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Usefulness of LIFE in diagnosis of bronchogenic carcinoma (기관지 암의 진단에서 형광기관지 내시경검사의 유용성)

  • Lee, Sang Hwa;Shim, Jae Jeong;Lee, So Ra;Lee, Sang Youb;Suh, Jung Kyung;Cho, Jae Yun;Kim, Han Gyum;In, Kwang Ho;Choi, Young Ho;Kim, Hark Jei;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.69-84
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    • 1997
  • Background : Although the overall prognosis of patients with lung cancer is poor, highly effective treatment exists for the small subset of patients with early lung cancer(carcinoma in situ/micro- invasive cancer). But very few patients have benefit from them because these lesions are difficult to detect and localize with conventional white-light bronchoscopy. To overcome this problem, a Lung Imaging Fluorescence Endoscopic device(LIFE) was developed to detect and clearly delineate the exact location and extent of premalignant and early lung cancer lesions using differences in tissue autofluorescence. Purpose : The purpose of this study was to determine the difference of sensitivity and specificity in detecting dysplasia and carcinoma between fluorescence imaging and conventional white light bronchoscopy. Material and Methods : 35 patients (16 with abnormal chest X-ray, 2 with positive sputum study, 2 with undiagnosed pleural effusion, 15 with respiratory symptom) have been examined by LIFE imaging system. After a white light bronchoscopy, the patients were submitted to fluorescence bronchoscopy and the findings of both examinations have been classified in 3 categories(class I, II, III). From of all class n and III sites, 79 biopsy specimens have been collected for histologic examination: a comparison between histologic results and white light or fluorescence bronchoscopy has been performed for assessing sensitivity and specificity of the two methods. Results : 1) Total 79 sires in 35 patients were examined. Histology demonstrated 8 normal mucosa, 21 hyperplasia, 23 dysplasia, and 27 microinvasive and invasive carcinoma. 2) The sensitivity of white light or fluorescence bronchoscopy in detecting dysplasia was 60.9% and 82.6%, respectively. 3) The results of this study showed 70.3 % sensitivity for microinvasive or invasive carcinoma with LIFE system, versus 100% sensitivity for white light in 27 cases of carcinoma. The false negative study of LIFE system was 8 cases(3 adenocarcinoma and 5 small cell carcinoma), which were infiltrated in submucosal area and had normal epithelium. Conclusion : To improve the ability 10 diagnose and stage more accurately, fluorescence imaging may become an important adjunct to conventional bronchoscopic examination because of its high detection rate of premalignant and malignant epithelial lesion. But. it has limitation to detect in submucosal infiltrating carcinoma.

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Preselection of Bovine Blastocysts Expressing Exogeneous Gene Following Microinjection (외래유전자를 주입한 소 수정란에서 형질전환가능 수정란의 선발)

