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The Role of Neutrophils and Epidermal Growth Factor Receptors in Lipopolysaccharide-Induced Mucus Hypersecretion (리포다당질 (lipopolysaccharide)에 의한 기관지 점액 생성 기전에서 호중구와 상피세포 성장인자 수용체 (epidermal growth factor receptor)의 역할)

  • Bak, Sang Myeon;Park, Soo Yeon;Hur, Gyu Young;Lee, Seung Heon;Kim, Je Hyeong;Lee, Sang Yeub;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.80-90
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    • 2003
  • Background : Goblet cell hyperplasia is a critical pathological feature in hypersecretory diseases of the airways. A bacterial infection of the lung is also known to induce inflammatory responses, which can lead to the overproduction of mucus. Recently, mucin synthesis in the airways has been reported to be regulated by neutrophilic inflammation-induced epidermal growth factor receptor (EGFR) expression and activation. In addition, it was reported that migration of the activated neutrophils is dependent on the matrix metalloproteinases (MMPs), especially MMP-9. In this study, bacterial lipopolysaccharide (LPS)-induced goblet cell hyperplasia and mucus hypersecretion by EGFR cascade, resulting from the MMPs-dependent neutrophilic inflammation were investigated in the rat airways. Methods : Pathogen-free Sprague-Dawley rats were studied in vivo. Various concentrations of LPS were instilled into the trachea in $300{\mu}{\ell}$ PBS (LPS group). Sterile PBS ($300{\mu}{\ell}$) was instilled into the trachea of the control animals (control group). The airways were examined on different days after instilling LPS. For an examination of the relationship between the LPS-induced goblet cell hyperplasia and MMPs, the animals were pretreated 3 days prior to the LPS instillation and daily thereafter with the matrix metalloproteinase inhibitor (MMPI; 20 mg/Kg/day of CMT-3; Collagenex Pharmaceuticals, USA). The neutrophilic infiltration was quantified as a number in five high power fields (HPF). The alcian blue/periodic acid-Schiff (AB/PAS) stain were performed for the mucus glycoconjugates and the immunohistochemical stains were performed for MUC5AC, EGFR and MMP-9. Their expressions were quantified by an image analysis program and were expressed by the percentage of the total bronchial epithelial area. Results : The instillation of LPS induced AB/PAS and MUC5AC staining in the airway epithelium in a time- and dose-dependent manner. Treatment with the MMPI prevented the LPS-induced goblet cell hyperplasia significantly. The instillation of LPS into the trachea induced also EGFR expression in the airway epithelium. The control airway epithelium contained few leukocytes, but the intratracheal instillation of LPS resulted in a neutrophilic recruitment. A pretreatment with MMPI prevented neutrophilic recruitment, EGFR expression, and goblet cell hyperplasia in the LPS-instilled airway epithelium. Conclusion : Matrix metalloproteinase is involved in LPS-induced mucus hypersecretion, resulting from a neutrophilic inflammation and EGFR cascade. These results suggest a potential therapeutic role of MMPI in the treatment of mucus hypersecretion that were associated with a bacterial infection of the airways.

Scientific Analysis of the Historical Characteristics and Painting Pigments of Gwaebultaeng in Boeun Beopjusa Temple (보은 법주사 <괘불탱>의 미술사적 특징과 채색 안료의 과학적 분석 연구)

