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Prognostic Relevance of WHO Classification and Masaoka Stage in Thymoma (흉선종양에서의 WHO 분류와 Masaoka 병기, 임상양상간의 상관관계연구)

  • Kang Seong Sik;Chun Mi Sun;Kim Yong Hee;Park Seung Il;Eeom Dae W.;Ro Jaee Y.;Kim Dong Kwan
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.44-49
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    • 2005
  • Although thymomas are relatively common mediastinal tumors, to date not only has a universal system of pathologic classification not been established but neither has a clearly defined predictable relationship between treatment and prognosis been made. Recently, a new guideline for classification was reported by WHO, and efforts, based on this work, have been made to better define the relationship between treatment and pro­gnostic outcome. In the present study a comparative analysis between the WHO classification and Masaoka stage system with the clinical disease pattern was conducted. Material and Method: A total of 98 patients undergoing complete resection for mediastinal thymoma between Juanuary 1993 and June 2003 were included in the present study. The male female ratio was 48 : 50 and the mean age at operation was $49.6{\pm}13.9\;years.$ A retrospective analytic comparison studying the relationship between the WHO classification and the Masaoka stage system with the clinical disease pattern of thymoma was conducted. Pathologic slide specimens were carefully examined, details of postoperative treatment were documented, and a relationship with the prognostic outcome and recurrence was studied. Result: There were 7 patients in type A according to the WHO system of classification, 14 in AB, 28 in B 1, 23 in B2, 18 in B3, and 9 in type C. The study of the relationship between the Masaoka stage and WHO classification system showed 4 patients to be in WHO system type A, 7 in type AB, 22 in B 1, 17 in B2, and 3 in type B3 among 53 $(54{\%})$ patients shown to be in Masaoka stage I. Among 28 $(28.5{\%})$ patients in Masaoka stage II system, there were 2 patients in type A, 7 in AB, 4 in B 1, 2 in B2, 8 in B3, and 5 in type C. Among 15 $(15.3{\%})$ in Masaoka stage III, there were 1 patient in type B1, 3 in B2, 7 in B3, and 4 in type C. Finally, among 2 $(2{\%})$ patients found to be in Masaoka stage IV there was 1 patient in type B1, and 1 in type B2. The mean follow up duration was $28{\pm}6.8$ months. There were 3 deaths in the entire series of which 2 were in type B2 (Masaoka stages III and IV), and 1 was in type C (Masaoka stage II). Of the patients that experienced relapse, 6 patients remain alive of which 2 were in type B2 (Masaoka III), 2 in type B3 (Masaoka I and III) and 2 in type C (Masaoka stage II). The 5 year survival rate by the Kaplan-Meier method was $90{\%}$ for those in type B2 WHO classification system, $87.5{\%}$ for type C. The 5 year freedom from recurrence rate was $80.7{\%}$ for those in WHO type B2, $81.6{\%}$ for those in type B3, and $50{\%}$ for those in type C. By the Log-Rank method, a statistically significant correlation between survival and recurrence was found with the WHO system of classification (p<0.05). An analysis of the relationship between the WHO classification and Masaoka stage system using the Spearman correction method, showed a slope=0.401 (p=0.023), showing a close correlation. Conclusion: As type C of the WHO classification system is associated with a high postoperative mortality and recurrence rate, aggressive treatment postoperatively and meticulous follow up are warranted. The WHO classification and Masaoka stage system were found to have a close relationship with each other and either the WHO classification method or the Masaoka stage system may be used as a predict prognostic outcome of Thymoma.

