• Radiation Oncology Journal
• /
• v.22 no.2
• /
• pp.91-97
• /
• 2004

Propose: To Analyze the survival outcomes and prognostic factors In glioblastoma patients treated with surgery and radiation therapy. Materials and Methods : One hundred twenty glloblastoma patients treated with postoperative radiation therapy from 1994 to 2003 at Samsung Medical Center were retrospectively reviewed. Surgical extents were gross total resection in 22 patients (18$\%$), subtotal resection in 69 (58$\%$), and biopsy only in 29 (24$\%$). The median radiation dose was 50 Gy, ranging from 45 Gy to 72 Gy The median follow-up period was 12 months ranging from 2 to 52 months. Results The overall 1- and 2-year survival rates were 52$\%$ and 14$\%$, respectively, and the median survival duration was 13 months. Favorable prognostic factors by Uunivarlate analyses of prognostic factors on 1-year survival rate were revealed that age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.03), single lesion (p=0.02), and gross total resection (p=0.04), were the favorable prognostic (actors. and by Mmultlvarlate analyses were revealed that female (p<0.01), age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.05) and gross total resection (p=0.05) were the favorable prognostic factors. Conclusions : The results of our study were comparable with those previously reported. To Improve treatment outcome, various modifications, Including radiation dose escalation through newer radiation therapy techniques and use of effective chemotherapy regimen, should be further Investigated. Investigated. Also Furthermore, the application of Individualized treatment strategy based on 4he patient's prognostic factors might be needed.

• Journal of Veterinary Clinics
• /
• v.18 no.3
• /
• pp.195-200
• /
• 2001

Metabolism and phamacokinetics of albendazole have been studied in Korean native cattle after oral administration of 5 mg/kg of albendazole. As ABZ is known to be rapidly biotransformed to many metabolites in most animal species, it is very imperative to establish the analytical conditions for its metabolites. LC/MS methods for ABZSO and ABZS $O_2$met every requirement enough to study the metabolism of pharmacokinetics of albendazole in Korean native cattle. The parent drug (ABZ) was only measured at first two time points of 0.5 h and 1h, whereas two metabolites were consistently formed between 0.5 h to 48-72 h post-treatment. Formation kinetics for ABZSO and ABZS $O_2$were similar. Time to peak concentration (Tmax) of ABZ-SO appeared at 12h post-treatment of ABZ, faster than that of ABZS $O_2$at 24h. Cmax of ABZS $O_2$(1.05$\pm$0.05 ug/ml) was 1.09 times higher than that of ABZSO (0.96$\pm$0.15). Elimination half-life of ABZS $O_2$(4.2 h) was much shorter than ABZS $O_2$(7.0h) (p<0.005). ABZSO was detected until 48h post-administration but ABZS $O_2$was measurable even at 72h post-dosing. AU $C_{0longrightarrow{\infty}}$ of ABZSO was smaller than that of ABZS $O_2$. Regimen of ABZ is advised to take into consideration is metabolite profiles, especially that of ABZSO, an active metabolite.

• Korean Journal of Veterinary Research
• /
• v.32 no.1
• /
• pp.15-24
• /
• 1992