  • Lee, Jang-jon;Gyeong, Yu-jin;Lee, Jong-su;Seo, Min-seok
    • Korean Journal of Heritage: History & Science
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    • v.52 no.4
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    • pp.226-245
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    • 2019
  • Beopjusa Gwaebultaeng (Large Buddhist Painting), designated as Treasure No. 1259, was painted in 1766 and featured Yeorae (Buddha) at the center in the style of a single figure. It is the longest existing buddhist painting and was created by Duhun, a painter who was representative of 18th century Korean artists. His other remaining work is Seokgayeorae Gwaebultaeng (1767) in Tongdosa Temple. Considering their same iconography, they are assumed to have used the same underdrawing. Duhun had a superb ability to maintain a consistent underdrawing, while most painters changed theirs within a year. The Beopjusa painting carries significance because it was not only painted earlier than the one in Tongdosa, but also indicates possible relevance to the royal family through its records. Beopjusa Temple is also the site of Seonhuigung Wondang, a shrine housing the spirit tablet of Lady Yi Youngbin, also known as Lady Seonhui. Having been built only a year before Beopjusa Gwaebultaeng was painted, it served as a basis for the presumption that it has a connection to the royal family. In particular, a group of unmarried women is noticeable in the record of Beopjusa painting. The names of some people, including Ms. Lee, born in the year of Gyengjin, are recorded on the Bonginsa Temple Building, the construction of which Lady Yi Youngbin and Princess Hwawan donated money to. In this regard, they are probably court ladies related to Lady Yi Youngbin. The connection of Beopjusa Gwaebultaeng with the royal family is also verified by a prayer at the bottom of the painting, reading "JusangJusamJeonhaSumanse (主上主三殿下壽萬歲, May the king live forever)." While looking into the historical characteristics of this art, this study took an approach based on scientific analysis. Damages to Beopjusa Gwaebultaeng include: bending, folding, wrinkles, stains due to moisture, pigment spalling, point-shaped pigment spalling, and pigment penetration to the lining paper at the back. According to the results of an analysis of the painting pigments, white lead was used as a white pigment, while an ink stick and indigo were used for black. For red, cinnabar and minium were used independently or were combined. For purple, organic pigments seem to have been used. For yellow, white lead and gamboge were mixed, or gamboge was painted over white lead, and gold foil was adopted for storage. As a green pigment, atacamite or a mixture of atacamite and malachite was used. Azurite and smalt were used separately or together as blue pigments.

Histological Comparative Study of Rabbit Maxillary Sinus Augmentation with Bio-Oss and β-TCP (Bio-Oss와 β-TCP를 이용한 토끼 상악동 거상술 후의 조직학적 비교 연구)

  • Moon, Yong-Suk
    • Journal of Life Science
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    • v.28 no.10
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    • pp.1220-1232
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    • 2018
  • The purpose of this animal study was to evaluate, by histological analysis, bone regeneration in rabbit maxillary sinuses with an anorganic bovine graft (Bio-Oss) and a ${\beta}-tricalcium$ phosphate (${\beta}-TCP$) grafting. Bilateral sinus augmentation procedures were performed in 12 adult male rabbits. Rectangular replaceable bony windows were made with a piezoelectric thin saw insert. In the Bio-Oss group, Bio-Oss was grafted and in the ${\beta}-TCP$ group, ${\beta}-TCP$ was grafted and covered by replaceable bony windows. The animals were sacrificed at 2, 4, and 8 weeks after the surgical procedure. The augmented sinuses were evaluated by histomorphometric analysis using hematoxylin-eosin, Masson trichrome, and tartrate-resistant acid phosphatase stains and also by immunohistochemical analysis of proliferating cell nuclear antigen (PCNA), type I collagen, and osteocalcin content. Histologically, new bone formation was found on the surface of Bio-Oss and ${\beta}-TCP$ particles from 2 weeks and continued to 8 weeks. Significant higher new bone formation was revealed in the ${\beta}-TCP$ group than in the Bio-Oss group at 8 weeks. The amount of graft materials was significantly decreased in the ${\beta}-TCP$ group and the number of osteoclasts was significantly increased in the ${\beta}-TCP$ group from 4 to 8 weeks. Immunoreactivity to PCNA was reduced at 8 weeks. The expression of type I collagen was significantly increased in the ${\beta}-TCP$ group at 2 weeks, but was significantly increased in the Bio-Oss group at 8 weeks. Immunoreactivity to osteocalcin was increased from 2 to 8 weeks. These histological results can help in the selection of graft materials for implants. Both Bio-Oss and ${\beta}-TCP$ are proven graft materials, however, these results indicate that ${\beta}-TCP$ showed better bone regeneration results in rabbit maxillary sinus augmentation.