  • 공일근
    • Korean Journal of Animal Reproduction
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    • v.21 no.2
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    • pp.167-176
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    • 1997
  • This study was carried out to evaluate the potential for preselection of transgenic embryos prior to transfer into recipient animals. In these experiments, I used a 3.2 kb transgene which contained the neomycin resistance gene (neo) and lac Z gene driven by the $\beta$ actin promoter (iacZ Ineo). Oocytes were aspirated from abattoir ovaries, matured in TCM-199 supplemented with 10% fetal bovine serum (FBS), 5 ${\mu}\textrm{g}$/ml LH, 0.5 ${\mu}\textrm{g}$/ml FSH, 100 unit/ml penicillin, and 100 ${\mu}\textrm{g}$/ml streptomycin for 22 to 24 hrs then inseminated with a sperm suspension of 1 X 10$^6$ sperm/ml containing 5 ${\mu}\textrm{g}$/ml of heparin. At 18-20 hrs after insemination, cumulus cells were removed by vortexing and pronuclei of centrifuged zygotes microinjected with the lacZ/neo construct (3 ng/$\mu$l). All cultures were carried out in CR1aa with transfected BRL monolayers containing 3 mg/ml BSA, 20 $\mu$/ml NEM amino acids and 40 $\mu$I/ml BME amino acids. To identify the appropriate concentration of G418 for selection, non-microinjected zygotes were cultured in the presence of 0, 50, 100 and 200 $\mu$g/ml of G418. After 8 days of culture in these treatments, 44/145 (30.3%), 13/150 (8. 7%), 1/151 (0.7%) and 0/134 (0.0%) devel-oped to the blastocyst stage in 0, 50, 100 and 200 $\mu$g/ml of G418, respectively. A total of 1,127 zygotes were microinjected and placed into culture (without G418) and subsequently 710 (63.0%) cleaved. At 48 hrs post-injection, embryos ($\geq$2-cell) were randomly assigned to control (medium alone) or G418 (100 ${\mu}\textrm{g}$/ml) treatments. A control culture of 740 non-microinjected embryos from the same replicates of embryos were also placed into control medium. After 8 days in culture, 54/343 (15.7%) and 22/367 (6.0 %) of the microinjected embryos developed to the blastocyst stage in control and G418 media, respectively. A total of 151/740 (27.2%) of the non-microinjected embryos placed in the control medium developed to the blastocyst stage. The blastocysts in the control treatment had a mean of 70.7 ${\pm}$ 4.7 cells of which 23.1 ${\pm}$ 2.6 (32.7%) stained for $\beta$-Gal activity. B1astocysts in the G418 treatment had a mean of 48.8${\pm}$7.5 cells of which 40.3 ${\pm}$ 4.1 (82.6%) stained for $\beta$-Gal ac tivity (P<0.05). In the control treatment 26 of 30 (87.0%) blastocysts had some cells with $\beta$-Gal activity while all of the blastocysts in the G418 treatment had some cell with $\beta$-Gal ac tivity (P<0.05). However, ICM colonies in either control or G418 treatments were not expressed any epiblast cell except of trophetoderm celIs. The $\beta$-actin promoter/lacZ gene may not be e expression or silence expression in epiblast cells These results clearly show an enrichment of blastocysts expressing the transgene in the majority of their cells after culture in the presence of G418. The exogeneous gene was not express a and silence in ICM colonies especiallly epiblast cells except of trophectederm cells. Even though the higher rate cell number expressed of exogeneous gene in the G418 treatments, a total cell number was decrease significantly (P<0.05) of which might be also drop of the establishment of ES like-cell colonies and production of transgenic animals. However, futher studies need to determine the viability of these selected embryos and the avability of production of transgenic offspring.

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Effect of Flywheel Weight on the Vibration of Diesel Engine (플라이휠 중량(重量)이 디젤 기관(機關)의 진동(振動)에 미치는 영향(影響))

  • Myung, Byung Soo;Kim, Sung Rai
    • Korean Journal of Agricultural Science
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    • v.20 no.2
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    • pp.167-180
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    • 1993
  • Most of small size diesel engines are widely used with the same size and weight flywheel in the levels of 6.0kW and 7.5kW. This study was conducted to obtain basic data which affect the engine performance of the power tiller. The flywheel weight was considered as a major factor in this research. Basically, fuel consumption ratio, motoring loss, torque, vibration and mechanical efficiency of the engine were measured and analyzed on four levels of flywheel weight, 32.2, 29.4, 26.2 and $24.2kg_f$, respectively. Results were obtained as follows: 1. The weights of flywheel were $23.7kg_f$ from design program of JSME and $24.5kg_f$ from ASME and SAE design criteria. Therefore, the flywheel weight of $32.2kg_f$ might be reduced about $8kg_f$ in 7.5kW engine. 2. The rated outputs of 6.0kW and 7.5kW engine were actually 7.43kW and 7.85kW, respectively. When flywheel weight was reduced from $32.2kg_f$ to $24.2kg_f$, outputs were increased from 7.43kW to 7.70kW in 6.0kW engine and from 7.85kW to 8.25kW in 7.5kW engine. 3. When the flywheel weight was reduced from $32.2kg_f$ to $24.2kg_f$, fuel consumption ratio was decreased from 300.8 to 296.8g/kW-hr in 6.0kW engine and also from 313.6 to 312.8g/kW-hr in 7.5 kW engine, respectively. 4. When the flywheel weight was reduced from $32.2kg_f$ to $24.2kg_f$, mechanical efficiency of engine was increased from 76.1% to 76.8% in 6.0kW engine and also from 76.7% to 77.0% in 7.5kW engine, respectively. 5. When the flywheel weight was reduced from $32.2kg_f$ to $24.2kg_f$, vibration was decreased at X-axis and Z-axis in 6.0kW engine, however, slightly increased at Y-axis in 6.0kW engine and at all axes in 7.5kW engine. 6. When the flywheel weight was reduced from $32.2kg_f$ to $24.4kg_f$ motoring loss was decreased from 2.33kW to 1.75kW in 6.0kW engine and also from 2.46kW to 1.84kW in 7.5kW engine.