The effects of CC the ovulatory response, oocyte normality, ovarian steroidogenesis and subsequent embryo developmental potential were examined in PMSG-treated rats. On Days of 25~27 of age, immature female Sprague Dawley rats were treated with three different doses(0.05, 0.1 or 1.0mg /day) of clomiphene citrate or vehicle. The females subsequently received 4IU PMSG on Day 28 and/or 10IU hCG on Day 30, and were killed on Day 31. Some females given 0.1mg CC or vehicle with 4IU PMSG were then mated and killed on Days 2, 3, 4 and 5 of pregnancy. Compared to vehicle(control) group, by increasing the doses of CC, there were a significant decrease in the ovulatory response as judged by both the proportion of rats ovulating and the mean number of oocytes per rat and a marked reduction of ovarian weight. The increasing doses of CC substantially promoted the degeneration(%) of oocytes ovulating in a dose-dependent manner. The CC-mediated inhibitions of the ovulatory response and ovarian weight were oompletely overcome by a subsequent treatment of hCG. Increasing doses of CC resulted in a siginificant elevation of serum estradiol with the decreased levels of progesterone and androgens. The additive treatment with hCG was effective to reduce the elevation of estradiol and to increase the reduction of progesterone produced by high dose(1.0mg) of CC. The preimplantation embryos recovered from 0.1mg CC-treated pregnant rats demonstrated a progressive early loss from Day 3 of pregnancy with a significant increase in the percentage of degeneration during all periods examined, compared to controls. The rate of progressive embryo cleavage in the CC-treated rats were slower than that in controls from Day 3 of pregnancy. Additionally, the percentage of the cleaved embryos recovered from the CC-treated rats remained significantly lower consistently from Day 2 of pregnancy, compared to control regimen. These results demonstrate a possible mechanism of CC-mediated inhibition of ovulatory response in the rats which may include the attenuation or blockade of the endogenous secretion of gonadotropins and also suggest that its detrimental effects observed on oocyte normality and embryonic development may be caused by abnormal follicular steroidogenesis( especially elevated estradiol) preceding fertilization.

• Radiation Oncology Journal
• /
• v.12 no.2
• /
• pp.209-217
• /
• 1994

Between July 1987 and December 1992, we treated 22 patients with chronic myelogenous leukemia; 14 in the chronic phase and 8 with more advanced disease. All were received with allogeneic bone marrow transplantation from HLA-identical sibling donors after a total body irradiation(TBI) cyclophosphamide conditioning regimen. Patients were non-randomly assigned to either 1200 cGy/6fractions/3days (6 patients) or 1320 cGy/8 fractions/4days (16 patients) by dose of TBI. Of the 22 patients, 8 were prepared with cyclophosphamide alone, 14 were conditioned with additional adriamycin or daunorubicin. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with methotrexate. The actuarial survival and leukemic-free survival at four years were $58.5\%$ and $41.2\%$, respectively, and the relapse rate was $36\%$ among 22 patients. There was a statistically significant difference in survival between the patients in chronic phase and more advanced phase ($76\%\;vs\;33\%$, p=0.05). The relapse rate of patients receiving splenectomy was higher than that of patients receiving splenic irradiation ($50\%\;vs\;0\%$, p=0.04). We conclude that the probability of cure is highest if transplantation is performed while the patients remains in the chronic phase.

• Clinical and Experimental Pediatrics
• /
• v.49 no.2
• /
• pp.173-180
• /
• 2006

Purpose : Cytomegalovirus(CMV) infection still remains as a major cause of morbidity and mortality after stem cell transplantation. In this study, we analyzed the results of antigenemia-guided preemptive therapy among children with allogeneic hematopoietic stem cell transplantation to determine the incidence and risk factors associated with CMV antigenemia, and evaluated the efficacy of the CMV antigenemia based preemptive therapy. Methods : We enrolled 213 pediatric patients following allogeneic hematopoietic stem cell transplantation(HSCT), at the Catholic HSCT center between October 1998 and December 2003. Pre-emptive ganciclovir was started when more than 5 CMV Ag-positive cells were detected in matched sibling HSCT, and when any Ag-positive cells were seen in unrelated allogenic HSCT. Results : CMV antigenemia was observed in 88(41.3 percent) of 213 patients on median day 28(day 11-99). In univariated analysis, use of unrelated donors(other than siblings), age of recipient(more than 5 years at transplant) at transplantation, the presence of recipient CMV-IgG before transplantation, TBI-based conditioning regimen and the presence of acute GvHD(grade ${\geq}II$) were the risk factors for positive CMV antigenemia. In multivariate analysis, unrelated bone marrow transplantation, positive recipient CMV serology and acute GvHD(grade ${\geq}II$) were the independent risk factors for positive CMV antigenemia. Conclusion : Risk factors of CMV infection in children were CMV serostatus of the recipient, the source of stem cells, and acute graft-versus-host disease. The pre-emptive therapy based on CMV antigenemia was effective in the prevention of CMV disease.