Monitoring of Methicillin Resistant Staphylococcus aureus from Medical Environment in Korea. (국내 의료 환경 중의 Methicillin 내성 Staphylococcus aureus의 모니터링에 관한 연구)

  • Kwon, Young-Il;Kim, Tae-Woon;Kim, Hae-Yeong;Chang, Yun-Hee;Kwak, Hyo-Sun;Woo, Gun-Jo;Chung, Yun-Hee
    • Microbiology and Biotechnology Letters
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    • v.35 no.2
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    • pp.158-162
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    • 2007
  • Methicillin-resistant Staphylococcus aureus (MRSA) is one of a major nosocomial pathogen worldwide and the emergence of this strain has become a major clinical problem. This study was performed for 13 hospitals with more than 400 beds in the country by collecting samples including hands and nasal cavities of doctors, nurses, guardians and patients. Also, additional 320 samples of hands and nasal cavities of 160 community resident in different locations and regions were collected. In all of medical environments and community resident, 625 strains of S. aureus were detected. Among 625 strains of S. aureus, 585 strains(93.6%) showed the resistance to at least one kind of antimicrobial and 112 strains (17.9%) showed multi-drug resistance with the resistance to 4 different types of antimicrobial. Total 152 MRSA strains (24.3%) were isolated from medical environment and community resident. In nasal cavity and hand, 49 MRSA (19.4%) and 103 (27.6%) MRSA were isolated, respectively Minimum inhibitory concentration(MIC) test is used to measure for susceptibility of MRSA isolated to oxacillin. At a concentration $16{\mu}g/ml$ of oxacillin, 11 strains were inhibited. 32 strains at $32{\mu}g/ml$, 41 strains at $64{\mu}g/ml$, 3 strains at $128{\mu}g/ml$, 25 stains at $256{\mu}g/ml$ and 40 strains at over $256{\mu}g/ml$ were inhibited. It was considered that medical environment showed higher than livestock and marine environments in MRSA detection rate.

The Immunohistochemical Expression of Collagens and the Morphogenesis in the Developing Mandible of Human Embryos and Fetuses (배자와 태아에서 하악골의 형태발생 및 교원질 발현에 관한 면역조직화학적 연구)

  • Kook, Yoon-Ah;Kim, Sang-Cheol;Kim, Eun-Cheol;Kim, Oh-Hwan;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.26 no.2 s.55
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    • pp.187-196
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    • 1996
  • Underlying malocclusions and dentofacial deformities are often related to variations in the craniofacial development. Type I and type II collagens are considered the major collagens of bone and cartilage respectively. Monitoring the patterns of those protein expressions during development will Provide a basis for the understanding of normal and abnormal growths. This study was undertaken to investigate the morphogenetic changes and the expression patterns of type I and II collagen proteins involved in the developing mandible of human embryos and fetuses. 50 embryos and fetuses were studied with Hematoxylin and Eosin, Alcian, blue-PAS, Masson Trichrome, md Immunohistochemical stains. The results were as follows : 1. A 13.5 mm embryo showed the stomatodeum with dental lamina, maxillary and mandibular processes. Meckel's cartilage appeared in the mandibular arch of a 20.5 mm embryo. New bone formation was bilaterally initiated at the outer side of middle portion of Meckel's cartilage of 22-38 mm embryos. 2. Meckel'cartilage was resorbed at the 15th week fetus. The endochondral ossification was observed where there was direct replacement of cartilage by bone. Meckel'cartilage disappeared and membraneous ossification were observed at the 25th week. 3. Before the appearance of Meckel's cartilage, the expression of type I collagen was moderate at the odontogenic epithelium of maxillary & mandibular process, but mild for the expression of type II collagen. 4. During the appearance of Meckel's cartilage and new bone formation, the immunoactivity of type II collagen was more expressed than type I collagen at the Meckel's cartilage and new bone. 5. During intrarmembranous bone formation, the expression of type II collagen was rare in the bony trabeculae. There was a switch for the expression of collagens from type II to type I during the appearance of Meckel's cartilage.

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Preparation of Drinkable Yoghurt Added with Green Tea Powder (가루녹차를 첨가한 Drinkable Yoghurt의 제조)

