• Title/Summary/Keyword: control period

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Treatment Results in Anal Cancer : Non-operative Treatment Versus Operative Treatment (항문암의 치료성적 : 비수술적방법과 수술적방법의 결과 비교)

  • Chie Eui Kyu;Ha Sung Whan;Park Jae-Gahb;Bang Yung-Jue;Heo Dae Seog;Kim Noe Kyeong
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.62-67
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    • 2002
  • Purpose : This study was undertaken to analyze the efficacy and sphincter preservation rate of platinum based neoadjuvant chemotherapy Plus radiotherapy versus abdominoperineal resection and Postoperative radiotherapy for anal cancer. Materials and Methods : Data of forty-two patients with anal cancer were retrospectively analyzed. Among thirty-eight patients with epidermoid histology, four patients received radiotherapy, and nineteen patients received abdominoperineal resection and adjuvant radiotherapy with or without chemotherapy $(APR+RT{\pm}CT)$, and fifteen patients received neoadjuvant chemotherapy and radiotherapy (CRT). The CRT regimen was composed of three cycles of 5-fluorouracil $(1,000\;mg/m^2\;bolus\;on\;D1\~5)$ and cisplatin $(60\;mg/m^2\;bolus\;on\;D1)$ followed by 50.4 Gy to the tumor bed and regional lymphatics over 5.5 weeks. Both inguinal lymphatics were treated with an identical dose schedule. Residual disease was treated with an additional three cycles of identical adjuvant chemotherapy. An identical dose schedule was used for post-operative radiotherapy. Median follow-up period was eighty-five months. Results : Overall five-year survival rates were $80.3\%$, 88.9 and $79.4\%$ for entire patients, $APR+RT{\pm}CT$ group, and the CRT group, respectively. No significant difference was found between the two groups (p=0.49). Anus preservation rate for the CRT group was $86.7\%$. Age (0=0.0164) and performance status (p=0.0007) were found to be significant prognostic factors by univariate analysis. Age (p=0.0426), performance status (p=0.0008), and inguinal lymph node metastasis (e=0.0093) were statistically significant prognostic factors by multivariate analysis. No case of RTOG grade 3 complication or higher was reported. Conclusion : This and other recent studies have shown that combined chemotherapy plus radiotherapy for anal cancer results in a high rate of anal sphincter preservation as well as local control and survival. Furthermore, neoadjuvant use of chemotherapy with a cisplatin based regimen rather than a concurrent regimen may lead to a decrease in complications.

The Role of Radiation Therapy on Local Recurrence of Rectal Cancer (직장암에서 수술후 방사선치료의 역활)

  • Chung, Woong-Ki;Ahn, Sung-Ja;Nam, Taek-Keun;Nah, Byung-Sik;Kim, Young-Jin
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.205-212
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    • 1992
  • Ninety five patients of rectal cancer treated with surgery with or without adjuvant radiation therapy since January 1982 to December 1990 at the Chonnam University Hospital were analysed retrospectively regarding local failure. Of these 95 patients 72 patients were treated with surgery alone and remaining 23 patients received postoperative radiation therapy to pelvis. There were 45 men and 50 women with 53 years of median age. Minimum follow-up period was 19 months and median was47 months (range, 19-125 months). Kaplan-Meier method was used to calculate actuarial risk of local recurrence and survival rate. Comparison between two groups was evaluated by Log rank test. Of total 95 patients twenty seven patients ($28.4\%$) developed local recurrence and 13 patients ($17.3\%$) developed local and distant metastasis concomitantly. Eighty nine percent (24/27) of patients developed local recurrence within 24 months. Pelvic organ adjacent to the primary tumor area was the most common site of initial local recurrence. Of 72 patients treated with surgery alone local recurrence developed in 24 patients. Of 17 patients with stage A and 81 (Gunderson-Sosin modification of Dukes' staging system) 6 patients experienced local recurrence ($31.2\%$). The local recurrence rate of B2 and B3 group was $29.9\%$ (7/33) and that of C2 and C3 was $54.7\%$ (11/19), respectively. There was statistically significant difference between two groups (p<0.05). Of 23 patients treated with definitive surgery and radiation therapy $10\%$ (1/10) recurred in B2 and B3 patients. This was slightly lower than C2 and C3 patients ($22.2\%$, 2/10) of similar policy, but revealed no statistically significant difference (p>0.05). In the patients of B2+3 local failure rate decreased when radiation therapy was added ($29.9\%$ vs $10\%$, p>0.05) and also similar results in C2+3 group ($34.7\%$ vs $22.2\%$, p<0.05). The local failure rate in relation to distance from the anal verge had no statistically significant difference.

