Purpose :The aim of this study is to analysis of suwival and recurrence rates of the uterine cervical carcinoma patients whom received the radiation therapy respectively. The prognostic factors, such as Papanicolaou (Pap) smear, carcinoembriogenic antigen (CEA) and squamous cell carcinoma (SCC) antigen has been studied. Methods and Materials : From January 1981 to December 1998, eight-hundred twenty-seven uterine carvical cancer patients were treat with radiation therapy. All of the patients were divided into two groups : the radiation therapy only (S2l patients) group and the postoperative radiation therapy (326 patients) group. The age, treatment modality, clinical stage, histopathology, recurrence, follow-up Pap smears, CEA and SCC antigen were used as parameters for the evaluation. The prognostic factors such as survival and recurrence rates were peformed with the Kaplan-Meier method and the Cox hazard model, respectively. Median rollow-up was 38.6 months. Results :On the radiation therapy only group, 314 patients (60$\%$) achieved complete response (CR), 47 patients (9$\%$) showed local recurrence (LR), 78 patients (15$\%$) developed distant metastasis (DM). On the Postoperative radiation therapy group, showed 276 Patients (85$\%$) CR, 8 Patients (2$\%$) LR, 37 Patients (11$\%$) DM. The 5-year survival and recurrence rates was evaluated for all parameters. The statistically significant factors for the survival rate in univariate analysis were clinical stage (p=0.0001), treatment modality (p=0.0010), recurrence (p=0.0001), Pap smear (p=0.0329), CEA (p=0.0001) and SCC antigen (p=0.0001). Conclusion: This study indicated that after treatment, the follow-up studies of Pap smear, CEA and SCC antigen were significant parameter and prediction factors for the survival and recurrence of the uterine cervical carcinoma.
Park, Sue Jee;Lim, Sa-Hoe;Kim, Young-Jin;Moon, Kyung-Sub;Kim, In-Young;Jung, Shin;Kim, Seul-Kee;Oh, In-Jae;Hong, Jong-Hwan;Jung, Tae-Young
Journal of Korean Neurosurgical Society
/
v.64
no.6
/
pp.983-994
/
2021
Objective : The effectiveness of gamma knife radiosurgery (GKR) in the treatment of brain metastases is well established. The aim of this study was to evaluate the efficacy and safety of maximizing the radiation dose in GKR and the factors influencing tumor control in cases of small and medium-sized brain metastases from non-small cell lung cancer (NSCLC). Methods : We analyzed 230 metastatic brain tumors less than 5 mL in volume in 146 patients with NSCLC who underwent GKR. The patients had no previous radiation therapy for brain metastases. The pathologies of the tumors were adenocarcinoma (n=207), squamous cell carcinoma (n=18), and others (n=5). The radiation doses were classified as 18, 20, 22, and 24 Gy, and based on the tumor volume, the tumors were categorized as follows : small-sized (less than 1 mL) and medium-sized (1-3 and 3-5 mL). The progression-free survival (PFS) of the individual 230 tumors and 146 brain metastases was evaluated after GKR depending on the pathology, Eastern Cooperative Oncology Group (ECOG) performance score (PS), tumor volume, radiation dose, and anti-cancer regimens. The radiotoxicity after GKR was also evaluated. Results : After GKR, the restricted mean PFS of individual 230 tumors at 24 months was 15.6 months (14.0-17.1). In small-sized tumors, as the dose of radiation increased, the tumor control rates tended to increase (p=0.072). In medium-sized tumors, there was no statistically difference in PFS with an increase of radiation dose (p=0.783). On univariate analyses, a statistically significant increase in PFS was associated with adenocarcinomas (p=0.001), tumors with ECOG PS 0 (p=0.005), small-sized tumors (p=0.003), radiation dose of 24 Gy (p=0.014), synchronous lesions (p=0.002), and targeted therapy (p=0.004). On multivariate analyses, an improved PFS was seen with targeted therapy (hazard ratio, 0.356; 95% confidence interval, 0.150-0.842; p=0.019). After GKR, the restricted mean PFS of brain at 24 months was 9.8 months (8.5-11.1) in 146 patients, and the pattern of recurrence was mostly distant within the brain (66.4%). The small and medium-sized tumors treated with GKR showed radiotoxicitiy in five out of 230 tumors (2.2%), which were controlled with medical treatment. Conclusion : The small-sized tumors were effectively controlled without symptomatic radiation necrosis as the radiation dose was increased up to 24 Gy. The medium-sized tumors showed potential for symptomatic radiation necrosis without signifcant tumor control rate, when greater than 18 Gy. GKR combined targeted therapy improved the tumor control of GKR-treated tumors.
