• Title/Summary/Keyword: pathologic

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Prognostic significance of lymphovascular invasion in patients with prostate cancer treated with postoperative radiotherapy

  • Jeong, Jae-Uk;Nam, Taek-Keun;Song, Ju-Young;Yoon, Mee Sun;Ahn, Sung-Ja;Chung, Woong-Ki;Cho, Ick Joon;Kim, Yong-Hyub;Cho, Shin Haeng;Jung, Seung Il;Kwon, Dong Deuk
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.215-223
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    • 2019
  • Purpose: To determine prognostic significance of lymphovascular invasion (LVI) in prostate cancer patients who underwent adjuvant or salvage postoperative radiotherapy (PORT) after radical prostatectomy (RP) Materials and Methods: A total of 168 patients with prostate cancer received PORT after RP, with a follow-up of ≥12 months. Biochemical failure after PORT was defined as prostate-specific antigen (PSA) ≥0.2 ng/mL after PORT or initiation of androgen deprivation therapy (ADT) for increasing PSA levels regardless of the value. We analyzed the clinical outcomes including survivals, failure patterns, and prognostic factors affecting the outcomes. Results: In total, 120 patients (71.4%) received salvage PORT after PSA levels were >0.2 ng/mL or owing to clinical failure. The 5-year biochemical failure-free survival (BCFFS), clinical failure-free survival (CFFS), distant metastasis-free survival (DMFS), overall survival, and cause-specific survival rates were 78.3%, 94.3%, 95.0%, 95.8%, and 97.3%, respectively, during a follow-up range of 12-157 months (median: 64 months) after PORT. On multivariate analysis, PSA level of ≤1.0 ng/mL at the time of receiving PORT predicted favorable BCFFS, CFFS, and DMFS. LVI predicted worse CFFS (p = 0.004) and DMFS (p = 0.015). Concurrent and/or adjuvant ADT resulted in favorable prognosis for BCFFS (p < 0.001) and CFFS (p = 0.017). Conclusion: For patients with adverse pathologic findings, PORT should be initiated as early as possible after continence recovery after RP. Even after administering PORT, LVI was an unfavorable predictive factor, and further intensive adjuvant therapy should be considered for these patients.

Protective Effects of Gami Yugan-tang on Liver Damage in Rats (흰쥐의 간손상(肝損傷)에 대한 가미유간탕(加味愈肝湯)의 간(肝) 보호효과(保護效果))

  • Jung, Hee;Go, Ho-Yeon;Hsia, Yu-Chun;Yeo, Hyun-Soo;Baik, Jong-Woo;Ko, Seung-Gyu;Park, Jong-Hyung;Jun, Chan-Yong;Kang, Jea-Chun
    • The Journal of Internal Korean Medicine
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    • v.29 no.1
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    • pp.265-277
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    • 2008
  • In order to investigate the protective effects of Gami Yugan-tang on liver damage in rats induced by $CCl_{4}$ and d-galactosamine, the serum transaminase(ALT & AST), alkaline phosphatase(ALP), lactic dehydrogenase(LDH), superoxide dismutase(SOD), catalase, glutathione S-transferase(GST), glutathione peroxidase(GPX) for enzyme activities, and lipid peroxidation were measured. All animals were divided into 4 groups: normal group (untreated), control group (treated with 0.9% saline solution), sample I group (treated with 740mg/kg Gami Yugan-tang), and sample II group (treated with 1,480mg/kg Gami Yugan-tang). The results were as follows : 1. The results of liver damage in rats induced by $CCl_4$ : The protective effects of ALT were displayed in sample I and sample II, and AST, ALP, LDH, SOD, catalase, GST, GPX, and lipid peroxidation were noted in sample II group. It showed slight necrosis of hepatic cell and pathologic changes, for example, inflammatory cells infiltration were improved in sample II group compared to the control group. 2. The results of liver damage in rats induced by d-galactosamine : The inhibitory effects of AST, ALT, LDH, and ALP activities were noted in both sample I and sample II groups. The findings from this experiment suggests that Gami Yugan-tang has protective effects against liver damage in rats induced by $CCl_{4}$ and d-galactosamine.