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Comparison of marginal fit before and after porcelain build-up of two kinds of CAD/CAM zirconia all-ceramic restorations (두 종류의 CAD/CAM 지르코니아 전부도재관의 도재 축성 전후의 변연적합도 비교)

  • Shin, Ho-Sik;Kim, Seok-Gyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.528-534
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    • 2008
  • Purpose: Marginal fit is one of the important components for the successful prosthodontic restoration. Poor fitting margin of the restoration causes hypersensitivity, secondary caries, and plaque accumulation, which later result in prosthodontic failure. CAD/CAM zirconia all-ceramic restorations, such as $LAVA^{(R)}$ (3M ESPE, St.Paul, MN) and $EVEREST^{(R)}$ (KaVo Dental GmbH, Biberach, Germany) systems were recently introduced in Korea. It is clinically meaningful to evaluate the changes of the marginal fit of the CAD/CAM zirconia systems before and after build-up. The purposes of this study are to compare the marginal fit of the two CAD/CAM all-ceramic systems with that of the ceramometal restoration, before and after porcelain build-up Material and methods: A maxillary first premolar dentiform tooth was prepared with 2.0 mm occlusal reduction, 1.0 mm axial reduction, chamfer margin, and 6 degree taperness in the axial wall. The prepared dentiform die was duplicated into the metal abutment die. The metal die was placed in the dental study model, and the full arch impressions of the model were made. Twenty four copings of 3 groups which were $LAVA^{(R)}$, $EVEREST^{(R)}$, and ceramometal restorations were fabricated. Each coping was cemented on the metal die with color-mixed Fit-checker $II^{(R)}$ (GC Cor., Tokyo, Japan). The marginal opening of each coping was measured with $Microhiscope^{(R)}$ system (HIROX KH-1000 ING-Plus, Seoul, Korea. X300 magnification). After porcelain build-up, the marginal openings of $LAVA^{(R)}$, $EVEREST^{(R)}$,and ceramometal restorations were also evaluated in the same method. Statistical analysis was done with paired t-test and one-way ANOVA test. Results: In coping states, the mean marginal opening for $EVEREST^{(R)}$ restorations was $52.00{\pm}11.94\;{\mu}m$ for $LAVA^{(R)}$ restorations $56.97{\pm}10.00\;{\mu}m$, and for ceramometal restorations $97.38{\pm}18.54\;{\mu}m$. After porcelain build-up, the mean marginal opening for $EVEREST^{(R)}$ restorations was $61.69{\pm}19.33\;{\mu}m$, for $LAVA^{(R)}$ restorations $70.81{\pm}12.99\;{\mu}m$, and for ceramometal restorations $1115.25{\pm}23.86\;{\mu}m$. Conclusion: 1. $LAVA^{(R)}$ and $EVEREST^{(R)}$ restorations in comparison with ceramometal restorations showed better marginal fit, which had significant differences (P < 0.05) in coping state and also after porcelain build-up . 2. The mean marginal opening values between $LAVA^{(R)}$ and $EVEREST^{(R)}$ restorations did not showed significant differences after porcelain build-up as well as in coping state (P > .05). 3. $EVEREST^{(R)}$, $LAVA^{(R)}$ and ceramometal restorations showed a little increased marginal opening after porcelain build-up, but did not show any statistical significance (P > .05).

