Yoon Sei Chul;Oho Yoon Kyeoung;Shinn Kyeong Sub;Bahk Yong Whee;Kim In Chul;Lee Kyung Sik
Radiation Oncology Journal
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v.6
no.1
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pp.41-47
/
1988
Thirty-five patients with locally advanced gastric carcinoma were treated with combined modalities of external radiation therapy (RT) and 5-FU based chemotherapy at the Division of Radiation Therapy, Department of Radiology, Kangnam 51. Mary's Hospital, Catholic University Medical College from May 1983 to May 1987. The purpose of this retrospective study is for the evaluation of the palliative response to RT. There were 25 men and 10 women. The age ranged from 38 to 80 years (median: 56 years). The pathologic classification showed $14(40\%)$ poorly differentiated, $12 (34\%)$ moderately differentiated, $3(9\%)$ well differentiated adenocarcinomas, 2 mucinous cystadenocarcinomas, 1 signet ring cell and 3 not specified ones. The time intervals from the initial surgicopathologic diagnosis to the starting day of RT was within 1 year for $18 (51\%)$, 1 to 2 years for $8 (23\%)$ and 2 to 3 years for $5 (14\%)$, respectively. The major symptoms to be treated were pain in $30 (80\%)$, mass for $29 (83\%)$, obstruction for $11 (31\%)$ and jaundice for $9 (20\%)$ patients. The response rate (patient number of positive response/total patient number) according to treated radiation doses were observed as follows; $14/16(88\%)$ for $40\~50Gy,\;8/10(80\%)$ for over $50Gy,6/8 (75\%)\;for\;30\~40Gy\;and\;8/10(53\%)\;for\;20\~30 Gy$ in decreasing order. The over ail survival was 3.0 months and that of 5FU+RT, FAM+RT and RT alone groups were 4.6 months, 3.7 months and 2.5 months respectively. Complications induced by RT were nausea and vomiting in $16(46\%)$, diarrhea in $7(20\%)$, leukopenia in $6(17\%)$ and anemia and intercurrent pneumonia in each $3(9\%)$ patients in decreasing order.
Purpose : Radiation therapy in combination with surgery has an important role in the therapy of the head and neck cancer We conducted a prospective study for patients with head and neck cancer treated with surgery and radiation to evaluate the effect of therapies on the thyroid gland, and to identify the factors that might influence the development of hypothyroidism. Materials and Methods : From September 1986 through December 1994, 71 patients with head and cancer treated with surgery and radiation were included in this prospective study. Patients' age ranged from 32 to 73 years with a median age of 58 years. There were 12 women and 59 men. The primary tumor sites were larynx in 34 patients, hypopharynx in 13 patients, oral cavity in 12 patients, unknown primary of the neck in 6 patients, salivary gland in 3 patients, maxillary sinus in 2 patients, and oropharynx in 1 patient. Total laryngectomy with neck dissection was carried out in 45 patients and neck dissection alone in 26 patients. All patients were serially monitored for thyroid function (T3, T4, free T4, TSH, antithyroglobulin antibody and antimicrosomal antibody) before and after radiation therapy. Radiation dose to the thyroid gland ranged from 40.6Gy to 60Gy with a median dose of 50Gy The follow-up duration was 3 to 80 months. Results :The overall incidence of hypothyroidism was 56.3\%$);7 out of 71 patients $(9.9\%)$ developed clinical hypothyroidism and 33 patients $(46.4\%)$ developed subclinical hypothyroidism. No thyroid nodules, thyroid cancers, or hyperthyroidism was detected. Hypothyroidism developed earlier in patients who underwent total laryngectomy with neck dissection than in patients with neck dissection alone (P<0.05). The risk factor that significantly influenced the incidence of hypothyroidism was a combination of surgery (total laryngectomy with neck dissection) and radiation therapy (P=0.0000), Four of 26 patients $(15.4\%)$ with neck dissection alone developed hypothyroidism while 36 of 45 patients $(80\%)$ with laryngectomy and neck dissection developed hypothyroidism. Conclusion : The hypothyroidism following surgery and radiation therapy was a relatively common complication. The factor that significantly influenced theincidence of hypothyroidism was combination of surgery and radiation therapy. Evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests is recommended for an early detection of hypothyroidism and thyroid hormone replacement therapy is recommended whenever hypothyroidism develops.