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Effect of Naeso-san on Gastric Motility between Normal Intact and Antral Dilatated Rats (내소산(內消散)의 정상 및 위 유문부 확장 흰 쥐의 위 운동성에 대한 효능)

  • Kim, Jin-Seok;Yoon, Sang-Hyub
    • The Journal of Internal Korean Medicine
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    • v.29 no.1
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    • pp.117-129
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    • 2008
  • Background & Objective : Naeso-san(NSS) has been used for the treatment of functional dyspepsia, regarded as a gastric dysmotility disease. A main cause of gastric dysmotility is antral dilatation or antroduodenal uncoordination. Therefore, we investigated the effect of NSS on gastric motility and its mechanism of action, as well as the morphologic changes in antral dilatated rats. Methods : Antral dilatated rats were induced by wrapping a nonabsorbable rubber ring(D:6mm, W:4mm, T:1mm) around the 1st portion of the duodenum for 8 weeks. Then morphologic changes were investigated and compared with normal intact rats before and after 8 weeks. Gastric emptying was measured by administration of normal saline(NS) or NSS in normal intact and antral dilatated rats. In another series of experiments to evaluate the mechanism of NSS under delayed conditions, normal intact rats were treated with atropine sulfate(1mg/kg, s.c.), quinpirole HCl(0.3mg/kg, i.p.), $NAME(N^{G}-nitro-L-arginine$ methyl ester, 75mg/kg, s.c.) and cisplatin(10mg/kg, i.p.), respectively. The myoelectrical activity of the gastric smooth muscle was recorded in normal intact and antral dilatated rats. The contractile waves were measured for 30 minutes before and after administration of each solution(NS, NSS). Results : Body weight gain of antral dilatated rats was significantly lower than that of the controls. Futhermore, we found the thickness of the mucosal and muscular layers and surface area of the stomach increased significantly compared with controls. NSS 278㎎/㎏ improved gastric emptying more than normal saline or NSS 93mg/kg in normal intact(p=0.026) and antral dilatated rats(p=0.03). NSS enhanced gastric emptying significantly in the NAME treated group(p=0.002). NSS 278mg/kg increased the significant postprandial dominant power than that of NS in normal intact rats, whereas there was no statistical significance in antral dilatated rats. Conclusions : NSS stimulates gastric motility through the cholinergic pathway. We expect that pathologic model with antral dilatation can be used as an exprimental tool which is similar to dyspepsia and NSS would be effective especially in dysmotility-like functional dyspepsia with antral dilatation or impaired reservoir functions such as gastric adaptive relaxation.

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Study on Diagnosis by Facial Shapes and Signs as a Disease-Prediction Data for a Construction of the Ante-disease Pattern Diagno-Therapeutic System - Focusing on Gallbladder's versus Bladder's Body and Masculine versus Feminine Shape - (미병학(未病學) 체계구축을 위한 질병예측자(疾病豫側子)로서의 형상진단연구 - 담방광체(膽膀胱體)와 남녀형상(男女形象)을 중심으로 -)

  • Kim, Jong-Wan;Kim, Kyung-Chul;Lee, Yang-Tae;Lee, In-Seon;Kim, Kyu-Kon;Chi, Gyoo-Yang
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.3
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    • pp.540-547
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    • 2009
  • There needs disease-predictable signs in order to enable preventive diagnosis and therapy. Then traditional Chinese medicine applies various medical diagnostic equipments used in western medicine to diagnosing sub-healthy state. But such data are not originated from inherent oriental medicine, and not obtained easily in ordinary clinical practice. This paper is to provide synopsis of the ante-disease diagno-therapeutics partly and to show predictable data based on the facial shapes and signs, especially of gall bladder's versus bladder's body and masculine versus feminine shape. Ante-disease means not only the complete healthy state, but also the state unseen any symptoms in macrographically in the course of outbreak of disease. It contains two stages, first one is the former state of disease and second one is untransmitted state of disease. The patterns of ante-disease consist of latent disease, pre-disease, transmission type like senescent syndrome, abnormal reactive syndrome(變證), syndrome of transmission and transmutation. The classification with gall bladder and bladder type manifests the differences of shape, color and size of each organ in comparison of the universal and standard figures of the human being. On the other hand, the classification with masculine and feminine shape contrasts the innate sexual difference and the shape, characteristics originated from in itself. These two classification theories have their own pathologic types and syndrome types with each disease so that disease-predictable data can be constructed based on such a relationship. In addition, this diagnostic method by facial shapes and signs is able to be applied to whole stages from prenatal to present state of disease even if the cause and inducement are not clear. Ante-disease diagno-theraputic system by Gall Bladder's versus Bladder's Body and Masculine versus Feminine Shape is getting more important in the chronic and internal disease in comparison of the acute and traumatic disease. So this study is able to make up for the limit of diagnosis on ante-disease in the field of oriental medicine clinic.