A Basic Study on the Establishment of Preservation and Management for Natural Monument(No.374) Pyeongdae-ri Torreya nucifera forest of Jeju (천연기념물 제374호 제주 평대리 비자나무 숲의 보존·관리방향 설정을 위한 기초연구)

  • Lee, Won-Ho;Kim, Dong-Hyun;Kim, Jae-Ung;Oh, Hae-Sung;Choi, Byung-Ki;Lee, Jong-Sung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.1
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    • pp.93-106
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    • 2014
  • In this study, Analyze environment of location, investigation into vegetation resources, survey management status and establish to classify the management area for Natural monument No.374 Pyengdae-ri Torreya nucifera forest. The results were as follows: First, Torreya nucifera forest is concerned about influence of development caused by utilization of land changes to agricultural region. Thus, establish to preservation management plan for preservation of prototypical and should be excluded development activity to cause the change of terrain that Gotjawal in the Torreya nucifera forest is factor of base for generating species diversity. Secondly, Torreya nucifera forest summarized as 402 taxa composed 91 familly 263 genus, 353 species, 41 varieties and 8 forms. The distribution of plants for the first grade & second grade appear of endangered plant to Ministry of Environment specify. But, critically endangered in forest by changes in habitat, diseases and illegal overcatching. Therefore, when establishing forest management plan should be considered for put priority on protection. Thirdly, Torreya nucifera representing the upper layer of the vegetation structure. But, old tree oriented management and conservation strategy result in poor age structure. Furthermore, desiccation of forest on artificial management and decline in Torreya nucifera habitat on ecological succession can indicate a problem in forest. Therefore, establish plan such as regulation of population density and sapling tree proliferation for sustainable characteristics of the Torreya nucifera forest. Fourth, Appear to damaged of trails caused by use. Especially, Scoria way occurs a lot of damaged and higher than the share ratio of each section. Therefore, share ratio reduction Plan should be considered through the additional development of tourism routes rather than the replacement of Scoria. Fifth, Representing high preference of the Torreya nucifera forest tourist factor confirmed the plant elements. It is sensitive to usage pressure. And requires continuous monitoring by characteristic of Non-permanent. In addition, need an additional plan such as additional development of tourism elements and active utilizing an element of high preference. Sixth, Strength of protected should be differently accordance with importance. First grade area have to maintenance of plant population and natural habitats. Set the direction of the management. Second grade areas focus on annual regeneration of the forest. Third grade area should be utilized demonstration forest or set to the area for proliferate sapling. Fourth grade areas require the introduced of partial rest system that disturbance are often found in proper vegetation. Fifth grade area appropriate to the service area for promoting tourism by utilizing natural resources in Torreya nucifera forest. Furthermore, installation of a buffer zone in relatively low ratings area and periodic monitoring to the improvement of edge effect that adjacent areas of different class.

THE EFFECT OF INTERMITTENT COMPOSITE CURING ON MARGINAL ADAPTATION (복합레진의 간헐적 광중합 방법이 변연적합도에 미치는 영향)

  • Yun, Yong-Hwan;Park, Sung-Ho
    • Restorative Dentistry and Endodontics
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    • v.32 no.3
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    • pp.248-259
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    • 2007
  • The aim of this research was to study the effect of intermittent polymerization on marginal adaptation by comparing the marginal adaptation of intermittently polymerized composite to that of continuously polymerized composite. The materials used for this study were Pyramid (Bisco Inc., Schaumburg, U.S.A.) and Heliomolar (Ivoclar Vivadent, Liechtenstein) . The experiment was carried out in class II MOD cavities prepared in 48 extracted human maxillary premolars. The samples were divided into 4 groups by light curing method: group 1- continuous curing (60s light on with no light off), group 2-intermittent curing (cycles of 3s with 2s light on & 1s light off for 90s); group 3- intermittent curing (cycles of 2s with 1s light on & 1s light off for 120s); group 4- intermittent curing (cycles of 3s with 1s light on & 2s light off for 180s). Consequently the total amount of light energy radiated was same in all the groups. Each specimen went through thermo-mechanical loading (TML) which consisted of mechanical loading (720,000 cycles, 5.0 kg) with a speed of 120 rpm for 100hours and thermocycling (6000 thermocycles of alternating water of $50^{\circ}C$ and $55^{\circ}C$). The continuous margin (CM) (%) of the total margin and regional margins, occlusal enamel (OE), vertical enamel (VE), and cervical enamel (CE) was measured before and after TML under a $\times200$ digital light microscope. Three-way ANOVA and Duncan's Multiple Range Test was performed at 95% level of confidence to test the effect of 3 variables on CM (%) of the total margin: light curing conditions, composite materials and effect of TML. In each group, One-way ANOVA and Duncan's Multiple Range Test was additionally performed to compare CM (%) of regions (OE, VE CE). The results indicated that all the three variables were statistically significant (p < 0.05). Before TML, in groups using Pyramid, groups 3 and 4 showed higher CM (%) than groups 1 and 2, and in groups using Heliomolar. groups 3 and 4 showed higher CM (%) than group 1 (p < 0.05). After TML, in both Pyramid and Heliomo)ar groups, group 3 showed higher CM (%) than group 1 (p < 0.05) CM (%) of the regions are significantly different in each group (p < 0.05). Before TML, no statistical difference was found between groups within the VE and CE region. In the OE region, group 4 of Pyramid showed higher CM (%) than group 2, and groups 2 and 4 of Heliomolar showed higher CM (%) than group 1 (p < 0.05). After TML, no statistical difference was found among groups within the VE and CE region. In the OE region, group 3 of Pyramid showed higher CM (%) than groups 1 and 2, and groups 2,3 and 4 of Heliomolar showed higher CM (%) than group 1 (p < 0.05). It was concluded that intermittent polymerization may be effective in reducing marginal gap formation.