Effects of Adjuvant Radiation Therapy and Chemotherapy Following Curative Surgery in Locally Advanced Rectal Cancer (국소 진행된 직장암에서 근치적 절제술 후 방사선치료와 항암화학요법과의 병용치료에 대한 효과)

  • Kang, Ki-Mun;Choi, Ihl-Bohng;Kim, In-Ah;Jang, Jee-Young;Shin, Kyung-Sub;Jang, Suck-Kyun;Lee, Jae-Hak;Kim, Young-Ha;Won, Chong-Man;Choi, Dong-Hwan;Kim, Jin-Seung;Park, Shinn-Hee
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.121-128
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    • 1997
  • Purpose : To evaluate the effect of postoperative adjuvant radiation therapy and chemotherapy on the survival, pattern of failure and complication for locally advanced rectal carcinoma Materials and Methods : From October 1992 to September 1995, twenty eight patients with rectal carcinoma were treated by postoperative adjuvant radiation therapy and chemotherapy Radiation therapy was delivered with 6MV and 15MV linear accelerator, 180c0y fractions 5 day per week. Total radiation doses were 5040cGy in $B_{2+3}$ and 5580cGy in $C_{2+3}$. Within 4 weeks after radical surgery. 5-FU$(400mg/m^2/day)\;and\;Leucovorin(20mg/m^2/day)$ were administered by intravenous injection for 4 days during the first and fifth week of radiation therapy. The median follow up was 19 months with a range 2 to 47 months. Results : The 2 year overall survival and disease free survival rates were $78.6\%\;and\;70.8\%$, respectively. The 2 year overall survival was $93.0\%\;in\;B_{2+3}$ and $76.2\%\;in\;C_{2+3}$(p=0.11) The 2 year disease free survival was $79.4\%\;in\;B_{2+3}\;and\;69.2\%\;in\;C_{2+3}(p=0.13)$. The overall failure rate was $21.42\%$(6/28) including $10.72\%$(3/28) locoregional recurrence, $3.62\%$(1/28) distant metastasis and $7.12\%$(2/28) locoregional recurrence with distant metastasis. The overall locoregional recurrence rate was $17.92\%$(5/28). The 2 year locoregional recurrence rates were $13.32\%(2/15)\;and\;23.12\%$(3/13) for respectively for $B_{2+3}\;and\;C_{2+3}$ The difference between the locoregional recurrence of $B_{2+3}\;and\;C_{2+3}$ patients was not significant(p=0.07). Complications developed in 13 patients$(46.42\%)$, including 8 dermatitis, 7 loose stool, 6 leukopenia, 4 tenesmus, 2 diarrhea. In Univariate analysis, there was no statistically significant factor except for tumor grade in locoregional recurrence, disease free survival and overall survival rate(p=0.04, 0.05, 0.04). Conclusion : This study sugges1s that postoperative adjuvant radiation therapy and chemotherapy is effective in patients with locally advanced rectal cancer. Therefore these results need to be confirmed with a long term follow-up and larger number of patients with the further clinical trials including prospective controlled studies.

