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Sequential Chemotherapy and Radiation Therapy for Advanced Nasopharyngeal Carcinoma (진행된 비인강암의 화학요법 및 방사선 치료)

  • Park, In-Kyu;Kim, Song-Bo;Yun, Sang-Mo;Kim, Jae-Cheol;Park, Jun-Sik
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.259-265
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    • 1993
  • Between January 1985 and July 1992, 52 patients with locally advanced nasopharyngeal carcinoma were studied retrospectively for the effectiveness of sequential chemotherapy and radiation therapy. The male to female ratio was 3.3:1 with a median age of 41 years. Forty patients had squamous cell carcinoma and the remaining 12 had undifferentiated carcinoma. Seven patients had stage III disease and the remainder had stage IV disease at time of presentation. All patients were treated two courses of chemotherapy followed by radiation therapy. Chemotherapy consisted of either CVB (cisplatin, vincristine and bleomycin) or CF (cisplatin and 5-FU). Total radiation dose to the primary site ranged from 6000 cGy to 7500 cGy. Neck nodes were given booster treatment to maximum of 7000 cGy, depending on the extent of disease. Local control, overall survival and disease-free survival rates were analyzed. The complete response (CR) rate to chemotherapy was $15\%$ and the partial response (PR) rate was $46\%,$ for overall major response rate of $61\%.$ The CR rate was $87\%$ after radiation therapy. Median follow-up time was 51 months. The overall survival and disease-free survival rates at 36 months were $54\%\;and\;49\%,$ respectively. Median time to relapse was 15 months. The patterns of initial relapse in CR patients was as follows: locoregional failure only, 12 patients; distant metastasis only,11: both,2. Cox's multivariate regression model revealed that nodal status was the single most important independant prognostic factor influencing disease-free survival (p=0.001). Comparision of these results with other published reports with radiation therapy alone showed that a high rate of initial response to chemotherapy did not translate into local control or survival. At present time radiation therapy alone remains the standard treatment for locoregional cancer of the nasopharyngeal cancer. More controlled clinical trials must be completed before acceptance of chemotherapy as a part of treatment of advanced nasopharyngeal carcinoma.

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Radiation Therapy in Recurrence of Carcinoma of the Uterine Cervix after Primary Surgery (자궁경부암으로 수술 후 재발암의 방사선치료)

  • Kim, Jin-Hee;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.143-148
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    • 2003
  • Purpose: The purpose of this study was to evaluate treatment results in terms of the survival and failure patterns subsequent to radiation therapy in recurrent cervical cancer, fellowing primary surgery. Material and Methods: Between January 1990 and December 1999, 27 patients, with recurrent cervical cancer following primary surgery, were subsequently treated with radiation in the Department of Radiation Oncology, at the Keimyung University Dongsan Medical Center. Their median age was 48, ranging from 31 to 70 years old. With regard to the Initial FIGO stage on presentation, 20 and 7 patients were stages I and II, respectively. Twenty three patients had squamous cell carcinomas and 4 had adenocarcinomas. The time interval from the primary surgery to the recurrence ranged from 2 to 90 months with a median of 29 months. The recurrent sites were the vaginal cuff alone, the pelvic cavity and combined recurrence in 14, 9 and 4 patients, respectively. Radiation was peformed, with external and vaginal intracavitary radiation in 13 patients, external radiation alone in 13 and vaginal intracavitary radiation alone in another one. The median follow-up period was 55 months, ranging from 6 to 128 months. Results: The five year disease free survival (5y DFS) and five year overall survival (5y OS) rates were 68.2 and 71.9$\%$, respectively. There was a marginal statistically significant difference in the 5y DFS in relation to the recurrent site (5y DFS, 85.7$\%$ in vaginal cuff recurrence alone, 53.3$\%$ in pelvic cavity recurrence, p=0.09). There was no difference in the survival according to the time interval between the primary surgery and a recurrence. There was only a 7$\%$ local failure rate in the patients with a vaginal cuff recurrence. The major failure patterns were local failure in the patients with pelvic cavity recurrence, and distant failure in the patients with a combined recurrence. There were no complications above grade 3 after the radiation therapy. Conclusion: Radiation therapy was safe and effective treatment for a recurrent carcinoma of the uterine cervix following primary surgery, especially the external beam radiation and vaginal intracavitary irradiation achieved the best results in the patients with a vaginal cuff recurrence following primary surgery.