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Comparing Concurrent Chemoradiotherapy to Chemotherapy Alone for Locally Advanced Unresectable Pancreatic Cancer (절제 불가능한 췌장암의 동시 항암화학 방사선 요법과 항암화학 단독 요법의 비교)

  • Park, Jeong-Hoon;Kim, Woo-Chul;Kim, Hun-Jung;Gwak, Hee-Keun
    • Radiation Oncology Journal
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    • v.27 no.2
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    • pp.64-70
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    • 2009
  • Purpose: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced unresectable pancreatic cancer. However, the introduction of gemcitabine and the recognition of a benefit in patients with advanced disease stimulated the design of trials that compare chemotherapy alone to concurrent chemoradiation. Therefore, we evaluated role of CCRT for locally advanced unresectable pancreatic cancer. Materials and Methods: We carried out a retrospective analysis of treatment results for patients with locally advanced unresectable pancreatic cancer between January 2000 and January 2008. The radiation was delivered to the primary tumor and regional lymph nodes with a 1~2 cm margin at a total dose of 36.0~59.4 Gy (median: 54 Gy). The chemotherapeutic agent delivered with the radiation was 5-FU (500 mg/$m^2$). The patients who underwent chemotherapy alone received gemcitabine (1,000 mg/$m^2$) alone or gemcitabine with 5-FU. The follow-up period ranged from 2 to 38 months. The survival and prognostic factors were analyzed using Kaplan-Meier method and log-rank test, respectively. Results: Thirty-four patients received concurrent chemoradiotherapy, whereas 21 patients received chemotherapy alone. The median survival time was 12 months for CCRT patients, compared to 11 months for chemotherapy alone patients (p=0.453). The median progression-free survival was 8 months for CCRT patients, compared to 5 months for chemotherapy alone patients (p=0.242). The overall response included 9 partial responses for CCRT and 1 partial response for chemotherapy alone. In total, 26% of patients from the CCRT group experienced grade 3~4 bowel toxicity. In contract, no grade 3~4 bowel toxicity was observed in the chemotherapy alone group. The significant prognostic factors of overall survival were lymph node status, high CA19-9, and tumor location. Conclusion: The response rate and progression-free survival were more favorable in the CCRT group, when compared with the chemotherapy alone group. Therefore, radiation therapy seems to be an effective tool for local tumor control.

Human Lung Cancer Cell Xenografts Implanted under the Capsule of Kidney, Spleen and Liver (폐암 세포주를 사용한 신, 비장 및 간 피막하 분식법의 비교)