Seven-Year Follow Up of Microscopic Polyangiitis Presenting with Rapidly Progressive Glomerulonephritis (급속 진행성 사구체신염으로 시작된 현미경적 다발성 동맥염(Microscopic Polyangiitis) 환자의 7년간의 장기 추적관찰 1례)

  • Oh, Jin-Won;Kim, Pyung-Kil;Lee, Jae-Seung;Jeong, Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.99-104
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    • 2008
  • Microscopic polyangiitis(MPA) is a systemic necrotizing vasculitis that involves many organ systems including the skin, joint, kidneys, and lungs. In spite of early diagnosis and intensive care, the five-year actuarial patient and kidney survival rates are 65% and 55%. We experienced a case in 7-year-old girl of microscopic polyangiitis presenting with rapidly progressive glomerulonephritis which was confirmed by renal biopsy and positive serum perinuclear antineutrophil cytoplasmic autoantibodies(p-ANCA). The diagnosis of patients first renal biopsy was MPA, p-ANCA-associated crescentic glomerulonephritis. The patients second renal biopsy was done 5 years 6 months later since first renal biopsy, and pathologic diagnosis was chronic sclerosing glomerulonephritis, advanced, due to MPA. We began methylprednisolone pulse therapy, combined with a low dose of cyclophosphamide and plasmapheresis therapy. ACE inhibitor, angiotensin II receptor blocker, and cyclophosphamide were used until now and the patients current age is 14 years old. On admission, the patients laboratory findings showed BUN 117 mg/dL and Cr 2.3 mg/dL, while on the hospital day BUN and Cr values fell to 20.8 mg/dL and 1.6 mg/dL. But renal function was progressed to chronic failure with latest laboratory data BUN 51.7 mg/dL and Cr 3.2 mg/dL. ACE inhibitor, angiotensin II receptor blocker and small dose of immunosuppressant with close observation is the key to maintain the patient survival.

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Effects of Rhizoma Coptidis Herbal Acupuncture applied to HapGok $(LI_4)$ on TNBS-induced Colitis in rats (흰쥐의 합곡부위(合谷部位)에 황련약침(黃連藥鍼)이 TNBS로 유발된 대장염(大腸炎)에 미치는 영향(影響))

  • Do, Jin-Woo;An, Sung-Hun;Koo, Sung-Tae;Baek, Tae-Bong;Kim, Kyung-Sik;Sohn, In-Chul
    • Korean Journal of Acupuncture
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    • v.21 no.2
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    • pp.95-110
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    • 2004
  • Objectives : Ulcerative colitis and Crohn's diseases are chronic inflammatory disease of the gastrointestinal tract identified mainly for diarrhea, stomachache, hemafecia. The source and pathologic mechanism about ulcerative colitis and Crohn's disease are still unknown but stress, infection, a genetic factor, environmental factors etc. may be the cause of chronic inflammatory disease of the gastrointestinal tract recently. Methods : Because ulcerative colitis and Crohn's disease is recognized as Ha-ri(下痢) or Jang-Byok(腸?) in Oriental Medicine, Rhizoma Coptidis Herbal acupunctures were injected in hapgok $(LI_4)$ which is used to treat intestinal disease in clinic. All animals were subjected to the injection of saline $(300\;{\mu}l,\;500\;{\mu}l)$ for a study control and TNBS $(300\;{\mu}l,\;500\;{\mu}l)$ into the lumen of the colon, 8cm proximal to the anus through the intestine. Rhizoma Coptidis Herbal (20 mg/ml, 0.4 ml) acupuncture solution was injected to the $LI_4$ (both hands) at the secondary injection time of TNBS in rats. And body weight, RBC count, WBC count, total protein, Paw edema rate, rate of protein leakage into CMC-pouch fluid, IgG levels and IgM levels were observed to study the effects of Rhizoma Coptidis Herbal acupuncture in hapgok $(LI_4)$. Results : In results, Rhizoma Coptidis Herbal acupuncture in hapgok $(LI_4)$ on TNBS-induced colitis reduced the rate of weight loss but had no effect on RBC and WBC count. And it reduced total protein concentration, paw edema, rate of protein leakage into CMC-pouch fluid, IgG levels and IgM levels. Conclusion : Data suggest that injection of Rhizoma Coptidis herbal acupuncture solution into hapgok has significant therapeutic effect on the colitis.