The Effect of 131I Therapy by Taking in Laxatives (방사성요오드 치료 시 완하제 투여 효과)

  • Kil, Sang-Hyeong;LEE, Hyo-Yeong;Park, Kwang-Yeol;Jo, Kyung-Nam;Baek, Seung-Jo;Hwang, Kyo-Min;Cho, Seong-Mook;Choi, Jae-Hyeok
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.3-9
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    • 2014
  • Purpose: Our goals were to evaluate the effect of high dose radioiodine treatment for thyroid cancer by taking in laxatives. Materials and Methods: Twenty patients(M:F=13:7, age $46.3{\pm}8.1\;yrs$) who underwent high dose radioiodine treatment were seperated into Group 1 taking $^{131}I$ 5,500 MBq and Group 2 with the use of laxatives after taking $^{131}I$ 5,500 MBq. The whole body was scanned 16 hours and 40 hours after taking radioactive iodines by using gamma camera, the ROIs were drawn on the gastro-intestinal tract and thigh for calculation of reduction ratio. At particular time during hospitalization, the radioactivity remaining in the body was measured in 1 meter from patient by using survey meter (RadEye-G10, Thermo Fisher Scientific, USA). Schematic presentation of an Origin 8.5.1 software was used for spatial dose rate. Statistical comparison between groups were done using independent samples t-test. P value less than 0.05 was regarded as statistically significant. Results: The reduction ratio in gastro-intestinal 16 hours and 40 hours after taking laxatives is $42.1{\pm}6.3%$ in Group 1 and $72.1{\pm}6.4%$ in Group 2. The spatial dose rate measured when discharging from hospital was $23.8{\pm}6.7{\mu}Sv/h$ in Group 1 and $8.2{\pm}2.4{\mu}Sv/h$ in Group 2. The radioactivity remaining in the body is much decreased at the patient with laxatives(P<0.05). Conclusion: The use in combination with laxatives is helpful for decreasing radioactivity remaining in the body. The radioactive contamination could be decreased at marginal individuals from patients.

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Efficacy of deferoxamine on paraquat poisoning (파라쿼트 중독 환자에서 deferoxamine의 치료 효과)

  • Huh, Jin Won;Jegal, Yangjin;Hong, Sang-Bum;Oh, Yeon Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.113-118
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    • 2007
  • Background: Paraquat is known to induce oxidant injury that results in multiorgan failure and lung fibrosis. Iron has been considered to play a key role in paraquat-induced oxidant lung injury. This study examined the effect of deferoxamine, an iron-chelating agent, in the treatment of paraquat poisoning. Methods: From September, 2001 to April, 2005, 28 patients with paraquat poisoning who were admitted at a medical intensive care unit of a University-affiliated hospital, were enrolled in this study. Sixteen patients were treated according to the paraquat poisoning treatment guidelines and 12 received an intravenous infusion of deferoxamine in addition to the treatment guidelines. Results: There were no differences between the two groups in terms of age, gender, severity of paraquat poisoning, and the time elapsed from ingestion to presentation at hospital. There was no difference in overall mortality between the two groups but the incidence of respiratory failure in the deferoxamine group was higher than in the conventional group(4/7 versus 0/9, p=0.019). Conclusion: Deferoxamine seems to have no clinical benefit compared with the conventional treatment.