From June 1995 to May 1997, we have implanted 52 Sorin Bicarbon mechanical valves in 41 patients. They were 16 men and 25 women, and their mean age was 47.4${\pm}$14.8(range; 18∼74 y.o.). 35(27 mm∼31 mm) were in mitral position, 15(19 mm∼25 mm) in aortic position, and 2(31 mm) in tricuspid position. 3 CABGs and a tumor excision were taken concomittantly. 35 patients were primary operation, and 6 were re-do operations. By intraoperative transesophageal doppler echocardiography, transvalvular peak/mean pressure gradient was 6.1${\pm}$2.7/2.4${\pm}$1.4 mmHg in mitral position and 27.6/10.7 mmHg in aortic position. The effective valve opening area in mitral position was 3.2${\pm}$0.6 cm2. Follow-up was total 508.6 patient-months, and mean follw-up was 12.7${\pm}$9.2 months. NYHA class was improved from 2.6${\pm}$0.6 to 1.2${\pm}$0.3 in average postoperatively. During that period, there was no operative death. 2 late non-valve related deaths were occurred. One was died of COPD, and the other was possible acute myocardial infarction. Among 7 postoperative complications, one valve related complication(minimal paravalvular leakage) was noticed. In conclusion, Sorin Bicarbon mechanical valve is believed one of the safe choice in clinical settings. It showed excellent hemodynamic and mechanical functions, and very low postoperative valve related complications in short term clinical experience.
Background: Postoperative morbidity and mortality in destroyed lung are relatively high. We tried to identify the prognostic factors affecting postoperative morbidity and mortality in destroyed lung through a retrospective study. Material and method: The retrospective study was undertaken in 112 patients who had undergone pneumonectomy or pleuropneumonectomy for destroyed lung at Severance Hospital from 1970 to 2000. We analyzed the correlation between postoperative morbidity and mortality and etiology, duration of disease, preoperative FEV1, presence or absence of peroperative empyema, operation timing, the side of operation, duration of operation, and operation type. Result: There were 55 men and 57 women, aged 20 to 81 years (mean 44 years). Etiologic diseases were tuberculosis in 86 patients(76.8%) including tuberculos empyema in 20 and tuberculous bronchiectasis in 4, pyogenic empyema in 12(10,7%), bronchiectasis in 12(10.7%), and lung abscess in 2(1.8%). Postoperative morbidity were 25%(n=28) and postoperative mortality was 6%(n=7). The presence of preoperative empyema(p=0.016), pleuropneumonectomy(p=0.037) and preoperative FEV1 of less than 1.75 L(P=0.048) significantly increased the postoperative morbidity, If operation time was less than 300min, postoperative morbidity(p=0.002) and mortality(p=0.03) were significantly low. Conclusion: Postoperative morbidity and mortality in destroyed lung were acceptable. Postoperative morbidity and mortality were significantly low when operation time was less than 300 min. Preoperative existence of empyema, pleuropneumonectomy and preoperative FEV1 of less than 1.75 L significantly increased postoperative morbidity.
In spite of the establishment of chemotherapy and the gradual decrease in prevalence, pulmonary tuberculosis is still mainly treated with an operation. Through analyzing and examining some cases of surgical treatment, we hope to provide some help in treating of pulmonary tuberculosis in the future. Material and Method: By comparing four journals previously published in our department with 144 cases of lung surgery during ten years from January of 1991 to December of 2000 performed by the department of thoracic and cardiovascular surgery of the National Medical Center, we analyzed and reviewed the most recent trends and the results of the surgical treatment. Annual frequency of the operation, distribution of age, examination of sputum, adaptability and types of techniques, complications, and results of the postoperative follow-up were used as methods. Result: It was found that the annual frequency of operations had decreased. The ratio of men to women, 2:1 indicates that there are more incidences in men. Aging of patients could be speculated by the .results that the decrease in the incidence rate in the 20s age range and increase rate in the 50s age range. The range of preoperative lesions belonged mostly to far advanced and moderately advanced tuberculosis. By monitoring the period of use in preoperative antituberculosis drugs, cases for more than 3 years remarkably increased from 16.0 % to 55.6 %. The positive reactive rate for preoperative sputum examinations were drastically decreased from 91 % to 27 %. Total pulmonary destruction and partial destruction were the most common cases in terms of adaptability to the operations and there were significant increases in forming empyema accompanied by parenchymal lesions from 4.0 % to 20.1 %. Pneumonectomy and pulmonary lobectomy were the major type of operations. Especially, there were increases in the incident rate of empyema and recurrence of tuberculosis resulted. Post operative follow-up indicates that the rate of complete recovery was more than 70 % and the rate of gradual increase in treating with persistent antituberculosis drug was from 5.8 % to 18.0 %. Conclusion: In recent cases, there is an increasing number of patients showing tolerance to chemotherapy. Patients with pleural tuberculosis and severe lesions were typically increased. It is important to accurately analyze those complaints accurately that are mostly difficult to be treated medically. Surgical treatment is strongly recommended Before multiple drug resistance occurs.