The Ruling System of Silla to Gangneung Area Judged from Archaeological Resources in 5th to 6th Century (고고자료로 본 5~6세기 신라의 강릉지역 지배방식)

  • Shim, Hyun Yong
    • Korean Journal of Heritage: History & Science
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    • v.42 no.3
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    • pp.4-24
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    • 2009
  • This paper examined archaeological resources that discuss how Silla entered the Gangneung area, the coastal region along the East Sea that has been excavated most actively. Silla expanded its territories while organizing the its system as an ancient state and acquired several independent townships in various regions, stretching its forces to the East Sea area faster than any other ancient states of the time. In particular, many early relics and heritages of Silla have been found in Gangneung, the center of the East Sea area. Many archaeological resources prove these circumstances of that time and provide brief texts that are valuable for our interpretation of historical facts. In this respect, it was possible for me to examine these resources to answer my question as to why early relics and heritages of Silla are found in the Gangneung area. Based on my research on Silla's advancement into the Gangneung area, I have acquired the following results: How did Silla rule this area after conquering Yeguk in the Gangneung area? After conquering the Gangneung area, Silla attempted an indirect ruling at first. Later, Silla adopted a direct ruling system. I divided the indirect ruling period into two phases: introduction and settlement. In detail, Silla's earthenware and stone chamber tombs first appeared in Hasi-dong in the fourth quarter of the 4th Century and the tombs spread to Chodang-dong in the second quarter of the 5th Century. A belt with dragon pattern openwork, which seems to be from the second quarter of the 5th Century, was found to tell us that the Gangneung region began receiving rewards from Silla during this time. Thus, the period from the fourth quarter of the 4th Century to the second quarter of the 5th Century is designated as the 1st Phase (Introduction) of indirect ruling in terms of aechaeological findings. This is when Silla was first advanced to the Gangneung area and tolerated independent administration of the conquered. In the third and fourth quarters of the 5th Century, old mound tombs appeared and burials of relics that symbolized power emerged. In the third quarter of the 5th Century, stone chamber tombs were prevalent, but wooden chamber tombs, stone mounded wooden chamber tombs, and lateral entrance stone chamber tombs began to emerge. Also, tombs that were clustered in Hasi-dong and Chodang-dong began to scatter to Byeongsan-dong, Yeongjin-ri, and Bangnae-ri nearby. Steel pots were the symbol of power that emerged at this time. In the fourth quarter of the 5th Century, stone chamber tombs were still dominating, but wooden chamber tombs, stone mounded wooden chamber tombs, and lateral entrance stone chamber tombs became more popular. More crowns, crown ornaments, big daggers, and belts were bestowed by Silla, mostly in Chodang-dong and Byeongsan-dong. The period from the third quarter to the fourth quarter of the 5th Century was designated as the 2nd Phase (Settlement) of indirect ruling in terms of aechaeological findings. At this time, Silla bestowed items of power to the ruling class of the Gangneung area and gave equal power to the rulers of Chodang-dong and Byeongsan-dong to keep them restrained by each other. However, Silla converted the ruling system to direct ruling once it recognized the Gangneung area as the base of its expedition of conquest to the north. In the first quarter of the 6th Century, old mound tombs disappeared and small/medium-sized mounds appeared in the western inlands and the northern areas. In this period, the tunnel entrance stone chamber tombs were large enough for people to enter with doors. A cluster of several tunnel entrance stone chamber tombs was formed in Yeongjin-ri and Bangnae-ri at this time, probably with the influence of Silla's direct ruling. In the first quarter of the 6th Century, Silla dispatched officers from the central government to complete the local administration system and replaced the ruling class of Chodang-dong and Byeongsan-dong with that of Silla-friendly Yeonjin-ri and Bangnae-ri to reorganize the local administration system and gain full control of the Gangneung area.