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The Evaluation of IL-8 in the Serum of Pneumoconiotic patients (진폐증 환자에서의 혈청내 IL-8 농도)

  • Ahn, Hyeong Sook;Kim, Ji Hong;Chang, Hwang Sin;Kim, Kyung Ah;Lim, Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.945-953
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    • 1996
  • Background : Many acute and chronic lung diseases including pneumoconiosis are characterized by the presence of increased numbers of activated macrophages. These macrophages generate several inflammatory cell chemoattractants, by which neutrophil migrate from vascular compartment to the alveolar space. Recruited neutrophils secrete toxic oxygen radicals or proteolytic enzymes and induce inflammatory response. Continuing inflammatory response results in alteration of the pulmonary structure and irreversible fibrosis. Recently, a polypeptide with specific neutrophil chemotactic activity, interleukin-8(IL-8), has been cloned and isolated from a number of cells including : monocytes, macrophages and fibroblasts. IL-1 and/or TNF-${\alpha}$ preceded for the synthesis of IL-8, and we already observed high level of IL-1 and TNF-${\alpha}$ in the pneumoconioses. So we hypothesized that IL-8 may be a central role in the pathogenesis of pneumoconiosis. In order to evaluate the clinical utility of IL-8 as a biomarker in the early diagnosis of pneumoconiosis, we investigated the increase of IL-8 in the pneumoconiotic patient and the correlation between IL-8 level and progression of pneumoconiosis. Method : We measured IL-8 in the serum of 48 patients with pneumoconiosis and 16 persons without dust exposure history as a control group. Pneumoconiotic cases were divided into 3 groups according to ILO Classification : suspicious group(n=16), small opacity group(n=16) and large opacity group(n=16). IL-8 was measured by a sandwich enzytne immunoassay technique. All data were expressed as the $mean{\pm}standard$ deviation. Results: 1) The mean value of age was higher in the small opacity and large opacity group than comparison group, but smoking history was even. Duration of dust exposure was not different among 3 pneumoconiosis groups. 2) IL-8 level was $70.50{\pm}53.63pg/m{\ell}$ in the suspicious group, $107.50{\pm}45.88pg/m{\ell}$ in the small opacity group, $132.50{\pm}73.47pg/m{\ell}$ in the large opacity group and $17.85{\pm}33.85pg/m{\ell}$ in the comparison group. IL-8 concentration in all pneumoconiosis group was significant higher than that in the comparison group(p<0.001). 3) IL-8 level tended to increase with the progression of pneumoconiosis. Multiple comparison test using Anova/Scheffe analysis showed a significant difference between suspicious group and large opacity group(p<0.05). 4) The level of IL-8 was correlated with the progression of pneumoconiosis(r=0.4199, p<0.05). Conclusion : IL-8 is thought to be a good biomarker for the early diagnosis of pneumoconiosis.

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Development of Conformal Radiotherapy with Respiratory Gate Device (호흡주기에 따른 방사선입체조형치료법의 개발)

  • Chu Sung Sil;Cho Kwang Hwan;Lee Chang Geol;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.41-52
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    • 2002
  • Purpose : 3D conformal radiotherapy, the optimum dose delivered to the tumor and provided the risk of normal tissue unless marginal miss, was restricted by organ motion. For tumors in the thorax and abdomen, the planning target volume (PTV) is decided including the margin for movement of tumor volumes during treatment due to patients breathing. We designed the respiratory gating radiotherapy device (RGRD) for using during CT simulation, dose planning and beam delivery at identical breathing period conditions. Using RGRD, reducing the treatment margin for organ (thorax or abdomen) motion due to breathing and improve dose distribution for 3D conformal radiotherapy. Materials and Methods : The internal organ motion data for lung cancer patients were obtained by examining the diaphragm in the supine position to find the position dependency. We made a respiratory gating radiotherapy device (RGRD) that is composed of a strip band, drug sensor, micro switch, and a connected on-off switch in a LINAC control box. During same breathing period by RGRD, spiral CT scan, virtual simulation, and 3D dose planing for lung cancer patients were peformed, without an extended PTV margin for free breathing, and then the dose was delivered at the same positions. We calculated effective volumes and normal tissue complication probabilities (NTCP) using dose volume histograms for normal lung, and analyzed changes in doses associated with selected NTCP levels and tumor control probabilities (TCP) at these new dose levels. The effects of 3D conformal radiotherapy by RGRD were evaluated with DVH (Dose Volume Histogram), TCP, NTCP and dose statistics. Results : The average movement of a diaphragm was 1.5 cm in the supine position when patients breathed freely. Depending on the location of the tumor, the magnitude of the PTV margin needs to be extended from 1 cm to 3 cm, which can greatly increase normal tissue irradiation, and hence, results in increase of the normal tissue complications probabiliy. Simple and precise RGRD is very easy to setup on patients and is sensitive to length variation (+2 mm), it also delivers on-off information to patients and the LINAC machine. We evaluated the treatment plans of patients who had received conformal partial organ lung irradiation for the treatment of thorax malignancies. Using RGRD, the PTV margin by free breathing can be reduced about 2 cm for moving organs by breathing. TCP values are almost the same values $(4\~5\%\;increased)$ for lung cancer regardless of increasing the PTV margin to 2.0 cm but NTCP values are rapidly increased $(50\~70\%\;increased)$ for upon extending PTV margins by 2.0 cm. Conclusion : Internal organ motion due to breathing can be reduced effectively using our simple RGRD. This method can be used in clinical treatments to reduce organ motion induced margin, thereby reducing normal tissue irradiation. Using treatment planning software, the dose to normal tissues was analyzed by comparing dose statistics with and without RGRD. Potential benefits of radiotherapy derived from reduction or elimination of planning target volume (PTV) margins associated with patient breathing through the evaluation of the lung cancer patients treated with 3D conformal radiotherapy.