Background: Postinfarction ventricular septal rupture is associated with mortality as high as $85\sim90%$, if it is treated medically. This report documents our experience with postinfarction ventricular septal rupture that was treated surgically, Material and Method: We retrospectively reviewed the medical records of 11 patients who were operated on due to postinfarction ventricular septal rupture between August 1996 and August 2006. There were 4 men and 7 women, with a mean age of $70{\pm}11$ years (age range: $50\sim84$ years). The location of the rupture was anterior in 7 cases and posterior in 4 cases. The interval between the onset of acute myocardial infarction and the occurrence of the ventricular septal rupture was $2.0{\pm}1.3$ days (range: $1\sim5$ days). Operation was performed at an average of $2.4{\pm}2.7$ days (range: $0\sim8$ days) after the diagnosis of septal rupture. Preoperative intraaortic balloon pump therapy was performed in 10 patients. Result: The infarct exclusion technique was used in all cases. Coronary artery bypass grafting was done in 8 cases, with the mean number of distal anastomosis being $1.0{\pm}0.8$. There was one operative death. In 2 patients, reoperation was performed due to a residual septal defect. The postoperative morbidities were transient atrial fibrillation (n=7), paroxysmal supraventricular tachycardia (n=1), low cardiac output syndrome (n=3), bleeding reoperation (n=2), delayed sternal closure (n=2), acute renal failure (n=2), pneumonia (n=1), intraaortic balloon pump-related thromboembolism (n=1), and transient delirium (n=2). Nine patients have been followed up for a mean of $38{\pm}40$ months except for one follow-up loss. There have been 3 late deaths. At the latest follow-up, all 6 survivors were in a good functional class. Conclusion: We demonstrated satisfactory operative and midterm results with our strategy of preoperative intraaortic balloon pump therapy, early repair of septal rupture by infarct exclusion and combined coronary revascularization.
The purposes of this study were to develop Hazard Analysis Critical Control Point plan applicable to cook/chilled Pork Bulkogi (broiled sliced pork with sauces) in school foodservice operations and to establish reasonable shelf-life limits by assessing food quality during chilled storage period of 5 days. During the product flow, time-temperature profile was recorded and microbiological analyses including mesophilic and psychrotrophic total plate counts, coliform, and fecal coliform and qualitative analyses of Salmonella and Listeria monocytogenes were done. Chemical analyses (pH, acid value, total volatile basic nitrogen), sensory evaluation, and quantitative analysis of thiamin were conducted for 5 days of chilled storage. The number of mesophiles in raw pork ($4.26{\pm}0.11\;Log\;CFU/g$), seasoning mixture ($5.97{\pm}O.04\;Log\;CFU/g$) and marinated pork ($5.56{\pm}0.21\;Log\;CFU/g$) were below the microbial standards for "requires further cooking" food items. Listeria monocytogenes was detected in seasoning mixture. After heating, the number of mesophiles ($5.17{\pm}0.04\;Log\;CFU/g$) were slightly reduced but it did not meet the microbial guidelines of $5\;Log\;CFU/g$ for "ready-to-eat" foods. No other microbes including pathogens were detected. By reheating the menu item after chilled storage, the number of mesophiles were reduced in every phase of 1st day ($4.62{\pm}0.22\;Log\;CFU/g$), 3rd day ($4.55{\pm}0.20\;Log\;CFU/g$) and 5th day ($4.25{\pm}0.16\;Log\;CFU/g$) of chilled storage, and the number of microbes was below the standard limits for "ready-to-eat" foods. At the fifth day of chilled storage, pH (p<0.05), acid value (p<0.01) and TVBN (p<0.05) showed significant increases. Sensory evaluation results did not show any significant change for 5 days of chilled storage. Thiamin content showed a decrease for 5 days of chilled storage. Consequently, the ideal shelflife recommended for Pork Bulkogi was within 3 days of chilled storage. CCPs for Pork Bulkogi were purchasing and receiving of raw meat and some seasoning ingredients, heating, chilling, chilled storage, reheating, and distribution.
