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Postoperative Radiotherapy for Low Grade Glioma of the Brain (뇌 신경교종의 수술 후 방사선치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.79-84
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    • 2000
  • Purpose : To evaluate the effectiveness and tolerance of postoperative e지ernai beam radiotherapy for patients with low grade glioma of the brain and define the optimal radiotherapeutic regimen. Materials and Methods : Between June, 1985 and May, 1998, 72 patients with low grade gliomas were treated with postoperative radiotherapy immediately following surgery. Median age was 37 years with range of 11 to 76 years. Forty one patients were male and 31 patients were female with male to female ratio of 1.3:1. Of those patients, 15 underwent biopsy alone and remaining 57 did subtotal resection. The distribution of the patients according to histologic type was as follows: astrocytomas-42 patients (58$\%$), mixed oligodendrogliomas-19 patients (27$\%$), oiigodendrogliomas-11 patients (15$\%$). Two patients were treated with whole brain irradiation followed by cone down boost and remaining 70 patients were treated with localized field with appropriate margin. Ail of the patients were treated with conventional once a day fractionation. Most of patients received total tumor dose of 5000 $\~$ 5500 cGy. Results : The overall 5 and 7 year survival rates for entire group of 72 patients were 61$\~$ and 50$\~$. Corresponding disease free survival rates for entire patients were 53$\~$ and 45$\~$, respectively. The 5 and 7 year overall survival rates for astrocytomas, mixed oligodendrogiiomas, and oligodendrogiiorras were 48$\%$ and 45$\%$, 76$\%$ and 56$\%$, and 80$\%$ and 52$\%$, respectively. Patients who underwent subtotal resection showed better survival rates than those who did biopsy alone. The overall 5 year survival rates for sub total resection patients and biopsy alone patients were 57$\%$ and 43$\%$, respectively. Forty six patients who were 40 years or younger survived batter than 26 patients who were 41 years or older (overall survival rate at 5 years, 69$\%$ vs 45$\%$). Although one patient was not able to complete the treatment because of neurological deterioration, there was no significant treatment related acute toxicities. Conclusion : Postoperative radiotherapy was safe and effective treatment for patients with low grade gliomas. However, we probably need prospective randomized trial to define optimal treatment timing and schedule for low grade gliomas and select patient group for different treatment philosophies.

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The Measurement of $^{99m}Tc-DTPA$ Pulmonary Clearance in Normals, Asymptomatic Smokers and Diabetic Patients (정상 성인, 무증상 흡연자, 당뇨병 환자에서 $^{99m}Tc-DTPA$ 폐제거율의 측정)

  • Kim, In-Ju;Kim, Seong-Jang;Kim, Yong-Ki;Kim, Yun-Seong;Lee, Min-Ki;Park, Soon-Kew
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.266-275
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    • 1998
  • Purpose: We measured pulmonary epithelial permeability by $^{99m}Tc-DTPA$ radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate $^{99m}Tc-DTPA$ radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. Materials and Methods: We performed $^{99m}Tc-DTPA$ radioaerosol scan in 10 normal subjects, 10 asymptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). $^{99m}Tc-DTPA$ clearance half-time ($T_{1/2}$) was calculated, then compared with the result of chest radiography and pulmonary function test. Results: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with microangiopathy were significantly older (p<0.05). The $T_{1/2}$ of normal subjects and asymptomatic smokers were significantly different ($65.2{\pm}23.7min$ vs $39.6{\pm}9.8min$, p<0.05). For diabetic patients with microangiopathy, the $T_{1/2}$ was $90.5{\pm}46.5min$ and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the $T_{1/2}$ of diabetic patients without microangiopathy, $70.0{\pm}12.7min$, was not significantly different from those of normals or asymptomatic smokers (p>0.05). No significant correlation was found between the $T_{1/2}$ and spirometric parameters including DLco, FVC, $FEV_1,\;FEV_1/FVC$ (%) and $FEF_{25-75%}$ in all subjects, and between the $T_{1/2}$ and duration of diabetes ;in diabetic patients. Conclusion: Eventhough the influence of age can't be excluded, delayed $^{99m}Tc-DTPA$ clearance half-time ($T_{1/2}$) in diabetic patients with microangiopathy indicates decreased pulmonary capillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.

