only. Radiotherapy dose ranged from 50.4 Gy to 61.2 Gy (median, 55.8; mode, 59.4) with fraction size of 1 8 Gy-2.0 Gy for 33-83 days(median, 48) except three patients delivered 33, 36, 39 Gr, respectively with fraction size of 3.0 Gy due to poor postoperative performance status. Follow-up rate was 93$\%$ and median follow-up period was 14 months. Results : Overall survival rate at 2 and 3 years and median survival were 38$\%$, 20$\%$, and 16 months for entire patients; 67$\%$, 44$\%$, and 34 months for anaplastic astrocytoma; 18$\%$, 4$\%$, and 14 months for glioblastoma multiforme, respectively (p=0.0001). According to the extent of surgery, 3-year overall survival for gross total resection, partial resection, and biopsy only was 38$\%$, 11$\%$, and 0$\%$, respectively (p=0.02) The 3-year overall survival rates for patients age 40>, 40-59, and 60< were 52$\%$, 8$\%$, and 0$\%$, respectively (p=0.0007). For the variate of performance score 80< vs 80>, the 3-year survival rates were 53$\%$ and 9$\%$, respectively (p=0.008). On multivariate analysis including covariates of three surgical and age subgroups as above, pathology, extent of surgery and age were significant prognostic factors affecting overall survival. On another multivariate analysis with covariates of two surgical (total resection vs others) and two a9e (50> vs 50<) subgroups, then, pathology, extent of surgery and performance status were significant factors instead of age and 3-year cumulative survival rate for the five patients with these three favorable factors was 100$\%$ without serious sequela. Conclusion : We confirmed the role of postoperative conventional radiotherapy in the management of supratentorial malignant glioma by improving survival as compared with historical data of surgery only. Patients with anaplastic astrocytoma, good performance score, gross total resection and/or young age survived longest. Maximum surgical resection with acceptable preservation of neurologic function should be attempted in glioblastoma patients, especially in younger patients. But the survival of most globlastoma patients without favorable factors is still poor, so other active adjuvant treatment modalities should be tried or added rather than conventional radiation treatment alone in this subgroup.

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Studies on the Internal Changes and Germinability during the Period of Seed Maturation of Pinus koraiensis Sieb. et Zucc. (잣나무 종자(種字) 성숙과정(成熟過程)에 있어서의 내적변화(內的變化)와 발아력(發芽力)에 대(對)한 연구(硏究))

  • Min, Kyung-Hyun
    • Journal of Korean Society of Forest Science
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    • v.21 no.1
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    • pp.1-34
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    • 1974
  • The author intended to investigate external and internal changes in the cone structure, changes in water content, sugar, fat and protein during the period of seed maturation which bears a proper germinability. The experimental results can be summarized as in the following. 1. Male flowers 1) Pollen-mother cells occur as a mass from late in April to early in May, and form pollen tetrads through meiosis early and middle of May. Pollen with simple nucleus reach maturity late in May. 2) Stamen number of a male flower is almost same as the scale number of cone and is 69-102 stamens. One stamen includes 5800-7300 pollen. 3) The shape is round and elliptical, both of a pollen has air-sac with $80-91{\mu}$ in length, and has cuticlar exine and cellulose intine. 4) Pollen germinate in 68 hours at $25^{\circ}C$ with distilled water of pH 6.0, 2% sugar and 0.8% agar. 2. Female flowers 1) Ovuliferous scales grow rapidly in late April, and differentiation of ovules begins early in May. Embryo-sac-mother cells produce pollen tetrads through meiosis in the middle of May, and flower in late May. 2) The pollinated female flowers show repeated divisions of embryo-sac nucleus, and a great number of free nuclei form a mass for overwintering. Morphogenesis of isolation in the mass structure takes place from the middle of March, and that forms albuminous bodies of aivealus in early May. 3. Formation of pollinators and embryos. 1) Archegonia produce archegonial initial cells in the middle and late April, and pollinators are produced in the late April and late in early May. 2) After pollination, Oespore nuclei are seen to divide in the late May forming a layer of suspensor from the diaphragm in early June and in the middle of June. Thus this happens to show 4 pro-embryos. The organ of embryos begins to differentiate 1 pro-embryo and reachs perfect maturation in late August. 4. The growth of cones 1) In the year of flowering, strobiles grow during the period from the middle of June to the middle of July, and do not grow after the middle of August. Strobiles grow 1.6 times more in length 3.3 times short in diameter and about 22 times more weight than those of female flower in the year of flowering. 2) The cones at the adult stage grow 7 times longer in diameter, 12-15 times shorter diameter than those of strobiles after flowering. 3) Cone has 96-133 scales with the ratio of scale to be 69-80% and the length of cone is 11-13cm. Diameter is 5-8cm with 160-190g weight, and the seed number of it is 90-150 having empty seed ratio of 8-15%. 5. Formation of seed-coats 1) The layers of outer seed-coat become most for the width of $703{\mu}$ in the middle of July. At the adult stage of seed, it becomes $550-580{\mu}$ in size by decreasing moisture content. Then a horny and the cortical tissue of outer coats become differentiated. 2) The outer seed-coat of mature seeds forms epidermal cells of 3-4 layers and the stone cells of 16-21 layers. The interior part of it becomes parenchyma layer of 1 or 2 rows. 3) Inner seed-coat is formed 2 months earlier than the outer seed-coat in the middle of May, having the most width of inner seed-coat $667{\mu}$. At the adult stage it loses to $80-90{\mu}$. 6. Change in moisture content After pollination moisture content becomes gradually increased at the top in the early June and becomes markedly decreased in the middle of August. At the adult stage it shows 43~48% in cone, 23~25% in the outer seed-coat, 32~37% in the inner seed-coat, 23~26% in the inner seed-coat and endosperm and embryo, 21~24% in the embryo and endosperm, 36~40% in the embryos. 7. The content compositions of seed 1) Fat contents become gradually increased after the early May, at the adult stage it occupies 65~85% more fat than walnut and palm. Embryo includes 78.8% fat, and 57.0% fat in endosperm. 2) Sugar content after pollination becomes greatly increased as in the case of reducing sugar, while non-reducing sugar becomes increased in the early June. 3) Crude protein content becomes gradually increased after the early May, and at the adult stage it becomes 48.8%. Endosperm is made up with more protein than embryo. 8. The test of germination The collected optimum period of Pinus koraiensis seeds at an adequate maturity was collected in the early September, and used for the germination test of reduction-method and embryo culture. Seeds were taken at the interval of 7 days from the middle of July to the middle of September for the germination test at germination apparatus.