A Study on the Stand Structure Analysis by the Changing Growth in Korean White Pine Stand (잣나무 임분의 생장변화에 따른 임분구조 해석에 관한 연구 - 강원대학교 학술림을 중심으로 -)

  • Jang, Jae-Young;Shin, Hyun-Ji;Woo, Jong-Choon
    • Journal of Forest and Environmental Science
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    • v.20 no.1
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    • pp.58-68
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    • 2004
  • In this study, the stand structure of the Korean White Pine stand is analysed by the changing growth situation and the growth model for DBH, Height, and Volume per ha, which is estimated with the data collected for Korean White Pine stand in the Research Forests of Kangwon National University. The results were summarized as follows The estimated equations were (1) Y=20.687Ln(X)-50.431 for DBH, (2) Y=12.951Ln(X)-31.225 for Height, (3) Y=171.06Ln(X)-462.16 for Volume per ha. The mean volumes per ha according to the age classes using the estimated equations were $27.45m^3$ $91.05m^3$, $147.71m^3$, $190.03m^3$, $223.84m^3$, $252.01m^3$ and $276.15m^3$ for the age class II, III, IV, V, VI, VII and VIII, respectively. And also, the relationship between mean annual increment(MAI) and periodic average increment(PAI) was analysed.

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Logic for the use of stable structural superimposition method and introduction of its application (안정골구조물 중첩법(stable structural superimposition method)을 사용해야 하는 합리적 근거 및 그 중첩방법의 소개)

  • Chun, Youn-Sic;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.27 no.5 s.64
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    • pp.669-682
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    • 1997
  • [$Bj\ddot{o}rk$] and Skieller concluded after following facial growth patterns using implants in upper and lower jaw bones that stable structures, which are not influenced by the growth do exist and so these must be the reference landmarks in the process of superimposition. In spite of such facts, for the last 40 years since the discovery of stable structures, most orthodontists have preferred best fit superimposition method to structural method. Cases such as Angle's Class II division 2 malocclusion that show characteristic forward and upward growth or one under long period of post-treatment observation demonstrate that distinct differences exist between the two methods of superimposition. Today, ethical concerns prohibit further growth studies that use implants, md so there is no choice but to use stable structural superimposition method based on $Bj\ddot{o}rk's$ data. Thus, to encourage clinical use of stable structural superimposition method, logic for the use of stable structural superimposition method will be demonstrated, and its technical methods of application will be introduced step by step.