The Plant Succession of Improved Pasture Around Mt. Halla in Cheju Island (한라산 인공초지의 식물천이)

  • 조남기
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.31 no.3
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    • pp.336-349
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    • 1986
  • This study was conducted to examine the plant succession on the improved pasture of the mountain districts around Mt. Halla in Cheju Island. For this study, the researcher had investigated for ten years the improved pasture which had been used for grazing from 1976 to 1985. The pasture was reclaimed from native grassland. The mixed seeds of 17kgs' Dactylis glomerata, 7kgs' Festuca arundinacea, 2kgs' Lolium multiflorum and 2kgs' Trifolium repens were sowed per ha. The results of this study are the followings; The annual changes in the number of plant species were observed. 37 weed species were found in 1976 and increased year after year to 151 species in 1985. The changes in the distribution of annual and perennial plant, and one species of arbor were found in 1976 and increased respectively year by year to 56 species (annual plant), 95 species (perennial plant) and 9 species (arbor) in 1985. The average plant height of introduced grasses by year increased from 38.05cm (1976) to 47.30cm (1978) and decreased from 40.50cm (1979) to 10.36cm in 1985 (y =-0.501x$^2$+1.609x + 41.946). While the average plant height of invading weeds increased from 26.61cm to 42.84cm (y=-0.80$\chi$$^2$+2.540$\chi$+27.570) between 1976 and 1985. The density of introduced grasses was 70.90% in 1976 and was reduced to 0.49% in 1985 (y =-0.501$\chi$$^2$+1.609$\chi$+41.946); while that of introduing weeds was 29.10% in 1976 and was increased to 99.51% in 1985 (y=-0.080$\chi$$^2$+2.540$\chi$+27.570). The coverage of introduced grasses by year increased gradually from 72.8% (1976) to 74.86% (1978) and decreased from 43.01% (1979) to 1.21% in 1986 while that of intruding weeds developed a tendency to increase every year. Their coverage in 1976 was 22.09% and increased to 98.78% in 1985. The weight of introduced grasses by year increased from 2,808kg (1976) to 3,535kg (1978) per l0a and after 1979 decreased gradually from 2,326kg (1978) to 35kg per l0a in 1985. That of intruding weeds increased yearly from 308kg in 1976 to 3,178kg in 1985. The type of annual vegetation were changed as follows; Year Type 1976-1978 Dactylis glomerata / Trifolium repens type 1979 Trifolium repens / Imperata cylindrica type 1980-1982 Imperata cylindrica / Zoysia Japonica type 1983 Imperata cylindrica / Pteridium aquilinum type 1984-1985 Imperata cylindrica / Miscanthus sinensis type The plants whose plant height, coverage, density, and weight increased year after year were Imperate cylind-rica, Zoysia japonica, Pteridium equilinum, Miscanthus sinensis, Cirsium japonicum, Erigeron canadensis, Artemisia japonica, Lespedeza cuneata, Spondiopogon cotuUfer. Cymbopogon tortilis, Plantago asiatica, Rumex acetosella, etc. The vegetation of Digitaria sanguinalis, Hydrocotyl japonica, Artemisia asiatica, etc. was com-paratively remarkable in the beginning.