  • 김수현;김종인;이해영;조봉균;박성달;김송명
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.711-720
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    • 2003
  • Bakground : Complete resection by the surgery has been selected as the treatment of choice in lung cancer patients, but in cases of recurrence after excision or inoperable cases, the importance of anticancer chemotherapy has been emphasized. If one can select a set of the sensitive chemotherapeutic agents before anticancer chemotherapy, it will give more favourable results. Subrenal capsular assay has been recognized as a useful in-vivo chemosensitivity test of thoracic and abdominal tumors and it can be done in a short time for a rapid interpretation of tumor responsiveness to anticancer chemotherapeutic drugs. It has been reported that various kinds of cancer cells can be implantable to the kidney, but so far there is no comparative study of xenogeneic cell implantation on liver, spleen and kidney. The author implanted the human lung cancer cells under the capsule of S.D rat's liver, spleen and kidney respectively and compared the pattern of growth and histology. Material and Method: After incubation of human lung cancer cell line (SW-900 G IV) in RPMI 1640 (Leibovitz L-15 medium) culture media, 3${\times}$3${\times}$3 mm size fibrin clots which contain 108 cancer cells were made. Thereafter the fibrin clots were implanted at subcapsule area of liver, spleen and kidney of S.D. female rat. For immune suppression, cyclosporin-A (80 mg/Kg) was injected subcutaneously daily from post-implantation first day to sixth day. The body weight was measured at pre and post implantation periods. The growth pattern and the size of tumor mass were observed and the pathologic examination and serum tumor marker tests were performed. Result: Body weight increased in both of control and experimental groups. Serum Cyfra 21-1 was not detected. Serum levels of CEA and NSE revealed no significant change. The SCC-Ag increased significantly in implanted group. The growth rate of human lung cancer cells which was implanted on spleen was higher than on liver or kidney. The surface area, thickness, and volume of tumor mass were predominant at spleen. The success rates of implantation were 80% on kidney, 76.7% on spleen and 43.3% on liver. Pathologic examination of implanted tumors showed characteristic findings according to different organs. Tumors that were implanted on kidney grew in a round shape, small and regular pattern. In the spleen, tumors grew well and microscopic neovascularization and tumor thrombi were also found, but the growth pattern was irregular representing frequent daughter mass. Human lung cancer cells that were implanted in the liver, invaded to the liver parenchyme, and had low success rate of implantation. Microscopically, coagulation necrosis and myxoid fibrous lesion were observed. Conclusion: The success rate of implantation was highest in the kidney. And the mass revealed regular growth that could be measured easily. The SCC-Ag was presented earlier than CEA or Cyfra21-1. The Cyfra21-1 was not detected at early time after implantation. The best model for tumor implantation experiment for chemosensitivity test was subrenal capsular analysis than liver and spleen and the useful serum tumor marker in early period of implantation was the SCC-Ag.

In vivo Antifungal Activity of Pyrrolnitrin Isolated from Burkholderia capacia EB215 with Antagonistic Activity Towards Colletotrichum Species (탄저병균에 대하여 길항작용을 보이는 Burkholderia cepacia EB215로부터 분리한 Pyrrolnitrin의 항균활성)

  • Park, Ji-Hyun;Choi, Gyung-Ja;Lee, Seon-Woo;Jang, Kyoung-Soo;Choi, Yong-Ho;Chung, Young-Ryun;Cho, Kwang-Yun;Kim, Jin-Cheol
    • The Korean Journal of Mycology
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    • v.32 no.1
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    • pp.31-38
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    • 2004
  • An endophytic bacterial strain EB215 that was isolated from cucumber (Cucumis sativus) roots displayed a potent in vivo antifungal activity against Colletotrichum species. The strain was identified as Burkholderia cepacia based on its physiological and biochemical characteristics, and 16S rDNA gene sequence. Optimal medium and incubation period for the production of antifungal substances by B. cepacia EB215 were nutrient broth (NB) and 3 days, respectively. An antifungal substance was isolated from the NB cultures of B. cepacia EB215 strain by centrifugation, n-hexane partitioning, silica gel column chromatography, preparative TLC, and in vitro bioassay. Its chemical structure was determined to be pyrrolnitrin by mass and NMR spectral analyses. Pyrrolnitrin showed potent disease control efficacy of more than 90% against pepper anthracnose (Colletotrichum coccodes), cucumber anthracnose (Colletotrichum orbiculare), rice blast (Magnaporthe grisea) and rice sheath blight (Corticium sasaki) even at a low concentration of $11.1\;{\mu}g/ml$. In addition, it effectively controlled the development of tomato gray mold (Botrytis cinerea) and wheat leaf rust (Puccinia recondita) at concentrations over $33.3\;{\mu}g/ml$. However, it had no antifungal activity against Phytophthora infestans on tomato plants. Further studies on the development of microbial fungicide using B. cepacia EB215 are in progress.