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Long-term Results of Surgical Treatment for Ventricular Septal defect Associated Aortic Insufficiency-Proper Timing and Method of Surgical Treatment (대동맥판 폐쇄부전증이 동반된 심실중격결손증 수술의 장기 성적- 적절한 수술시기 및 수술 방법-)

  • Kim, Jin-Guk;Ham, Si-Yeong;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.254-269
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    • 1988
  • 52 cases of ventricular septal defect [VSD] associated with aortic insufficiency [Al] were found among 1271 patients with simple VSD operated during 27-year period [1959, August-1987, June] at Seoul National University Hospital. Their preoperative data, intraoperative findings and postoperative short-term and long-term follow-up data were evaluated to find the proper timing and method of surgical treatment. The result of this survey shows as follows: 1. To obtain the proper surgical indication, cardiac catheterization and angiography, especially root aortography, was essential. 2. Of all 52 patients, the VSD were type I in 40 patients [77%], type II in 8 [15%] and combination of type I and II in 4 [3%]. Patch closure of VSD were performed in 46 patients and direct suture closure of small VSD in 6. Most common pathologic findings of Al were prolapse of right coronary cusp [40 cases, 77%]. Aortic valve reconstruction were performed in 19 patients, aortic valve replacement in 6 and VSD closure alone in 27. 3. There were 3 surgical deaths [mortality 5.8%], and the long-term follow-up shows that VSD closure alone might have been sufficient to arrest progression of Al in younger patients [less than 10-year old], particularly in those with mild insufficiency. Valve reconstructions, when necessary, were more effective when done at an early age [less than 15-year old]. In a conclusion, we could recommend followings: 1. If patient at any age having VSD with Al is diagnosed, prompt operation is recommended. As for the surgical method, VSD closure only may be fit for mild degree of Al when patient is less than 10-year old, but the management of valve itself may be needed for moderate to severe degree of Al, especially when patient is over 10 year old. The management of valve itself may be variable, but valve reconstruction should be considered as a first choice in less than 15-year old patient. If patient is diagnosed less than 5-year old without evidence of Al, close follow-up observation is recommended. But if Al evidences of clinical findings and/or echocardiography during follow-up examination are notified, corrective operation should be accomplished while the Al is mild. If cusp prolapse and/or even type I VSD of significant size is demonstrated on aortogram, without Al, it should be corrected as early as possible before the patient is about 5 years old.

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Surgical Result of Congenital Mitral Regurgitation in Children (선천성 승모판폐쇄부전증 교정수술의 단기성적)

  • 홍유선;박영환
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.373-377
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    • 1997
  • Between January, 1991 and May 1995, mitral valve repair was undertaken on 32 patients under 15 years for congenital mitral regurgitation. Mean age was 24.0$\pm$26.1 months(range 3 months to 15 years), 16 patients were male and 16 patients were female associated cardiac anomalies were found in 26 patients (81%), and ventricular septal defects were noted in 18 patients(56%). In regards to pathologic findings, there were annular dilatation(n:7), leaflet prolapse(n=18), cleft leaflet(n=5) and restricted valve motion (n=2). The method of repair consisted of annuloplasty(Modif ed Devega type) in 14, repair of redundunt leaflet in 6, closure of cleft in 5, triangular resection in 2 and splitting of papillary muscle in one. There was no operative mortality and two late deaths occurred as a result of heart failure and sepsis. Tro patients required replacement of the mitral valve after 3 months and 7 months respectivehy because of recurrent mitral regurgitation. Actuarial survival was 92.5% at 46 months and actuarial freedom from reoperation was 95% at 12 months and 92.5% at 46 months. Actuarial freedom from valve repair failure was 68% at 12 months and 61.8% at 46 months. Although valve repair failure rate was high, we believe that mitral valve repair should be of rcrred to children because of low mortality and low reoperation rate.

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Clinical and pathological studies on co-infection of lowpathogenic avian influenza virus and Newcastle disease virus in the chicken (닭에서 저병원성 조류인플루엔자와 뉴캐슬 바이러스의 복합감염에 따른 임상적, 병리학적 연구)