Radiotherapy Results of Uterine Cervix Cancer Stape IIB : Overall Survival, Prognostic factors, Patterns of Failure and Late Complications (자궁경부암 병기 IIB에서의 방사선 치료 성적: 생존율 및 예후인자, 치료 후 실패양상, 만성 합병증)

  • Kim Eun-Seog;Choi Doo-Ho;Huh Seung-Jae
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.51-61
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    • 1998
  • Purpose : Treatment of choice for uterine cervix cancer stage IIB is radiotherapy. We analyzed survivals, Prognostic factors, patterns of failure and complications. Materials and Methods : This is a retrospective analysis of 167 patients with stage IIB carcinoma of uterine cervix treated with curative external pelvic and high dose rate intracavitary radiotherapy at the Department of Therapeutic Radiology, Soonchunhyang University Hospital from August 1985 to August 1994. All the patients followed up from 3 to 141 months(mean 60 months) and age of patients ranged from 31 to 78 years at presentation(mean : 55 years). Results : Overall complete response rate was $84\%$. The response rate for squamous cell carcimoma and adenocarcinoma were $86\%$ and $60\%$, respectively. Overall 5-years survival rate and disease free survival rate was 62 and $59\%$, respectively Mass size and treatment response were significant Prognostic factors for survival Pathologic type and parametrial involvement were marginally significants Prognostic factors. Local failure was 43 cases, distant metastasis was 14 cases and local failure plus distant metastasis was 3 cases, and most of local failures occurred within 24 months, distant metastasis within 12 months after treatment Twenty eight($16.8\%$) patients developed late rectal and urinary complications There were tendency to increasing severity and frequency according to increased fractional dose and total(rectal and bladder) dose. Conclusions : Survival rate was significantly related to tumor size and radiotherapy response. Tumor size should be considered in the clinical s1aging. To increased survival and local control, clinical trials such as decreasing duration of radiotherapy or addition of chemotherapy is needed. To detect early recurrence, regular follow up after RT is important. Because total rectal and bladder dose affected late complications. meticulous vaginal packing is needed to optimize dose of normal tissues and to decrease late complications.

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Legibility Evaluation of Two and Three Syllable Words Used in Pesticides According to Font, Thickness, Gender, and Visual Acuity (시력, 폰트, 굵기, 성별에 따른 2음절 및 3음절 농약 제품 표시글자의 가독성 평가)

  • Hwang, Hae-Young;Song, Young-Woong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.8
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    • pp.3444-3451
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    • 2012
  • Safety and health related information for the proper use and handing of pesticides is usually printed on the surface of the pesticide products in the form of texts. But, the guidelines or standards for the appropriate presentation of the texts for the pesticide products are most vague or not practical. Thus, this study aimed to provide the preliminary guidelines for the text sizes based on the legibility experiments. To achieve the objective legibility evaluation experiments were conducted to test the effects of different near vision (0.6, ${\geq}0.8$), gender, font type(thick gothic-type and fine gothic-type), thickness of font(plain and bold), and number of syllables(2 and 3 syllables) in the same age group of 20s. The results showed that legibility was different according to the visual acuity (p<0.05), and no other main effects showed statistically significant effects. The 'maximum illegible size' to read at least one word correctly in all the text conditions was 2 pt when the near vision was ${\geq}0.8$, and 2 pt or 3 pt when the near vision was 0.6. The 'minimum legible size' for 100% correct answer was 9 pt for the near vision of 0.6, and 5.3 pt for ${\geq}0.8$, respectively. Mean character size does not read any discomfort in 0.6 was 15.5 pt in both male and female but male was mean 8.5 pt, female was 10 pt in ${\geq}0.8$. Considering these experimental results, it was recommended that the 16 pt or larger characters should be used the important information such as 'Pesticides' or toxicity, and the minimum character size was 9 pt for the less important information.

Clinical Presentation and Prognosis of SARS-CoV-2 Infection in Infants Aged ≤90 Days: Insights for Management During Outbreaks