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The Results of Definitive Radiation Therapy and The Analysis of Prognostic Factors for Non-Small Cell Lung Cancer (비소세포성 폐암에서 근치적 방사선치료 성적과 예후인자 분석)

  • Chang, Seung-Hee;Lee, Kyung-Ja;Lee, Soon-Nam
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.409-423
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    • 1998
  • Purpose : This retrospective study was tried to evaluate the clinical characteristics of patients, patterns of failure, survival rates, prognostic factors affecting survival, and treatment related toxicities when non-small cell lung cancer patients was treated by definitive radiotherapy alone or combined with chemotherapy. Materials and Methods : We evaluated the treatment results of 70 patients who were treated by definitive radiation therapy for non-small cell lung cancer at the Department of Radiation Oncology, Ewha Womans University Hospital, between March 1982 and April 1996. The number of patients of each stage was 2 in stage I, 6 in stage II, 30 in stage III-A, 29 in stage III-B, 3 in stage IV. Radiation therapy was administered by 6 MV linear accelerator and daily dose was 1.8-2.0 Gy and total radiation dose was ranged from 50.4 Gy to 72.0 Gy with median dose 59.4 Gy. Thirty four patients was treated with combined therapy with neoadjuvant or concurrent chemotherapy and radiotherapy, and most of them were administered with the multi-drug combined chemotherapy including etoposide and cisplatin. The survival rate was calculated with the Kaplan-Meier methods. Results : The overall 1-year, 2-year, and 3-year survival rates were 63$\%$, 29$\%$, and 26$\%$, respectively. The median survival time of all patients was 17 months. The disease-free survival rate for 1-year and 2-year were 23$\%$ and 16$\%$, respectively. The overall 1-year survival rates according to the stage was 100$\%$ for stage I, 80$\%$ for stage II, 61$\%$ for stage III, and 50$\%$ for stage IV. The overall 1-year 2-year, and 3-year survival rates for stage III patients only were 61$\%$, 23$\%$, and 20$\%$, respectively. The median survival time of stage III patients only was 15 months. The complete response rates by radiation therapy was 10$\%$ and partial response rate was 50$\%$. Thirty patients (43$\%$) among 70 patients assessed local control at initial 3 months follow-up duration. Twenty four (80$\%$) of these 30 Patients was possible to evaluate the pattern of failure after achievement of local control. And then, treatment failure occured in 14 patients (58$\%$): local relapse in 6 patients (43$\%$), distant metastasis in 6 patients (43$\%$) and local relapse with distant metastasis in 2 patients (14$\%$). Therefore, 10 patients (23$\%$) were controlled of disease of primary site with or without distant metastases. Twenty three patients (46$\%$) among 50 patients who were possible to follow-up had distant metastasis. The overall 1-year survival rate according to the treatment modalities was 59$\%$ in radiotherapy alone and 66$\%$ in chemoirradiation group. The overall 1-year survival rates for stage III patients only was 51$\%$ in radiotherapy alone and 68$\%$ in chemoirradiation group which was significant different. The significant prognostic factors affecting survival rate were the stage and the achievement of local control for all patients at univariate- analysis. Use of neoadjuvant or concurrent chemotherapy, use of chemotherapy and the achievement of local control for stage III patients only were also prognostic factors. The stage, pretreatment performance status, use of neoadjuvant or concurrent chemotherapy, total radiation dose and the achievement of local control were significant at multivariate analysis. The treatment-related toxicities were esophagitis, radiation pneunonitis, hematologic toxicity and dermatitis, which were spontaneously improved, but 2 patients were died with radiation pneumonitis. Conclusion : The conventional radiation therapy was not sufficient therapy for achievement of long-term survival in locally advanced non-small cell lung cancer. Therefore, aggressive treatment including the addition of appropriate chemotherapeutic drug to decrease distant metastasis and preoperative radiotherapy combined with surgery, hyperfractionation radiotherapy or 3-D conformal radiation therapy for increase local control are needed.