• Clinical and Experimental Pediatrics
• /
• v.53 no.3
• /
• pp.420-427
• /
• 2010

Purpose : Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods : One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid function, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction. Results : Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were $0.08{\pm}1.04$, $-0.09{\pm}1.02$, and $-0.27{\pm}1.18$, respectively (P =0.001). Height SDS significantly decreased in patients who received total body irradiation (TBI) (P =0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P =0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P =0.001). Conclusion : The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.33 no.1
• /
• pp.25-34
• /
• 2006

Fluoride released from dental restorative materials effectively declines the incidence and activity of dental caries and inhibits tooth demineralization. This study investigated the fluoride release and uptake characteristics of one composite resin $(Z-250^{TM})$ three glass ionomer-based restorative material ($Dyract^{(R)}$ AP, Fuji II $LC^{(R)}$, Fuji IX GP $Fast^{(R)}$) Forty discs(6mm diameter and 1mm height) were prepared for each material. Each disc was immersed in 5ml of distilled water within polyethylene vial and stored at $37^{\circ}C$. The distilled water was changed every 24 hours and the release of fluoride was measured for 31 days. At the end of this period, each specimen was subjected to one of four treatments : (A) no fluoride treatment (control), (B) application of a fluoride dentifrice (500ppm) for three minutes three times; (C) application of the 1.23% acidulated phosphate fluoride(APF) foam for one minute once, (D) the same regimen as (B), plus application of the APF foam for one minute once. Then, all samples were reassessed for an additional 7 days. For all samples, the greatest fluoride release was observed after the first day of the study but diminished with time. On the 7th day of the study, fluoride release level was stabilized. Fuji II $LC^{(R)}$ and Fuji IX GP $Fast^{(R)}$ released higher amount of fluoride than other materials ; however, no statistically significant difference was found from Fuji II $LC^{(R)}$ and Fuji IX GP $Fast^{(R)}$. The amount of fluoride of $Dyract^{(R)}$ AP, Fuji II $LC^{(R)}$ and Fuji IX GP $Fast^{(R)}$ was increased after fluoride treatment, and diminished with time.

• Tuberculosis and Respiratory Diseases
• /
• v.47 no.6
• /
• pp.735-746
• /
• 1999

Background: As the prevalence of nontuberculous mycobacteriosis has been increasing rapidly, there has been recent advance in diagnostic methods and drug therapies for disease. Although the incidence of pulmonary disease caused by nontuberculous mycobacteria(NTM) has been increasing in Korea since 1990, detailed clinical description about the disease were very few. In this study we described the clinical manifestations, radiologic findings, and therapeutic outcomes of nontuberculous mycobacterial pulmonary disease. Methods: Medical records and radiologic findings were retrospectively reviewed in 27 patients who were fulfilled the diagnostic criteria of ATS guideline for NTM pulmonary disease between January of 1990 and August of 1998 in Seoul National University Hospital(SNUH). Results: Of the 27 patients, 15 were male. The mean age was 51.5 yr($\pm$11.9). Twenty patients(74.1%) had preexisting pulmonary diseases. Among them, 19 patients had previous pulmonary tuberculosis. Sixteen patients(59.2%) had cavitary lesions and the majority showed slow progression over 1 yr during follow up period on radiography. Susceptibility test to standard antituberculous drugs showed 100% resistance to INH, 72.2% to RMP, 81.5% to EMB, 92.6% to PZA. The average resistance rate to 2nd-line antituberculous drugs was 66.1%. Among twenty-one patients(77.8%) who received drug therapy over 6 months, 11 subjects were improved and 10 subjects were aggravated. Of six subjects(22.2%) without therapy, 5 patients were aggravated. Presence of cavity and less than 3 sensitive drugs in the regimen were indicators for adverse outcome. Conclusion : The nontuberculous mycobacterial pulmonary diseases in our hospital developed predominantly in older patients with preexistent pulmonary disease. The results of antituberculous drug therapy has been frustrating and disappointing. To improve treatment response, different susceptibility tests and drug regimens for different species of NTM should be performed. Also, diagnostic and therapeutic guidelines of Korea should be made in the recent future.