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Trophic State Characteristics in Topjeong Reservoir and Their Relations among Major Quality Parameters (탑정저수지의 부영양화 특성 및 주요 변수 간의 상호관계)

  • Park, Yu-Mi;Lee, Eui-Haeng;Lee, Sang-Jae;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.42 no.3
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    • pp.382-393
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    • 2009
  • The objectives of this study were to characterize long-term annual and seasonal trophic state of Topjeong Reservoir using conventional variables of Trophic State Index (TSI) and to determine the empirical relations between the trophic parameters. For the analysis, we used water quality dataset of 1995$\sim$2007, which is obtained from the Ministry of Environment, Korea and the number of parameters was 9. Annual ambient mean values of TN and TP were 1.78 mg $L^{-1}$ and 0.03 mg $L^{-1}$, respectively and TN : TP ratios averaged 76, indicating that this system was nitrogen-rich hypertrophic, and was probably phosphorus-limitation for algal growth. Therefore, nitrogen varied little with seasons and years, and total phosphorus (TP) varied depending on season and year. Monsoon dilutions of TP occurred in August and monthly fluctuations of suspended solid (SS) was similar to those of chlorophyll-$\alpha$ (CHL). Annual mean values of BOD and $COD_{Mn}$ were 1.61 mg $L^{-1}$ and 4.23 mg $L^{-1}$, respectively and the interannual values were directly influenced by the intensity of annual rainfall. There were no significant differences in the trophic variables between the two sampling sites. Mean values of Trophic State Index (TSI, Carlson, 1977), based on TN, TP, CHL, and SD (Secchi depth), turned out as eutrophic state, except for the TN (hypertrophic). Regression analyses of log-transformed seasonal CHL against TP and TN showed that variation of the CHL was explained 37% by the variation of TP ($R^2$=0.37, p<0.001, r=0.616), but not by TN ($R^2$=0.03, p>0.05). Regression coefficient of $Log_{10}$CHL vs $Log_{10}SD$ was 0.330 (p<0.003, r=0.580), indicating that transparency is regulated by the organic matter in the system. Results, data suggest that one of the ways controlling the eutrophication would be a reduction of phosphorus from the watershed.

Acute Hyponatremia in Pneumonia and CNS Infections of Children (소아의 폐렴과 중추신경계 감염에서 급성 저나트륨혈증의 발생 양상)

  • Shin, Sung Hyun;Um, Tea Min;Lee, Yun Jin;Son, Seung Kook;Kim, Seong Heon;Kim, Su Yung
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.89-94
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    • 2012
  • Purpose: The option of selecting isotonic rather than hypotonic fluids for maintenance fluid in children has been advocated by some authors. Pneumonia and CNS infections are frequent clinical settings for acute hyponatremia because of nonosmotic anti-diuretic hormone stimuli in children. We conducted the present study to identify the incidence of hyponatremia in pneumonia and CNS infection of children and to determine the importance of maintenance intravenous fluid therapy regimen and other related factors. Methods: The study included 1,992 patients admitted to the Department of Pediatrics at Pusan National University Children's Hospital between November 2008 and August 2011, who were diagnosed with pneumonia or CNS infections and checked for serum sodium concentration. Their clinical data including laboratory findings were reviewed retrospectively. Results: During the study period, 218 patients were identified to have acute hyponatremia among 1,992 patients. The overall incidence of hyponatremia was 10.9%. The incidence of hyponatremia in encephalitis (37.3%) was highest and the incidence in bacterial meningitis (27.4%), viral meningitis (20.0%), bacterial pneumonia (11.1%), mycoplasma pneumonia (9.2%), and viral pneumonia (6.8%) were in descending order. The mean age was higher in hyponatremic patients than in isonatremic patients. The incidence of hyponatremia was higher in who had 0.18% NaCl in 5% dextrose (D5 0.18% NS) than 0.45% NaCl in 5% dextrose infusion (D5 1/2NS) (9.0% vs. 2.2%). SIADH was identified in 20.5% among hospital acquired hyponatremic patients after adequate evaluation for SIADH. Conclusion: We recommend D5 1/2NS rather than D5 0.18% NS as the maintenance fluid given to children with pneumonia or infectious CNS diseases.

Assessment of Hydroureteronephrosis in Children Using Diuretic Radionuclide Ureterography (동위원소 이뇨 요관그람을 이용한 소아 요관폐쇄의 평가)