The increase in the consumption of herb medicines have made their use a public health problem due to the potential fungal contamination and the risk of the presence of my cot ox ins. 360 samples of herb medicines were evaluated for the aflatoxin contamination. The natural occurrence of aflatoxins in these samples were determined using immunoaffinity column clean up and high performance liquid chromatography (HPLC) with post-column derivatization. For samples analyzed, mean levels (incidence) of AFB1, AFB2, AFG1 and AFG2 in positive samples were $1.4\;{\mu}g/kg$(46.4%), $0.4\;{\mu}g/kg$(25.4%), $1.1\;{\mu}g/kg$(37.8%) and $0.9\;{\mu}g/kg$(24.3%), respectively. Recoveries of the full analytical procedure were 71.7~99.7% for AFB1, 88.1~99.2% for AFB2, 82.8~95.5% for AFG1 and 77.9~90.0% for AFG2. The excess cancer risk estimated using the cancer potency of aflatoxin B1 (7 $(mg/kg/day)^{-1}$ for $HBsAg^-$ and 230 $(mg/kg/day)^{-1}$ for $HBsAg^+$) were $1.30{\times}10^{-5}{\sim}1.22{\times}10^{-7}$ for hepatits B surface antigen negative ($HBsAg^-$) and $3.31{\times}10^{-4}{\sim}3.12{\times}10^{-6}$ for hepatits B surface antigen positive ($HBsAg^+$) respectively. In conclusion, although the contamination levels of samples used in the study were low, further actions are also required to undertake a program of herbal surveys in order to access mycotoxin contamination overall so that the safety of public will be protected.
Park, Jung-Min;Gu, Hyo-Jung;Jeong, Jong-Youn;Chang, Un-Jae;Suh, Hyung-Joo;Kang, Duk-Ho;Kim, Cheon-Jei;Kim, Jin-Man
Food Science of Animal Resources
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v.27
no.2
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pp.185-189
/
2007
Animals must be inspected prior to and after slaughter to make certain they are free of diseases and unacceptable defects. Since meats are potentially hazardous foods, they should not be accept if there are any signs of contamination, temperature abuse, or spoilage. This survey was aimed to monitor the current situation of country-of-origin labels and sanitation for the meat markets in Seoul, Korea. The markets were divided into groups as to 25 territories in Seoul and the size of markets (large size, medium size, and small size). In terms of size distribution, small butcher shops occupied the highest percentage. On the itemized suitability test of unpacked and packed beer in Seoul, most butcher shops showed good evaluation. However, labels indicating the grade, storage and cooking instruction for unpacked beef were not properly posted on the products. The results of monitoring sanitation conditions for butcher shops in Seoul showed relatively low suitability. Especially, there were serious lack of knowledge about wearing the sanitation clothings, caps, and shoes. The problem with food safety is so complicated that producers, consumers, merchandisers, the press, the government and the scholar should try to solve the problems altogether. Also, it is important to educate and provide them with correct understanding and information for food hygiene and safety.
Sex steroids are known to be involved in skeletal muscle development (anabolic effect) and are frequently used in medicines. It has been known that pork contains a variety of steroids that are mainly synthesized in the gonads (testis and ovary). Thus, the present study was conducted to evaluate the effects of anabolic steroids of pork on the proliferation and differentiation of myogenic satellite cells (MSC). Three different methods (M1, M2, and M3) were developed for the isolation and purification of steroids from porcine tissues. Among three extraction methods that we developed, M3 was the best method with respect to the quantities of steroids and the induction of MSC proliferation. Hormonal analysis showed that the steroid hormone levels were the highest in muscle and fat of intact male than those of castrated males and females. In addition, the highest serum levels of nandrolone and testosterone were detected in intact males, whereas estrone and $17{\beta}$-estradiol levels were similar in the entire experimental serum samples. Expression of androgen receptor (AR), myoD, desmin, and myogenin in bovine muscle cells were significantly up-regulated by the treatment of steroid extracts. The highest increas of myogenin and AR mRNA abundance were observed in the MSCs treated with M3 extract (p<0.001). Altogether, the present research showed the positive effect of steroids on MSC proliferation and differentiation in vitro. These results would certainly imply a beneficial effect of pork consumption on human muscle development.
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