A Study of Serum Lipid, Blood Sugar, Blood Pressure of Buddhist Nuns in Vegetarians and Non-Vegetarians (III) - Based on Age - (채식인과 비채식 일반인의 혈중 지질, 혈당, 혈압에 관한 연구(III) -연령을 중심으로-)

  • Cha, Bok-Kyeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.8
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    • pp.1311-1319
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    • 2004
  • The purpose of this study was to compare the serum lipid level, blood sugar and blood pressure in vegetarians and non-vegetarians. The subjects of the study were 127 Buddhist nuns (age: 23∼79 y) from Oonmoon Temple in Choungdo district Gyeongsang Bookdo province and 118 Buddhist nuns practicing Zen meditation at Soodeok Temple in Yeosan district Chongcheong Namdo province. For control subjects, 235 healthy female adults (age: 23∼79 y) were selected. They were the nurses in the Gyeongsang National University Hospital, teachers and housekeepers living in Jinju, Gyeongsang Namdo province. The period of this study was from October 1996 to February 1997. The contents were consisted of food consumption survey, anthropometric measurement, estimated amount of energy expenditure, physical activity and clinical examination. The mean ages of the subjects were 44.2 y for vegetarians and 40.5 y for non-vegetarians, respectively. Average body mass index (BMI) of vegetarians and non-vegetarians were 22.47 and 21.08, WHR 0.85 and 0.84, percentage of body fat 28.79 and 26.55 respectively. The average duration of vegetarian diet of the vegetarians was 13.16 y. Levels of total cholesterol, LDL-cholesterol, atherogenic index (AI), diastolic blood pressure, blood sugar and HDL-cholesterol were significantly higher (p<0.01) in non-vegetarians than those of vegetarians. In both of subjects, levels of TG, total cholesterol, LDL-cholesterol, atherogenic index (AI) and systolic blood pressure were significantly higher (p<0.01) with an increment of age and the vegetarians showed a lower ratio of rise than the non-vegetarians. Levels of serum TG, LDL-cholesterol and AI were utmost in the 60 s and declined in the 70 s. Consequently, vegetarian diet can be considerably effective in reducing the level of the risk factors causing cardiovascular disease.

Factors Related with Job Satisfaction in Workers - Through the Application of NIOSH Job Stress Model - (직장인의 직무만족도 관련요인 분석 - NIOSH의 직무스트레스 모형을 적용하여 -)