  • Kim, Jong-Ho;Lee, Dong-Soo;Kwark, Cheol-Eun;Lee, Kyung-Han;Choi, Chang-Woon;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Choi, Yong;Choi, Hwang
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.75-84
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    • 1994
  • The need for assessment of ureteric function in the patient with an obviousely dilated ureter has increased particularly with the added spectrum of asymptomatic patients presenting with hydrone-phrosis and hydroureter on antenatal and perinatal ultrasound. To assess the influence of ureteral status on kidney washout during $^{99m}Tc$-DTPA diuretic renography, ureteral images were reviewed in 80 children referred for hydronephrosis. A scintigraphically abnormal ureter was defined as an intense and continuous image of > 10 min during diuretic renography. Out of them, a total of 16 nephroureteral systems in 12 children with scintigraphically abnormal ureter were analyzed. A diuretic washout index using response half time (t1/2) by linear fitting after lasix injection, was determined on renal (Kt1/2) and ureteral (Ut1/2) curves (diuretic renogram vs. diuretic ureterogram). Diuretic ureterogram curve patterns corresponding to normal (type I), obstructive (II) and non-obstructive (III) cases were described. Compared with X-ray data, diuretic renography was highly sensitive (88%) and specific (99%) for detecting any ureteral abnormality. Despite an obstructive Kt1/2 (>20 min), no patient with an abnormal ureter underwent therapy at the ureteropelvic junction because the hydronephrosis regressed after surgery at the lower level. Our data indicate that the abnormal ureter findings during diuretic renography have to be recognized before therapy for children with hydeonephrosis.

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Normal Limits of Left Ventricular Volumes and Ejection Fraction Measured by Gated Myocardial Perfusion SPECT: Comparison of Tc-99m MIBI and Tl-201 (심근 게이트 SPECT로 측정한 좌심실 용적과 구혈률의 정상 값 확립: Tl-201과 Tc-99m MIBI 게이트 SPECT의 비교)

  • Hyun, In-Young;Seo, Jeong-Kee;Kwan, Jun;Park, Keum-Soo;Choe, Won-Sick;Lee, Woo-Hyung
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.3
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    • pp.147-152
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    • 2003
  • Purpose: We evaluated radioisotope and sex-specific differences of normal limits for left ventricle volumes (LWs) and ejection fraction (EF) using myocardial perfusion gated SPECT (g-SPECT). Materials and Methods: Rest Tl-201/post-stress Tc-99m MIBI g-SPECT measurements with acquisitions of 8-frame were evaluated for 70 patients (mean age $55{\pm}14.56%$ female) who either had < 10% pretest likelihood of CAD (n = 12) or had normal coronary angiography (EF > 50%) (n = 58). LVEF, LWs were automatically determined by quantitative gated SPECT using QGS program. Results: Similar results were obtained for mean LVEF between Tc-99m MIBI ($62%{\pm}7%$ and Tl-201 ($63%{\pm}8%$) g-SPECT measurements. In Contrast, Tl-201 g-SPECT had significantly lower LWs values ($EDV;\;74{\pm}23mL,\;ESV;\;28{\pm}14mL$) than Tc-99m MIBI g-SPECT ($EDV;\;82{\pm}25mL,\;ESV;\;32{\pm}15mL$) (p<0.05). Women had significantly lower EDV ($Tc-99m\;MIBI;\;71{\pm}18mL,\;Tl-201;\;65{\pm}17mL$), and ESV values ($Tc-99m\;MIBI;\;27{\pm}10mL,\;Tl-201;\;23{\pm}8mL$) compared with EDV ($Tc-99m\;MIBI;\;96{\pm}27mL,\;Tl-201;\;85{\pm}24mL$), and ESV Values ($Tc-99m\;MIBI;\;40{\pm}17mL,\;Tl-201;\;36{\pm}16mL$) of men (p<0.05). Women had significantly higher LV EF Values ($65%{\pm}7%$) than men ($60%{\pm}8%$) by Tl-201 gated SPECT (p<0.05). Conclusion: These data suggest significant differeuces in normal limits for LWs and EF, according to genders and radiopharmaceutical. Therefore, the evaluation of cardiac function in patients should consider radioisotope and sex-matched normal values.

Effect of Vinclozolin on the Onset of Puberty in Immature Female Rats (미성숙 암컷 흰쥐의 사춘기 개시에 미치는 Vinclozolin의 영향)

  • An, Na-Kyung;Lee, Sung-Ho
    • Development and Reproduction
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    • v.11 no.3
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    • pp.245-251
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    • 2007
  • Vinclozolin(VCZ), a systemic dicarboximide fungicide, has been used in the control of diseases caused by microorganism of some species in fruits, vegatables and ornamental plants. Although VCZ itself is a very weak antagonist for androgen receptor binding, both melabolites M1 and M2 are effective antagonists. The present study was undertaken to examine whether prepubertal exposure to VCZ affects on the onset of puberty and the associated reproductive parameters such as hormone receptor expressions in female rats. VCZ(10 mg/kg/day) was administered daily from postnatal day 21(PND 21) through the day when the first vaginal opening(V.O.) was observed. Gross anatomy and weight of reproductive tissues were compared to test the VCZ's effects on the cell proliferation. Furthermore, histological studies were performed to assess the structural alterations in the tissues. To determine the transcriptional changes in progesterone receptor(PR), total RNAs were extracted and applied to the semi-quantitative reverse transcription polymerase chain reaction(RT-PCR). As a result, delayed V.O. was shown in the VCZ group(PND $34.00{\pm}1.22$) compared to the control group(PND $38.20{\pm}1.92$; p<0.01). VCZ treatment significantly decreased the wet weight of ovaries and uteri compared to the control group(p<0.01). Graafian follicles and corpora lutea were observed only in the ovaries from the control animals, while numerous primary, secondary follicles and small atretic follicles were observed in the ovaries from VCZ group. Similarly, hypotrophy of luminal and glandular uterine epithelium was found in the VCZ group. In the semi-quantitative RT-PCR studies, the transcriptional activity of PR in ovary(p<0.01) from VCZ group were significantly lower than those from the control group while in uterus were similar compared with the control group. The present studies demonstrated that the acute exposure to VCZ during the critical period of prepubertal stage could inactivate the reproductive system resulting delayed puberty in female rats.