Journal of the Korean Society of Food Science and Nutrition
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v.37
no.11
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pp.1529-1533
/
2008
The detection characteristics of gamma-irradiated ($0{\sim}10.0\;kGy$) medicinal herbs (Platycodon grandiflorum, Acanthopanax chiisanensis) were investigated by photostimulated luminescence (PSL), thermoluminescence (TL), and electron spin resonance (ESR). The results of the PSL, a first screening method in comparison with the TL, showed photon counts greater than 5,000 counts/60 s (positive) in the irradiated samples, while the non-irradiated samples yielded photon counts less than 700 counts/60 s (negative). The TL was also applied for the detection method of irradiated medicinal herbs and showed that the non-irradiated sample revealed a glow curve with a low intensity, while the irradiated samples showed a higher intensity. These results were normalized by re-irradiating the mineral grains with a irradiation dose of 1.0 kGy, and a second glow curve was recorded. The ratio of the intensity of the first glow curve ($TL_1$) to that after the normalization dose ($TL_2$) was determined and compared with the recommended threshold values. TL ratio ($TL_1/TL_2$) was below 0.007 for the non-irradiated sample and higher than 0.1 for all irradiated samples (above 1.0 kGy). ESR spectroscopy revealed specific signals (6.065 mT) derived from free radicals in cellulose containing irradiated medicinal herbs. The P. grandiflorum showed clearer signals than A. chiisanensis. From the results of our studies, the PSL, TL, and ESR determinations were found to be suitable for the detection of irradiated medicinal herbs such as P. grandiflorum and A. chiisanensis.
Background: Solar furnaces are used worldwide to conduct experiments to demonstrate the feasibility of solar-chemical processes with the aid of concentrated sunlight, or to qualify high temperature-resistant components. In recent years, high-flux solar simulators (HFSSs) based on short-arc xenon lamps are more frequently used. The emitted spectrum is very similar to natural sunlight but with dangerous portions of ultraviolet light as well. Due to special benefits of solar simulators the increase of construction activity for HFSS can be observed worldwide. Hence, it is quite important to protect employees against serious injuries caused by ultraviolet radiation (UVR) in a range of 100 nm to 400 nm. Methods: The UV measurements were made at the German Aerospace Center (DLR), Cologne and Paul-Scherrer-Institute (PSI), Switzerland, during normal operations of the HFSS, with a high-precision UV-A/B radiometer using different experiment setups at different power levels. Thus, the measurement results represent UV emissions which are typical when operating a HFSS. Therefore, the biological effects on people exposed to UVR was investigated systematically to identify the existing hazard potential. Results: It should be noted that the permissible workplace exposure limits for UV emissions significantly exceeded after a few seconds. One critical value was strongly exceeded by a factor of 770. Conclusion: The prevention of emissions must first and foremost be carried out by structural measures. Furthermore, unambiguous protocols have to be defined and compliance must be monitored. For short-term activities in the hazard area, measures for the protection of eyes and skin must be taken.
Background: Gastric cancer is one of the frequently seen cancers in the world and it is the second most common reason for death due to cancer. The prognostic role of expression of p53 detected by immunohistochemistry in gastric cancer remains controversial. This meta-analysis aimed to explore any association between overexpression and survival outcomes. Materials and Methods: We systematically searched for studies investigating the relationships between expression of p53 detected by immunohistochemistry and prognosis of gastric cancer patients. Study quality was assessed using the Newcastle-Ottawa Scale. After careful review, survival data were extracted from eligible studies. A meta-analysis was performed to generate combined hazard ratios for overall survival and disease-free survival. Results: A total of 4.330 patients from 21 studies were included in the analysis. Our results showed tissue p53 overexpression in patients with gastric cancer to be associated with poor prognosis in terms of overall survival (HR, 1.610; 95% CI, 1.394 -5.235; p:<0.001). Pooled hazard ratio for disease free survival showed that p53 positivity or negativity were not statitistically significant (HR, 1.219; 95%CI, 0.782-1.899; p:0.382). Conclusions: The present meta-analysis indicated overexpression of p53 detected by immunohistochemistry to be associated with a poor prognosis in patients with gastric cancer.
Objectives: The aim of this study was to evaluate and quantify the risk of both individual and combined health behaviors on premature mortality in middle aged men in Korea. Methods: In total, 14 533 male subjects 40 to 59 years of age were recruited. At enrollment, subjects completed a baseline questionnaire, which included information about socio-demographic factors, past medical history, and life style. During the follow-up period from 1993 to 2008, we identified 990 all-cause premature deaths using national death certificates. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of each health risk behavior, which included smoking, drinking, physical inactivity, and lack of sleep hours. Using the Cox model, each health behavior was assigned a risk score proportional to its regression coefficient value. Health risk scores were calculated for each patient and the HR of all-cause premature mortality was calculated according to risk score. Results: Current smoking and drinking, high body mass index, less sleep hours, and less education were significantly associated with all-cause premature mortality, while regular exercise was associated with a reduced risk. When combined by health risk score, there was a strong trend for increased mortality risk with increased score (p-trend < 0.01). When compared with the 1-9 score group, HRs of the 10-19 and 20-28 score groups were 2.58 (95% confidence intervals [CIs], 2.19 to 3.03) and 7.09 (95% CIs, 5.21 to 9.66), respectively. Conclusions: Modifiable risk factors, such as smoking, drinking, and regular exercise, have considerable impact on premature mortality and should be assessed in combination.