  • Kim, Soon-Lae;Lee, Bok-Im;Lee, Jong-Eun;Rhee, Kyung-Yong;Jung, Hye-Sun
    • Research in Community and Public Health Nursing
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    • v.14 no.2
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    • pp.190-199
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    • 2003
  • This study was conducted to determine the factors affecting job satisfaction in workers by using the Job Stress Model proposed by the National Institute for Occupational Safety and Health (NIOSH). Data were collected from December 1 to December 30, 1999. The subjects were 2,133 workers employed at 155 work sites, who were examined using NIOSH Job Stress questionnaire translated by the Korea Occupational Safety ${\pounds}|$ Health Academy and Occupational Safety ${\pounds}|$ Health Research Institute. SAS/PC program was used for statistical analysis using descriptive analysis. Pearson's correlation coefficient, ANOVA, and Stepwise multiple regression analysis. The results of this study were as follows. 1. According to general characteristics of the subjects, job satisfaction was high in those with less number of children. 2. By work condition, job satisfaction was higher in those who were working in a permanent job position, were working with regular time basis than with shift basis, were working in regular shift hours than in changing shift hours, were working for a short period, and were working less hours and overtime works per week. 3. In terms of physical work environment, job satisfaction was significantly related to 10 physical environmental factors. In other words, job satisfaction was high in workers who were working in an environment with no noise, bright light, temperature adjusted to an appropriate level during summer and winter, humidity adjusted to an appropriate level. well ventilation, clean air, no exposure to hazardous substance during work hour, overall pleasant work environment and not crowded work space. 4. By work-related factors, job satisfaction was high in those with less ambiguity about future job and role, high job control/autonomy, and less workload. On the other hand, job satisfaction was low in those with little utilization of competencies, and much role conflict at work and workload. 5. As for the relationships between job satisfaction and the non-work related factors, job satisfaction was high in workers who were volunteering at different organizations or active in religious activities for 5-10 hours per week. 6. In the relationships between job satisfaction and buffering factors, significantly positive correlations were found between job satisfaction and factors such as support by direct superior, support by peers, and support by spouse, friend and family. 7. There were nine factors that affected job satisfaction in the workers: age, number of children, work hours per week, noise, temperature at the work site during summer, uncomfortable physical environment, role ambiguity, role conflict, ambiguity in job future, work load, no utilization of competencies and social support from direct supervisor. These nine factors accounted for 26% of the total variance in the multiple regression analysis. In conclusion. the following are proposed based on the results of this study. 1. The most important physical environmental factors affecting job satisfaction in workers were noise, role ambiguity, and work load, suggesting a need to develop strategies or programs to manage these factors at work sites. 2. A support system that could promote job satisfaction is needed by emphasizing the roles of occupational health nurses who may be stationed at work sites and manage the factors that could generate job stress. 3. Job satisfaction is one of the three acute responses to stress proposed in NIOSH job stress model (job satisfaction. physical discomfort and industrial accidents). Therefore, further studies need to be conducted on the other two issues.

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Characteristics of Titanium Dioxide-Impregnated Fibrous Activated Carbon and Its Application for Odorous Pollutant (이산화티타늄 담지 섬유형 활성탄소의 특성 및 악취오염물질 제어를 위한 응용)

  • Jo, Wan-Kuen;Hwang, Eun-Song;Yang, Sung-Bong
    • Clean Technology
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    • v.17 no.1
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    • pp.48-55
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    • 2011
  • The application of fibrous activated carbon (FAC)-titanium dioxide ($TiO_2$) hybrid system has not been reported yet for the control of malodorous dimethyl sulfide (DMS) at residential environmental levels. Accordingly, the current study was designed not only to characterize this hybrid system using x-ray diffraction method, particulate surface measurement and Fourier transform Infrared (FTIR) method, but also to evaluate its adsorptional photocatalytic activity (APA) for the DMS removal. The physical/surface characteristics of FAC-$TiO_2$ which was prepared in this study suggested that the hybrid material might have certain APA for DMS. The Brunauer-Emmett-Teller (BET) specific area, total pore volume, micropore volume and mesopore volume decreased all as the $TiO_2$ amounts coated on FAC increased, whereas the reverse was true for average pore diameter. $TiO_2$ coated onto FAC did not influence the adsorptional activity of FAC for the DMS input concentration of 0.5 ppm. The APA test of the hybrid material presented that the initial removal efficiencies of DMS were 93, 78, 71 and 57% for the flow rates of 0.5, 1.0, l.5 and 2.0 L/min, respectively, and they decreased somewhat 2 h after the experiment started and kept almost constant for the rest experimental period. Under this pseudo-equilibrium condition, the DMS removal efficiencies were 78, 58, 53 and 36% for the four flow rates, respectively. Meanwhile, there were no significant byproducts observed on the surfaces of the hybrid material. Consequently, this study suggests that, under the experimental conditions used in the present study, the hybrid material can be applied for DMS at residential environment levels without being interfered by any byproducts.