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Overview of Transforming Growth Factor β Superfamily Involvement in Glioblastoma Initiation and Progression

  • Nana, Andre Wendindonde;Yang, Pei-Ming;Lin, Hung-Yun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6813-6823
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    • 2015
  • Glioblastoma, also known as glioblastoma multiforme (GBM), is the most aggressive of human brain tumors and has a stunning progression with a mean survival of one year from the date of diagnosis. High cell proliferation, angiogenesis and/or necrosis are histopathological features of this cancer, which has no efficient curative therapy. This aggressiveness is associated with particular heterogeneity of the tumor featuring multiple genetic and epigenetic alterations, but also with implications of aberrant signaling driven by growth factors. The transforming growth factor ${\beta}$ ($TGF{\beta}$) superfamily is a large group of structurally related proteins including $TGF{\beta}$ subfamily members Nodal, Activin, Lefty, bone morphogenetic proteins (BMPs) and growth and differentiation factor (GDF). It is involved in important biological functions including morphogenesis, embryonic development, adult stem cell differentiation, immune regulation, wound healing and inflammation. This superfamily is also considered to impact on cancer biology including that of GBM, with various effects depending on the member. The $TGF{\beta}$ subfamily, in particular, is overexpressed in some GBM types which exhibit aggressive phenotypes. This subfamily impairs anti-cancer immune responses in several ways, including immune cells inhibition and major histocompatibility (MHC) class I and II abolishment. It promotes GBM angiogenesis by inducing angiogenic factors such as vascular endothelial growth factor (VEGF), plasminogen activator inhibitor (PAI-I) and insulinlike growth factor-binding protein 7 (IGFBP7), contributes to GBM progression by inducing metalloproteinases (MMPs), "pro-neoplastic" integrins (${\alpha}v{\beta}3$, ${\alpha}5{\beta}1$) and GBM initiating cells (GICs) as well as inducing a GBM mesenchymal phenotype. Equally, Nodal promotes GICs, induces cancer metabolic switch and supports GBM cell proliferation, but is negatively regulated by Lefty. Activin promotes GBM cell proliferation while GDF yields immune-escape function. On the other hand, BMPs target GICS and induce differentiation and sensitivity to chemotherapy. This multifaceted involvement of this superfamily in GBM necessitates different strategies in anti-cancer therapy. While suppressing the $TGF{\beta}$ subfamily yields advantageous results, enhancing BMPs production is also beneficial.

Oral Features in a Child with Noonan Syndrome : A Case Report (누난 증후군 환자의 구강 내 특징 : 증례 보고)

  • Hwang, Inkyung;Lee, Yeonju;Sim, Dohee;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.1
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    • pp.115-122
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    • 2018
  • Noonan syndrome is characterized by distinctive facial features, short stature, and congenital heart disease. It is a congenital genetic disorder with a prevalence of between 1/1,000 and 1/2,500 in both genders. An 11-year-old boy with Noonan syndrome visited the hospital with an ectopically positioned tooth. A pulmonary stenosis was diagnosed and his growth and development were delayed. In many cases of this diseases there is obvious hemostasis, which he was not experiencing. His facial appearance showed characteristic features of Noonan syndrome. The patient showed a dental class II relationship, labioversion of the upper anterior teeth, and a shallow overbite. Radiographic examination revealed that the upper right canine was ectopically positioned, which led to root resorption of the upper right lateral incisor. A lateral cephalometric radiograph revealed a craniofacial pattern that was within normal limits. Surgical opening and button attachment on the impacted upper right canine were performed and traction was applied on the impacted tooth using a removable appliance. This patient was mildly affected by Noonan syndrome and showed some dental problems. However, few studies have reported the oral characteristics of Noonan syndrome despite its high incidence. Thus, this case report describes the oral features and management of Noonan syndrome.

A STUDY ON THE HUMAN PULPAL RESPONSE TO DENTIN BONDING DESENSITIZER (상아질 접착 지각과민 처치제에 대한 치수반응에 관한 연구)