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Studies on the Foliar Application of Urea as Nitrogen Source of Rice Plant Nutrition (요소엽면살포(尿素葉面撒布)에 따른 수도(水稻)의 질소영양(窒素營養)에 관(關)한 연구(硏究))

  • Cho, Seoung-Jin
    • Applied Biological Chemistry
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    • v.9
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    • pp.125-147
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    • 1968
  • This experiment was carried out as a part of the studies on reasonable application of nitrogen in rice plant to determine: (I) Nitrogen absorption. and rooting of rice seedlings as affected by urea foliar application at late seedling stage (II) Effect of leaf prunning and foliar application of urea at late heading stage on the maturation and yield of rice (III) Effect of foliar application of urea and its time during the stage of ear formation on yield of rice plant. Results obtained are summarized as follows. Exp.I: Nitrogen absorption and rooting of rice seedlings as affected be urea foliar application at late seedling stage. 1 : The foliar application of urea plots$(T_{1},T_2)$ snowed mare N-content than non-urea foliar application plot(T0) at lane seedling stage, being significant among treatments and foliar application of urea seemed more effective in increasing the N-content of seedlings. and promoted root settlement and early growth alter the transplanting. 2 : The carbon contents of the plants of $T_1$, and $T_2$ at late seedling stage increased than T0, and the carbon contents. of $T_1$ and $T_2$ plots became higher in amount in proportion to the nitrogen absorption as compared with those of $T_0$. 3 : C/N ratio appeared significant among soil application plots($N_1, \;N_2$) and foliar application of urea plots ($T_1$, $T_2$ and $T_0$). C/N ratio was lower in case of increased amount of nitrogen. The higher contents of nitrogen and carbon and lower C/N ratio resulted in the increment of root numbers and root lengths. Exp.II: Effect of leaf prunning and foliar application of urea at late heading stage on the maturation and yield of rice. 1 : There was a highly significant decrease in the maturing rate by severe leaf prunning. In the mean time, significant increase in maturing rate was observed with urea foliar application and it was found the more frequent application the more effective for higher maturing rate with a moderate significance. A correlationship between the level of prunning and maturing rate was enumerated to 0.961 of correlation coefficient, which indicated an increased maturing rate by the increased number of remaining leaves. 2 : The 1.000 grain weight, grain weight and hulled rice yield increased by leaf prunning in order (plot a$A_1$, $A_3$, $A_2$ and $A_0$ were 89.8%, 89.4%, 87.8% and 87.5% respectively, showing the highest of rate in $A_1$ and $A_3$ in methods of ear fertilization and being highly significant between its treatment. 3 : 1000 grain weights were highly significant between time of application, showing a tendency of increase of weights with the time lagging until days before earings as that of maturing rates. High significance was recognized between methods of ear fertilization, showing the highest in $A_2$ 23.18 gr. 4 : Yields per $3.3m^2$ were not significant between time of ear fertilization, whereas were highly significant between methods of ear fertilization. Those of $A_1$, $A_3$, $A_2$ and $A_0$ were 1.486 kg, 1.491 kg, 1.381 kg and 1.328 kg, respectively, showing the highest in $A_1$ and $A_3$. 5 : Hulling ratios showed significant different between time of ear fertilization, showing the highest in $T_2$, whereas those of methods of ear fertilization were highly significant between its treatment, Those of $A_1$, $A_3$, $A_2$ and $A_0$ were 84.72%, 84.06%, 83.29%, and 82.56% respectively, showing the highest m $A_2$ and $A_3$ among others. 6 : Yields of hulled rice per $3.3m^2$ showed significant different between time of ear fertilization, showing the highest in $T_1$ 1.192 kg. Whereas, those were highly significant between methods of ear fertilization. Those of $A_1$, $A_3$, $A_2$ and $A_0$ were 1.259 kg, 1.254 kg, 1.149 kg and 1.095 kg, respectively, showing the highest in $A_1$ and $A_2$. 7 : Contents of nitrogen on rice plant increased in case of nitrogen application as ear fertilizer and showed that the case of urea foliar application was more effective than that of soil application, showing the increased nitrogen content of rice plant was accompanied by carbon content.

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