  • Jung Da-Wa;Park Shin-In
    • The Korean Journal of Food And Nutrition
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    • v.18 no.4
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    • pp.349-356
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    • 2005
  • For the purpose of making a new type of functional drinkable yoghurt, skim milk containing $0.5\~2.0\%$(w/v) green tea powder was fermented by the mixed stains of Streptococcus thermophilus and Lactobacillus acidophilus. Quality characteristics of the drinkable yoghurts were evaluated in terms of quality-keeping properties(number of viable cells, pH, titratable acidity) and sensory properties. When the drinkable yoghurts added with $0.5\~2.0\%$ green tea powder were kept at $4^{\circ}C\;and\;20^{\circ}C$ for 20 days, the number of viable cell counts of the lactic acid bacteria($2.1\times10^8\~6.2\times10^8$ CFU/mL). pH($4.16\~4.22$) and titratable acidity($0.792\~0.881\%$) were not significantly changed for all drinkable yoghurts during the storage at $4^{\circ}C\;and\;20^{\circ}C$ days, but the number of viable cell counts($4.2\times10^3\~1.8\times10^5$ CFU/mL), pH($3.82\~3.92$) and titratable acidity($1.057\~1.174\%$) were markedly changed f3r the storage at $20^{\circ}C$ for 20 days. Therefore the keeping quality of the drinkable yoghurts with addition of green tea powder was relatively good at $4^{\circ}C$ for 20 days. The results of sensory evaluation of the drinkable yoghurts containing peen tea powder indicated that flavor, sweet taste, mouthfeel and aftertaste of the drinkable yoghurt with $0.5\%$ green tea powder showed higher preference than others. And the drinkable yoghurt containing $0.5\% green tea powder added $20\%$(v/v) oligosaccharide had the higher sensory scores in sweet taste, aftertaste and overall acceptability among the treatments.

Material Properties and Conservation of 『Collection of Yi Chungmugong』 in Manuscript (『이충무공전서』 정고본의 지질분석과 보존처리)

  • Lim, Se-Yeon;Ahn, Ji-Yoon;Yang, Min-Jeong
    • Korean Journal of Heritage: History & Science
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    • v.51 no.4
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    • pp.108-119
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    • 2018
  • "The Collection of Yi Chungmugong" manuscript is a hand-written manuscript of the volume 1 consisting of the Collection, published in 1795 and it seems to have completed the contents of the book by correcting the first part of the book before print. The book adopted a form of Seonjangbon(線裝本) of Ochimanjeongbeop(五針眼訂法) and was urgently needed some measures to preserve because it has been much damaged by stains, loss and oxidation due to moisture on the bottom of it. In addition, a scientific investigation was applied to find out the features of the quality of paper and fiber used for the book, which would be reflected in the process of the preservation. The characteristics of paper were measurmented for size(cm), thickness(mm), weight(g), basis weight($g/m^2$), density($g/cm^3$), chain line and laid lines($3{\times}3cm$). The measurement showed that the characteristics of paper used in royal books published in the late Joseon Dynasty. For the paper-fiber of the book, C stain was used and the technique revealed that the book is made of bast fibre of paper mulberry and its binding strings are cotton. SEM-EDS analysis was performed to verify the existence of additives in paper. As a result of the analysis, The crystallized calcium was detected in addition to the main components carbon(C) and oxygen(O). This artifact is the unique final version of "The collection of Yi Chungmugong", which has considerable value in terms of academic research, besides it helps to understand how to print books of Joseon Dynasty. And it also has a very accurate information of when and where the book was made, which primarily could be resources to conserve and restore for other book heritage.

Role of Growth Factors and Cytokines on Bleomycin Induced Pulmonary Fibrosis (Bleomycin 유도 폐 섬유화에 있어서 성장인자 및 Cytokine의 역할)