The paper aims at improving the understanding and mitigating the effects of tunnel fires that may breakout due to the burning fuel and/or explosion within the tunnel. This study particularly focuses on the behavior of the commonly used horse shoe geometry of tunnel systems. The problem has been obtained using an adequate well-established program incorporating the Lagrangian approach. A transient-thermo-coupled static structural analysis is carried out. The effects of radiation and convection to the outer walls of the tunnel is studied. The paper also presents the impact of the hazard on the structural integrity of the tunnel. A methodology is proposed to study the tunnel fire using a model which uses equivalent steel sheet to represent the presence of reinforcements to improve the computational efficiency with adequate validation. A parametric study has been carried out and the effect of suitable lining property for mitigating the fire hazard is arrived at. Detailed analysis is done for the threshold limits of the properties of the lining material to check if it is acceptable in all aspects for the integrity of the tunnel. The study may prove useful for developing insights for ensuring tunnel fire safety. To conduct such studies experimentally are tremendously costly but are required to gain confidence. But, scaled models, as well as loading and testing conditions, cannot be studied by many trials experimentally as the cost will shoot up sharply. In this context, the results obtained from such computational studies with a feasible variation of various combinations of parameters may act as a set of guidelines to freeze the adequate combination of various parameters to conduct one or two costly experiments for confidence building.
Background/Aims: Since the usefulness of neoadjuvant chemo(radiation) therapy (NAT) for pancreatic cancer has been demonstrated, recurrent biliary obstruction (RBO) in patients with pancreatic cancer with a fully covered self-expandable metal stent (FCSEMS) during NAT is expected to increase. This study investigated the impact of sarcopenia on RBO in this setting. Methods: Patients were divided into normal and low skeletal muscle index (SMI) groups and retrospectively analyzed. Patient characteristics, overall survival, time to RBO (TRBO), stent-related adverse events, and postoperative complications were compared between the two groups. A Cox proportional hazard model was used to identify the risk factors for short TRBO. Results: A few significant differences were observed in patient characteristics, overall survival, stent-related adverse events, and postoperative complications between 38 patients in the normal SMI group and 17 in the low SMI group. The median TRBO was not reached in the normal SMI group and was 112 days in the low SMI group (p=0.004). In multivariate analysis, low SMI was the only risk factor for short TRBO, with a hazard ratio of 5.707 (95% confidence interval, 1.148-28.381; p=0.033). Conclusions: Sarcopenia was identified as an independent risk factor for RBO in patients with pancreatic cancer with FCSEMS during NAT.
Purpose : This investigation was peformed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. Methods and Materials : The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyzed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. Results : The average of yearly radiation exposure of 347 persons was 1.52$\pm$1.35 mSv. Though it was less than 50mSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87$\pm$1.01 mSv/year, mean 1.22$\pm$0.69 mSv between 31 and 40 year old and mean 0.97$\pm$0.43 mSv/year over 41year old (p<0.001). Men received mean 1.67$\pm$1.54 mSv/year were higher than women who received mean 1.13$\pm$0.61 mSv/year (p<0.01). Radiation exposure in the department of nuclear modicine department in spite of low energy sources is higher than other departments that use radiations in hospital (p<0.05). And the workers who received mean 3.59$\pm$1.81 msv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department (p<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74$\pm$1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17$\pm$0.35 mSv/year and upper gastrointestinal room of mean 1.74$\pm$1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology (p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75$\pm$1.17 mSv/year and mean 1.50$\pm$1.39 mSv/year than other people who work in radiation area in hospital (p<0.05). Especially young doctors and technologists have the high opportunity to receive higher radiation exposure. Conclusions : The training and education of radiation workers for radiation exposure risks are important and it is necessary to rotate worker in short period in high risk area. The hospital management has to concern health of radiation workers more and to put an effort to reduce radiation exposure as low as possible in radiation areas in hospital.
The specific radioactivity concentrations in the coal fly ash obtained from heat producing stations in Korea were analyzed and its radiological hazard for reuse in construction purpose was evaluated. The concentrations of uranium isotopes in the real fly ash measured by TBP solvent extraction method and $\alpha$-spectrometer were found to be about 116.1 Bq $kg^{-1}$ for $^{238}U$, 5.01 Bq $kg^{-1}$ for $^{235}U$, and 121.2 Bq $kg^{-1}$ for $^{234}U$, respectively. The activity ratio of $^{234}U/^{238}U$, in the coal fly ash was in $1.04\;{\pm}\;0.03$, which is similar to that of uncontaminated Korean soil in natural conditions (1.14). The specific radioactivities of $^{226}Ra,\;^{232}Th,\;and\;^{40}K$ in the coal fly ash were also determined using $\gamma$-spectrometer with a HPGe detector The results showed that $^{226}Ra,\;^{232}Th,\;and\;^{40}K$ in the coal fly ash were in concentrations of $101.7{\sim}113.9$, $39.5{\sim}54.2\;and\;315.0{\sim}990.6$ Bq $kg^{-1}$, respectively. With the specific radioactivities obtained from $\gamma$-spectrometric measurements of the coal fly ash, its radiological hazard for reuse was evaluated. The result showed that the radioactivity of the coal fly ash was in permissible level.
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