  • Lee, Sung-Min;Cho, Eun-Sang;Choi, Bo-Hyun;Son, Hwa-Young
    • Korean Journal of Veterinary Service
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    • v.36 no.3
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    • pp.163-169
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    • 2013
  • Both of avian influenza (AI) and Newcastle disease (ND) can cause mild to severe diease in poultry. In this study, clinical signs, macro, and micro lesions were studied. Eighteen six-week-old SPF chicks were divided into 4 groups (E1, E2, E3 and C1) and housed in different rooms of the isolation facility at CAVAC (Daejeon, Korea). The control group (C1) of 3 chicks was housed separately as uninoculated. Experimental groups (E1, E2 and E3) challenged with H9N2 and/or NDV. E1 group was challenged with 0.1 mL A/Kr/Ck/01310/01 (H9N2) $10^{5.6}$ $EID_{50}$ by intranasal, E2 group was challenged with 0.5 mL Kyojeongwon (KJW) $10^{5.0}{\sim}10^{6.0}$ $ELD_{50}$ by intramuscular, and E3 group was challenged with 0.1 mL A/Kr/Ck/01310/01 $10^{5.6}$ $EID_{50}$ by intranasal and 0.5 mL KJW $10^{5.0}{\sim}10^{6.0}$ $ELD_{50}$ by intramuscular 7 days after H9N2 challenge. In clinical signs and gross findings, E1 group showed 0% mortality, anorexia, and hemorrhage of proventriculus and thymus, E2 group showed 100% mortality within 3~5 days after challenge, anorexia, green diarrhea, hemorrhage of proventriculus, proximal esophagus and thymus, enlargement of kidney, and bronze liver, and E3 group showed 100% mortality within 24~36 hours after NDV challenge, depression, anorexia, green diarrhea, hemorrhage of proventriculus, spleen, and lung, enlargement of kidney, and reduction of thymus size and number. In histopathological examination, E1 group showed depletion and necrosis in bursa of Fabricius, thymus, and spleen, and E2 and E3 group showed severe lymphocyte depletion and necrosis with destruction of lymphoid organ structures. In conclusion, co-infection of H9N2 with ND virus causes acute disease with high mortality than single infection and the pathologic lesions were more severe.

Combined Modality Therapy of Non-Hodgkin's Lymphoma of Waldeyer's Ring (Waldeyer's Ring 비호치킨 림프종의 병합요법)

  • Park In-Kyu;Yun Sang-Mo;Park Jun-Sik;Kim Jae-Cheol
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.22-28
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    • 1999
  • Purpose: We performed this study retrospectively to evaluate local control, survival, prognostic factors, and failure patterns in patients with non-Hodgkin's lymphoma of Waldeyer's ring. Materials and Methods: From April 1984 to November 1996,41 patients with non-Hodgkin's lymphoma of Waldeyer's ring were treated with combined chemotherapy and radiation therapy. Age was ranged from 19 to 73 years old with a median age of 55 years, and there were 26 male and 15 female patients. Primary site was tonsil in 26 and base of the tongue in 7 and nasopharynx in 8, and stage distribution showed stage I in 12 and stage II in 29 patients. Pathologic classification was done according to Working Formulation. There were 1 with follicular mixed small cleaved and large cell, 8 with diffuse small cleaved cell, 7 with diffuse mixed small and large cell, and 25 cases with diffuse large cell. All patients were treated with combination of chemotherapy and radiation therapy. Chemotherapy regimen consisted of either CHOP-Bleo(cyclophosphamide, adriamycin, vincristine, prednisolone, bleomycin) or COP-BLAM III(cyclophosphamide, vincristine, prednisolone, bleomycin, adriamycin, procarbazine). Radiation dose ranged from 3600cGy to 6620cGy with a median dose of 5040cGy. Follow-up time was ranged from 15 months to 159 months(median 55 months). Results: The complete response was achieved in 98%(40/41) and partial response in 2%(1/41). The complete response rate were the followings: 66.7% for stage I and 51.7% for stage II after chemotherapy, 100% for stage I and 96.6% for stage II after overall treatment respectively. The overall survival rate and disease-tree survival rates at 5 years were 82.6% and 79.5%, respectively. Prognostic factors for overall survival were age(p=0.007), stage(p=0.03), nodal status(p=0.006) and radiation dose(p=0.003). The factors associated with disease-tree survival were stage(p=0.04), nodal status(p=0.004) and radiation dose(p=0.009). The failure patterns were analized in evaluable 35 patients with complete response. Locoregional failure was noted in 2 patients and distant metastasis in 5 patients. Conclusion: Our results suggest that combined modality therapy is the appropriate treatment for stage I-II intermediate grade non-hodgkin's lymphoma of the Waldeyer's ring. However, our material is small and the analysis is retrospective. Randomized prospective studies for combined therapy, radiation therapy alone and chemotherapy alone are needed.

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