  • Lee, Yong-Hee;Jung, Soon-Hee;Ahn, Chul-Min;Kim, Sung-Kyu;Cho, Sang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.871-888
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    • 1997
  • Background : It is now thought that the earliest manifestation of idiopathic pulmonary fibrosis is alveolitis, that is, an accumulation of inflammatory and immune effector cells within alveolar walls and spaces. Inflammatory cells including alveolar macrophages and resident normal pulmonary tissue cells participate through the release of many variable mediators such as inflammatory growth factors and cytokines, which contribute to tissue damage and finally cause chronic pulmonary inflammation and fibrosis. This study was performed to investigate the source and distribution pattern of transforming growth factor-${\beta}_1$(TGF-${\beta}_1$), platelet derived growth factor(PDGF), basic fibroblast growth factor(bFGF), interleukin 1(IL-1), interleukin 6(IL-6), tumor necrosis factor-$\alpha$ (TNF-$\alpha$) and the role of these mediators on bleomycin(BLM)-induced pulmonary injury and fibrosis in rats. Method : Wistar rats were divided into three groups(control group, BLM treated group, BLM and vitamine E treated group). Animals were sacrificed periodically at 1, 2, 3, 4, 5, 7, 14, 21, 28 days after saline or BLM administration. The effects were compared to the results of bronchoalveolar lavage fluid analysis, light microscopic findings, immunohistochemical stains for six different mediators(TGF-${\beta}_1$, PDGF, bFGF, IL-1, IL-6 and TNF-$\alpha$) and mRNA in situ hybridization for TGF-${\beta}_1$. Results : IL-1 and IL-6 are maximally expressed at postbleomycin 1~7th day which are mainly produced by neutrophils and bronchiolar epithelium. It is thought that they induce recruitment of inflammatory cells at the injury site. The expression of IL-1 and IL-6 at the bronchiolar epithelium within 7th day is an indirect evidence of contribution of bronchiolar epithelial cells to promote and maintain the inflammatory and immune responses adjacent to the airways. TNF-$\alpha$ is mainly produced by neutrophils and bronchiolar epithelial cells during 1~5th day, alveolar macrophages during 7~28th day. At the earlier period, TNF-$\alpha$ causes recruitment of inflammatory cells at the injury site and later stimulates pulmonary fibrosis. The main secreting cells of TGF-${\beta}_1$ are alveolar macrophages and bronchiolar epithelium and the target is pulmonary fibroblasts and extracellular matrix. TGF-${\beta}_1$ and PDGF stimulate proliferation of pulmonary fibroblasts and TGF-${\beta}_1$ and bFGF incite the fibroblasts to produce extracellular matrix. The vitamine E and BLM treated group shows few positive cells(p<0.05). Conclusion : After endothelial and epithelial injury, the neutrophils and bronchiolar epithelium secrete IL-1, IL-6, TNF-$\alpha$ which induce infiltration of many neutrophils. It is thought that variable enzymes and $O_2$ radicals released by these neutrophils cause destruction of normal lung architecture and progression of pulmonary fibrosis. At the 7~28th day, TGF-${\beta}_1$, PDGF, bFGF, TNF-$\alpha$ secreted by alveolar macrophages sting pulmonary fibroblasts into proliferating with increased production of extracellular matrix and finally, they make progression of pulmonary fibrosis. TNF-$\alpha$ compares quite important with TGF-${\beta}_1$ to cause pulmonary fibrosis. Vitamine E seems to decrease the extent of BLM induced pulmonary fibrosis.

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Studies on the Virus in Silkworm Bombyx mori L. -Resistance to Virus Disease- (가잠 Virus에 관한 연구 -저항성에 관한 기초조사-)

  • 박광의;강석권
    • Journal of Sericultural and Entomological Science
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    • v.9
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    • pp.67-87
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    • 1969
  • 1. Objectives and Importance. Many silkworms have been damaged by nuclear polyhedrosis virus diseases thoughout the country every year causing a decease in cocoon production by approximately ten per cent per year. The damage caused by the infections virus has occured in spite of complete disinfection. In this respect, it is well known it is impossible, at the present time, to protect the silkworm from these virus infections through chemical and physical control methods. Therefore, this author has attempted to solve this urgent problem from the view point of heredity and breeding, discovering the different resistances and heritabilities among 120 stains collected from throughout the country, and selecting the ones with highest resistance for the basic materials in the silkworm breeding. 2. Results of work 1) The strains with strong resistance to the nuclear polyhedrosis virus diseases are N$_4$, N$\sub$15/, N$\sub$48/, C$\sub$55/ and Em. the log ED$\sub$50/ values of them vary between 0.799 and 1.611. The susceptible strains are N$\sub$20/, C$\sub$62/, N$\sub$76/, N$\sub$79/ and C$\sub$108/, the log ED$\sub$50/ values of them vary between 5.159 and 7.258. (Reference Table 4) The Japanese strain with a log ED$\sub$50/, value of 3.770 is the strongest, followed by the Chinese strain with a log ED$\sub$50/ value of 3.564. The weakest is the European strain with a log ED$\sub$50/ value of 3.3381. The direction coefficient of the regression equation of the susceptibility varies between 0.1 and 0.6, the uniformness of the resistance of the preserved strains of this country is comparatively low. The hereditary henomena of the resistance of each strain and the conerete method of its application for silkworm breeding main the subjects for later studies. 2) The content of water and ash in silkworm has not been correlated with the capability for resistance to the virus diseases(Reference. Table 8). but it is very significantly correlated with mortality rate (in common reaning). In the case of the silkworms which have just completed the fourth moulting the content of water and ash is not related to the mortality rate. In the case of the silkworms which have just completed the third moulting, however, the water( +0.326) and ash (+0.362) registered a high significance. The ash content in the first ($\div$0.520) and second ($\div$0.386) moults is highly significant but water content in both cases is not significant (Reference Table 7). 3) The No. 205 strain proved to be the best in character among the various F$_1$ hybrids. No. 204 was very good in strength but a little lower in cocoon character than the control. No. 212 was a little low in coccon character and mortality was average, but the cocoon harvest was the best among all the varieties offered for (Reference Table 9). 4), In short, the above mentioned strains which are known to have strong resistance to the virus disease are expected to provide basic data for breeding strong varieties. It is proposed that continued research should be conducted on the characteristics of various strains for a satisfactory preservation of various characteristics.research should be conducted on the characteristics of various strains for a satisfactory preservation of various characteristics.