  • You, Hee-Seung;Lee, Sung-Bok;Woo, Yi-Hyung;Park, Nam-Soo;Choi, Boo-Byung
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.3
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    • pp.483-495
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    • 1998
  • The purpose of this study was to evaluate the human pulpal response to Dentin Bonding Desensitizer. Class V cavities were prepared on the buccal surfaces of the first premolars and Dentin Bonding Desensitizer(ALL-BOND Desensitizer, Bisco, Inc. U.S.A.) was applicated in ten experimental teeth, or ZOE(PROPAC, GC Co. TOKYO, JAPAN) cement in eight control teeth and cavities were filled with light curing glass ionomer(Fuji II LC, GC Co., TOKYO, JAPAN). At 3-day and 25-day postoperative interval. pulpal response was observed and evaluated histologically with light microscope. The results were as follows. ; 1. At 3-day postoperative interval, the control teeth were grade 1 inflammatory cell response and grade 1 connective tissue response. 2. At 25-day postoperative interval, all control teeth were grade 1 inflammatory cell response and in three control teeth grade 1 connective tissue response were observed, and one teeth showed grade 2 connective tissue response. 3. At 3-day postoperative interval, the experimental teeth were grade 1 inflammatory cell response and grade 1 connective tissue response. Below the cavity, a few inflammatory cell(PMNs) in odontoblastic layer, increased blood vessels and pulpal cells were seen and this pulpal response was similar to control teeth. 4. At 25-day postoperative interval, in four experimental teeth grade 1 inflammatory cell response and grade 1 connective tissue response were observed, and one experimental teeth showed mild inflammatory response. 5. At 3-day and 25-day postoperative interval, no reparative dentin deposition was seen. 6. Both experimental and control group, pulpal response showed difference between 3 and 25-day of postoperative interval. In control teeth, increased predentin and pulpal cells were seen and in experimental teeth, congestion of blood vessels and increased pulpal cells were seen. In conclusion, the pulpal irritation due to this Dentin Bonding Desensitizer was not severe, and it was considered that the agent was not harmful to the human pulp.

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Study on the histomorphometry of guided bone regeneration using automated image analysis system (자동 영상분석 계기를 이용한 골 유도재생능력의 분석에 관한 조직계측학적 연구)

  • Kim, T.I.;Ku, Y.;Rhyu, I.C.;Chung, C.P.;Han, S.B.;Choi, S.M.;Son, S.H.
    • Journal of Periodontal and Implant Science
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    • v.26 no.3
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    • pp.771-778
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    • 1996
  • The assessment of alveolar bone changes on dental radiographs to indicate progression of periodontal diseases or healing response to therapy is routine procedure. However, the diagnostic accuracy in detecting small alveolar bone changes is very limited. Recently, guided bone regeneration therapy is popular, but the quantification of new bone is somewhat difficult with conventional evaluation method. To quantificate the amount of new bone, various evaluating methods have been introduced including histomorphometry, radiomorphometry, biochemical analysis, X-ray probe microanalysis, scanning electron microscope backscatter method. In this study, guided bone regeneration using resorbable membrane with & without PDGF-BB is quatificated through histomorphmetry to evaluate the efficacy of histomorphometric analysis. 4 beagle dogs and 8 Sprague-Dawley rats were selected as experimental animals. In beagle dog experiment, $4{\times}4mm$ Class II defects were created in maxillary both second premolars, and biodegradable membrane containing PDGF-BB(experimental group) were covered over one defect, and same membrane without PDGF-BB(control group) were covered over the other defect. At 2 weeks, 5 weeks after surgery, each beagle dogs were sacrificed, and the tissues were treated by undecalcified fixation. In Sprague-Dawley rat experiment, 5mm round defect were created in temporal bone, the same membranes were covered on the defects. At 1 week, 2 weeks after surgery, each rats were sacrificed, and undecalcified fixation were taken. After grinding tissue specimen, we analyse them histomorphometrically using image analysis system. In beagle dog 2 weeks specimens, new bone formation area were $0.03123mm^2$ in experimental group,and $0.03012mm^2$ in control group. At 5 weeks specimens, $0.15324mm^2$ in experimental group, and $0.09123mm^2$ in control group. In Sprague-Dawley rat specimens, new bone fomation area were $0.20448mm^2$ in 1 week experimental group, $0.03604mm^2$ in 1 week control group. At 2 weeks specimens, $0.46349mm^2$ in experimental group, $0.17741mm^2$ in control group. The results indicated that histomorphometric analysis of new bone formation using image analysis system is very effective quantification method to evaluate the efficacy of treatment modalities.

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