Effect of Feeding Multiple Probiotics on Performance and Fecal Noxious Gas Emission in Broiler Chicks (혼합 생균제의 급여가 육계의 생산성 및 계분의 유해가스 발생에 미치는 영향)

  • Yoon C.;Na C. S.;Park J. H.;Han S. K.;Nam Y. M.;Kwon J. T.
    • Korean Journal of Poultry Science
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    • v.31 no.4
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    • pp.229-235
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    • 2004
  • A study was conducted to examine the effect of dietary supplementation of multiple probiotics (EM) on growth performance, blood cholesterol, intestinal micro flora, and fecal gas emission in broiler chicks. A total of 450 one day old male broiler chicks (Ross $\times$ Ross) were divided into six treatments with five replications in each treatment for five weeks. Treatments were factorially designed with two levels of diet containing probiotics (DW; 0, $0.2\%$) and three levels of drinking water containing probiotics (DW; 0, 0.01, $0.1\%$). Basal diets contained $21.5\%$ CP and 3,100 kcal/kg ME for starting and $19\%$ CP and 3,100 kcal/kg ME for finishing period. Weight gain, feed intake, and feed conversions of birds fed with probiotics were not significantly different between Ds. Total cholesterol and triglyceride levels were significantly lower (P<0.05) in birds fed with DW $0.01\%$ or $0.1\%$ compared with no probiotics group, but there was no significant difference between D treatments. The number of E. coli, Salmonella and Lactobacillus in the ileum and cecum of the birds fed multiple probiotics were not significantly different from those of no probiotic groups. There were no significant differences in the $CO_2$ gas emissions of fecal between birds fed with Ds or among birds fed with DW. However, $NH_3$ gas emissions of DW $0.1\%$ were significantly lower (P<0.05) than DW $0\%$. In the results of this study, supplementation of probiotics tended to decrease the serum cholesterol and triglyceride compared to those of control groups and reduction of fecal $NH_3$ gas emission.

Clinical characteristics and risk factors for staphylococcal infections in neonatal intensive care unit (신생아 중환자실에서 포도알균 감염에 대한 임상적 고찰과 위험 요인 조사)

  • Chung, Min Kook;Choi, Jeong Ho;Chang, Jin Keun;Chung, Sung Hoon;Bae, Chong Woo;Cha, Sung Ho
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1287-1295
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    • 2006
  • Purpose : The importance of staphylococcal infections in NICU has been emphasized in terms of increased resistant strains and increased incidence of morbidity and mortality. In this study, we inrestignted the clinical characteristics and risk factors for staphylococcal infections, and looked into sensitivity trends of antibiotics in the era of a high rate of methicillin-resistant staphylococcus aureus (MRSA) in our society. Methods : This study included 240 neonates with positive blood, urine and other sites cultures for staphylococci who were admitted to NICU of Hanil General Hospital and Kyunghee University Hospital from January 2000 to December 2004. The analyses included clinical characteristics of staphylococcal infections and the relationship of incidence rate among various factors, including invasive procedures. Results : For 5 years, 3,593 patients were hospitalized in the NICU and 7,481 specimens were cultured from blood, urine, and other sites. During the study period, staphylococci were isolated from 240 patients, of whom 88 patients had MRSA, 41 patients methcillin sensitive staphylococcus aureus (MSSA), 63 patients S. epidermidis, 48 patients coagulase-negative staphylococcus (CNS) except S. epidermidis infections. The risk factors associated with staphylococcal infections were less than 37 weeks of gestational age, less than 7 on a 5 minutes Apgar score, receiving TPN, applied mechanical ventilation, use of central venous catheters and other tubes. The sensitivity to vancomycin was 100 percent. A relatively high sensitivity against teicoplanin, trimethoprim-sulfamethoxazole, chloramphenicol, clindamycin and low sensitivity against gentamicin and erythromycin were shown. Conclusion : To reduce staphylococcal infections in NICU, we need to monitor and manage premature neonates from the beginning of the birth process and to avoid as many invasive procedures as possible in NICU. Considering MRSA, control of preceding factors and early use of appropriate antibiotics is expected to reduce the morbidity and mortality caused by MRSA infections.