  • Hye Jeong Moon;Mi Seon Han;Kyung Min Kim;Kyung Jin Oh;Ju Young Chang;Seong Yong Lee;Ji Eun Choi
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.84-90
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    • 2023
  • Purpose: Infants aged ≤90 days with fever are susceptible to severe infections. This study aimed to analyze the clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in this particular age group. Methods: Infants aged ≤90 days who were diagnosed with coronavirus disease 2019 (COVID-19) and hospitalized between March 1, 2020, and May 1, 2022 were included. Medical records of patients were retrospectively reviewed. Results: A total of 105 infants with COVID-19 were included; 27 (25.7%) neonates aged <28 days, and 48 (45.7%) and 30 (28.6%) infants aged 28-59 days and 60-90 days, respectively. Five (4.7%) patients remained asymptomatic and 68 (62.8%) were febrile, with a median fever duration of 2 days. The most common symptoms were respiratory including cough (66.6%), nasal stuffiness (51.4%), and rhinorrhea (40.9%). Blood cultures were performed in 10 infants but no organisms were detected. Cultures of bag-collected urine specimens from 8 infants were grown, resulting in positive growth for 2 without pyuria. Nine (8.6%) infants were treated with empirical antibiotics for a median duration of 2.3 days (range, 1-7 days). All 105 infants showed improvement without any complications, and there were no fatal cases. Conclusions: In this study, most infants aged ≤90 days with COVID-19 presented with mild symptoms and none of those evaluated had documented bacterial co-infection. The favorable prognosis among young infants with SARS-CoV-2 may aid clinicians in tailoring their approach to evaluation and management during outbreaks.

The Effects of Bundle Price Discount Framing and Message Framing on Consumers' Evaluation of Bundle Component (번들가격할인 프레이밍과 메시지 프레이밍이 소비자의 번들구성제품에 대한 평가에 미치는 영향)

  • Park, Sojin
    • Asia Marketing Journal
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    • v.13 no.3
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    • pp.55-77
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    • 2011
  • This study investigate the interaction effects of bundle price discount framing and message framing on consumer's attitude of bundle component. Although each effect of bundle price discount framing and message framing has been explored individually, few attempts have been made to invest them jointly. This study tests the interaction effects of bundle price discount framing and message framing on consumer's evaluation of bundle component. Moreover, this research focuses on consumer's evaluation of individual bundle component while the existing research on bundling primarily focused on consumer's evaluation of the bundle. Prior research suggests that consumers are sensitive to the framing of prices and discounts in the presentation of the bundle offer. For example, there is considerable evidence that partitioning or consolidating the prices of a bundle can influence the attractiveness of the bundle offer. Similarly, there is evidence that an equivalent price reduction to the overall bundle, one of the individual products in the bundle, or distributed among the individual products in the bundle can alter the perceived attractiveness of the offer (e.g. Chakravarti, Krish, Paul, and Srivastava 2002; Hamilton and Srivastava 2008; Janiszewski and Cunha 2004; Johnson, Herrmann and Bauer 1999; ; Morwitz, Greenleaf, and Johnson 1998; Yadav 1994; 1995). In line with these earlier research, this research suggests that the bundle type can influence the consumer's evaluation of bundle component. There are two types of bundle - mixed-leader bundle and mixed-joint bundle. In mixed-leader bundling, the price of one of the two products is discounted when the other product is purchased at the regular price. In mixed-joint bundling, a single price is set when the two product are purchased jointly. This study supposes that the teeth whitening product is the leader product in a mixed-leader bundle. So bundle price discount framing is manipulated such as "Buy the teeth whitening product (regular price \80,000) and get 50% discount on the functional toothpaste(regular price \40,000), special set price \100,000" or "Buy the functional toothpaste and the teeth whitening product as a set and get discount for the set, special set price \60,000". Message framing is manipulated through the product claims described in an advertising bill. The positive framing presents that "Over 95% of users achieved the expected 2-3 shades of improvement in two weeks" where as the negative framing presents "less than 5% of users did not achieve the expected 2-3 shades of improvement in two weeks". This study uses hypothetical brand name of the teeth whitening product and the functional toothpaste This study is based on a 2x2 factorial design with bundle discount framing (mixed-leader bundle vs. mixed-joint bundle) and massage framing (positive vs. negative). The dependant variables are consumer's perceived quality and attitude of the teeth whitening product The data reveals that two dependant variables are correlated, so the data is analyzed with two-way MANOVA. This research explores the significant interaction effect of bundle discount framing and message framing on consumer's perceived quality and attitude of the teeth whitening product. When the message framing is positive, consumer's perceived quality and attitude of the teeth whitening product is higher in mixed-leader bundle than mixed-joint bundle condition. However, when the message framing is negative, consumer's evaluation is higher in mixed-joint bundle than mixed-leader bundle. The author explains this result by stating that consumers are less likely to use heuristics such as price-quality association and value discounting hypothesis(Raghubir 2004) in the negative message framing condition. Additionally, consumer's perceived risk of the teeth whitening product in the negative message framing condition can be more reduced by the bundle partner(e.g. the toothpaste) in mixed-joint bundle than mixed-leader bundle. Based on the results, marketing managers are advised to use different bundle type based on message framing of their product.