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Effects of Addition Level and Chemical Type of Propionate Precursors in Dicarboxylic Acid Pathway on Fermentation Characteristics and Methane Production by Rumen Microbes In vitro

  • Li, X.Z.;Yan, C.G.;Choi, S.H.;Long, R.J.;Jin, G.L.;Song, Man K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.22 no.1
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    • pp.82-89
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    • 2009
  • Two in vitro experiments were conducted to examine the effects of propionate precursors in the dicarboxylic acid pathway on ruminal fermentatation characteristics, $CH_4$ production and degradation of feed by rumen microbes. Fumarate or malate as sodium salts (Exp. 1) or acid type (Exp. 2) were added to the culture solution (150 ml, 50% strained rumen fluid and 50% artificial saliva) to achieve final concentrations of 0, 8, 16 and 24 mM, and incubated anaerobically for 0, 1, 3, 6, 9 and 12 h at $39^{\circ}C$. For both experiments, two grams of feed consisting of 70% concentrate and 30% ground alfalfa (DM basis) were prepared in a nylon bag, and were placed in a bottle containing the culture solution. Addition of fumarate or malate in both sodium salt and acid form increased (p<0.0001) pH of culture solution at 3, 6, 9 and 12 h incubations. The pH (p<0.0001) and total volatile fatty acids (VFA, p<0.05) were enhanced by these precursors as sodium salt at 3, 6 and 9 h incubations, and pH (p<0.001) and total VFA (p<0.01) from fumarate or malate in acid form were enhanced at a late stage of fermentation (9 h and 12 h) as the addition level increased. pH was higher (p<0.001) for fumarate than for malate as sodium salt at 3 h and 6 h incubations. Propionate ($C_3$) proportion was increased (p<0.0001) but those of $C_2$ (p<0.05) and $C_4$ (p<0.01 - p<0.001) were reduced by the addition of sodium salt precursors from 3 h to 12 incubation times while both precursors in acid form enhanced (p<0.011 - p<0.0001) proportion of $C_3$ from 6h but reduced (p<0.018 - p<0.0005) $C_4$ proportion at incubation times of 1, 3, 9 and 12 h. Proportion of $C_3$ was increased (p<0.05 - p<0.0001) at all incubation times by both precursors as sodium salt while that of $C_3$ was increased (p<0.001) from 6h but $C_4$ proportion was decreased by both precursors in acid form as the addition level increased. Proportion of $C_3$ was higher (p<0.01 - p<0.001) for fumarate than malate as sodium salt from 6 h incubation but was higher for malate than fumarate in acid form at 9 h (p<0.05) and 12 h (p<0.01) incubation times. Increased levels (16 and 24 mM) of fumarate or malate as sodium salt (p<0.017) and both precursors in acid form (p<0.028) increased the total gas production, but no differences were found between precursors in both chemical types. Propionate precursors in both chemical types clearly reduced (p<0.0001 - p<0.0002) $CH_4$ production, and the reduction (p<0.001 - p<0.0001) was dose dependent as the addition level of precursors increased. The $CH_4$ generated was smaller (p<0.01 - p<0.0001) for fumarate than for malate in both chemical types. Addition of fumarate or malate as sodium type reduced (p<0.004) dry matter degradation while both precursors in both chemical types slightly increased neutral detergent fiber degradability of feed in the nylon bag.