• Tuberculosis and Respiratory Diseases
• /
• v.48 no.6
• /
• pp.853-869
• /
• 2000

Background : Following several decades of decline, the incidence of tuberculosis has recent1y begun to increase in many countries of this the control of this disease has been impeded by the emergence of multi-drug resistant tuberculosis (MDR-TB). The development of rapid diagnostic methods and effective new drugs are needed to control MDR-TB. One of the new drugs for MDR-TB is rifabutin (RBU) which has been known to be effective in some patients with MDR-TB. A few reports showed that some types of mutations of the rpoB gene, which were known to be present in 96-98% of rifampicin-resistant M. tuberculosis, were associated with the rifampicin-resistant but RBU-susceptible phenotype. This study was performed to investigate the correlation between RBU susceptibility and the patterns of rpoB gene mutations in Korean MDR-TB. Methods : Sixty-five clinical isolates of multi-drug resistant Mycobacterium tuberculosis, gathered from patients who visited the Asan Medical Center from July 1997 to June 1999, were investigated. Clinical responses to rifabutin-containing regimen were evaluated. An RBU susceptibility test and sequencing analysis of rpoB gene were performed, and the results were analyzed to confirm which mutations correlated with RBU-susceptible MDR-TB. Results : Fifty-three of 56 (95%) clinical isolates of MDR-TB had 60 mutations of the rpoB gene. The most frequent mutations were found at codon 531 (43%), and two mutations were combined in seven clinical isolates. Five of 53 (10%) clinical isolates showed the RBU-susceptible phenotype, and in them the characteristic patterns of point mutations were found at codon 509, 516, and 526. Conclusion : The frequency and pattern of mutations of the rpoB gene of Korean MDR-TB isolates were similar to those in western countries, where the prevalence of tuberculosis is low, but some show RBU-susceptible phenotypes. RBU-susceptible MDR-TB isolates showed the characteristic pattern of mutations of the rpoB gene which could be used to rapidly diagnose RBU susceptibility.

• Clinical and Experimental Reproductive Medicine
• /
• v.37 no.1
• /
• pp.41-48
• /
• 2010

Objectives: The aim of this study was to assess appropriate time to convert intramuscular progesterone support to oral administration for luteal phase support in in vitro fertilization (IVF). Methods: Seventy-six cycles of IVF in which fetal heart beat was identified after treatment were included. Patients underwent controlled ovarian hyperstimulation with GnRH agonist long protocol (n=7) or GnRH antagonist protocol (n=66). Cryopreserved embryo transfer was performed in three cycles. Luteal support was initiated by daily intramuscular injection of progesterone, and after confirmation of fetal heart beat, converted to oral micronized progesterone (Utrogestan, Laboratoires Besins International, France) 300 mg daily before or after 8 gestational weeks. The oral progesterone was continued for 11 weeks. Results: Overall clinical abortion rate was 3.9% (3/76) and mean time to conversion was $8^{+4}$ gestational weeks ($46{\pm}5.8$ days after oocytes retrieval). The abortion rate was 5.6% (1/17) and 3.4% (2/59) in patients with conversion before 7 weeks and after 8 weeks, respectively, which were not statistically significant (p=0.678). The miscarriages were occurred at $9^{+4}$ weeks, $11^{+3}$ weeks and $11^{+4}$ weeks. Conclusion: Sequential luteal support using intramuscular and oral progesterone yields a relatively low clinical abortion rate. If fetal heart beat confirmed, sequential regimen appears to be safe and convenient method to reduce patients' discomfort induced by multiple injections.