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Radiotherapy in Small Cell Carcinoma of the Uterine Cervix (자궁경부 소세포암종의 방사선치료)

  • Chung Eun Ji;Lee Yong Hee;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.369-377
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    • 1997
  • Purpose : This study was Performed to identify the histopathologic feature by the reevaluation of the Pathologic specimen of the cervical tumors and to evaluate the clinical findings and the treatment results of the patients with small cell carcinoma of the cervix treated by radiotherapy. Materials and Methods : 2890 patients with cervical carcinoma received radiotherapy at the Department of Radiation Oncology. Yonsei Cancer Center, Yonsei University College of Medicine between October 1981 and April 1995. Of the 2890 patients in this data base, sixty were found to have small cell carcinomas $(2.08\%)$. Among them thirty six patients were transferred from other hospitals. the biopsy specimens of those Patients were not available. So we could review the slides of the other twenty four patients who were diagnosed at our hospital. Twenty four patients with small cell carcinoma of the cervix were analyzed retrospectively based on the assessment of H & E staining and other four immunohistochemical stains for neuroendocrine differentiation (neuron specific enolase, chromogranin. synaptophysin and Grimelius stain). And we also evaluate the Patients and tumor characteristics. response to radiation. patterns of failures, 5 year overall and disease free survival rates. Results : Thirteen tumors were neuroendocrine carcinomas(13/24 = $54.2\%$) and eleven tumors were squamous carcinomas, small cell type (11/24 = $47.8\%$) based on the assessment of H & E staining and other four neuroendocrine marker studies. So we classified the Patients two groups as neuroendocrine carcinoma and small cell type of squamous carcinoma, Among the 13 neuroendocrine carcinomas, five were well to moderately differentiated tumors and the other eight were Poorly differentiated or undifferentiated ones. The median age was 54 years old (range 23-79 years). Eight Patients had FIGO stage IB disease, 12 had stage 11, 3 had stage III and one had stage IV disease, Pelvic lymph node metastases were found in five Patients $(20.8\%)$. three of them were diagnosed by surgical histologic examination and the other two were diagnosed by CT scan. There was no difference between two histopathologic groups in terms of patients and tumor characteristics. response to radiation. 5 year overall and disease free survival rates. However the distant metastases rate was higher in neuroendocrine carcinoma Patients (6/13:$46.2\%$) than in small cell type of squamous carcinoma Patients (2/11:$18.2\%$), but there was no statistically significant difference because of the small number of patients (P>0.05). Conclusion : More than half of the small cell carcinoma of the cervix patients were neuroendocrine carcinoma (13/24 : $54.1\%$) by reevaluation of the biopsy specimen of the cervical tumors. The tendency of distant metastases of the neurolndocrine carcinoma was greater than those of the small cell type of squamous carcinoma $(46.2\%\;vs.\;18.2\%)$. But there were no differences in the patients and tumor characteristics and other clinical treatment results in both groups. These data suggest that radical local treatment such as radiotherapy or radical surgery combined with combination systemic cytotoxic chemotherapy might provide these patients with the best chance for cure.

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