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Biliary Atresia in Korea - A Survey by the Korean Association of Pediatric Surgeons - (담도폐색증 - 대한소아외과학회회원 대상 전국조사 -)

  • Choi, Kum-Ja;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Kim, H.Y.;Kim, H.H.;Park, K.W.;Park, W.H.;Song, Y.T.;Oh, S.M.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Jhung, S.Y.;Jhung, S.E.;P.M., Jung;S.O., Choi;Choi, S.H.;Han, S.J.;Huh, Y.S.;Hong, C.;Hwbang, E.H.
    • Advances in pediatric surgery
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    • v.8 no.2
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    • pp.143-155
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    • 2002
  • A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.

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Asymptomatic Primary Hematuria in Children (소아의 무증상성 일차성 혈뇨에 관한 고찰)

  • Lee, Jung-Mi;Park, Woo-Saeng;Ko, Cheol-Woo;Koo, Ja-Hoon;Kwak, Jung-Sik
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.25-32
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    • 2000
  • Purpose: This retrospective study of 126 children with symptomless primary hematuria was undertaken to determine the distribution of various histologic types by renal biopsy, clinical outcome according to the biopsy findings and also to find out feasibility of performing renal biopsy in these children. Patients and Methods : Study population consisted of 126 children with symptom-less primary hematuria who have been admitted to the pediatric department of Kyung-poot National University Hospital for the past 11 years from 1987 to 1998 and renal biopsy was performed percutaneously. Hematuric children with duration of less than 6 months, evidences of systemic illness such as SLE or Henoch-Schonlein purpura, urinary tract infection, and idiopathic hypercalciuria were excluded from the study. Results : Mean age of presentation was 9.2${\pm}$3.3 years (range ; 1.5-15.3 years) and male preponderance was noted with male to female ratio of 2:1. IgA nephropathy was the most common biopsy finding occuring in 60 children ($47.6\%$), followed by MsPGN in 13 ($10.3\%$), MPGN in 5 ($3.9\%$), TGBM in 6 ($4.7\%$), Alport syndrome in 2 ($1.6\%$), FSGS in 1 ($0.8\%$), and in 39 children ($30.9\%$), 'normal' glomeruli were noted. Recurrent gross hematuria was more common than persistent microscopic hematuria (84 versus 42), and especially in IgA nephropathy, recurrent gross hematuria was the most prevalent pattern of hematuria. In 58 out of 126 cases ($46.0\%$), hematuria was isolated without accompa-nying proteinuria and this was especially true In cases of MsPGN and 'normal' glomer-uli by biopsy finding. Normalization of urinalysis (disappearance of hematuria) in IgA nephropathy, MsPGN and 'normal' glomuli group were similar and it was $14\%,\;27\%\;and\;21\%$ respectively during 1-2 years of follow-up period, and $37.1\%,\;40\%\;and\;35\%$ respectively during 3-4 years of follow-up periods. However, abnormal urinalysis persi-sted in the majority of children with MPGN, TGBM. Alport syndrome and FSGS. Renal function deteriorated progressively in 6 cases (3 with IgA nephropathy, 2 with Alport syndrome and 1 with TGBM). Conclusion : In summary, present study demonstrates that in 126 children with symptomless primary hematuria, IgA nephropathy was the most common biopsy findings followed by MsPGN, MPGN, TGBM, Alport syndrome and FSGS, and 'normal glomeruli' was also seen in 39 cases ($30.9\%$). Renal histology could not be predictable on the clinical findings, so that to establish appropriate long-term planning for these children, we would recommend to obtain precise histologic diagnosis by renal biopsy.

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