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Evaluation on Cooling Effects of Geothermal Heat Pump System in Farrowing House (지열 냉방시스템을 이용한 분만돈사의 냉방효과 분석)

  • Choi, H.C.;Song, J.I.;Na, J.C.;Kim, M.J.;Bang, H.T.;Kang, H.G.;Park, S.B.;Chae, H.S.;Suh, O.S.;Yoo, Y.S.;Kim, T.W.;Park, J.H.
    • Journal of Animal Environmental Science
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    • v.16 no.2
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    • pp.99-108
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    • 2010
  • The principal objective of this study was to investigate the cooling effects of geothermal heat pump system (GHPS) in farrowing house. A total of 96 sows were allocated to 2 pig housings (GHPS and conventional housing) with 48 for four weeks in summer season. During the experimental period of four weeks, the highest outside temperature observed was approximately $34.1^{\circ}C$, GHPS decrease indoor temperature of pig housing up to $30.9^{\circ}C$, but conventional pig housing was similar to outside temperature. Dust concentrations (maximum 61.4%) of particulate matter less than $10{\mu}m$ (PM 10) in GHPS-housing were lower than the conventional housing. GHPS showed no signigicant difference in carbon dioxide emission, whereas the ammonia gas concentration was significantly decreased in GHPS-housing compared to that of conventional housing. Sows in GHPS-housing showed significantly lower respiratory rate than those of the control group. GHPS did not affect hormone level, litter size and birth weight, but weaning weight of piglets was influenced by GHPS. Feed consumption of sows was significantly increased in GHPS-housing compared to the conventional hosing. These results suggest that GHPS decrease dust concentration, ammonia gas emission and indoor temperature of pig housing and may affect performance in sows and weaned piglets.

Immunohistochemical and Ultrastructural Characterization of the Choline Acetyltransferase-immunoreactive Nerve Cells in the Diagonal Band of Broca of the Rat Basal Forebrains (흰쥐의 전뇌 기저부 대각 Broca대에서 Choline Acetyltransferase 면역반응 신경세포에 대한 면역조직화학 및 미세구조)

  • Back, Seung-Keun;Chung, Young-Wha
    • Applied Microscopy
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    • v.29 no.3
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    • pp.383-403
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    • 1999
  • This study was performed to investigate the immunohistochemical and ultrastructural characterization of the choline acetyltransferase (ChAT)-immunoreactive nerve cells in the diagonal band of Broca of the rat basal forebrains, utilizing techniques of immunohistochemical and immunocytochemical microscopy. The ChAT-immunoreactivities were shown within neuronal cell bodies and processes by the light micoscope. According to cell shape and ratio of long axis vs short axis of cell body, the ChAT-immunoreaclive nerve cells in both vertical and horizontal limbs of the diagonal band of Broca were classified into 6 types. at the light microscopic level; round, oval, elongated, fusiform, triangular and polygonal types. As a result of the electron microscopic observation, the ChAT-immunoreactivated products appeared on the outer nuclear envelope, membranes of rough endoplasmic reticula (rER), free ribosomes and polysomes. Each cell type was subdivided into subtype I and II according to the several criteria such as volume of cell body, nuclear size relative to the cytoplasm, kinds and distribution of cell organelles and numbers and sorts of synapses. The subtype I of immnunoreactive nerve cells had large cell body and a small nucleus showing shallow indentations of nuclear evelope. In this subtype I with abundant cytoplasm, rER were well differentiated. Their long cisternae were parallelly ditributed and lamellated. One or two lamellar bodies and nematosomes were observed. The subtype II cell had small cell body and a large nucleus with deep indentations of nuclear envelope. In this subtype II with small cytoplasm, the rER were irregularly distributed and the lamellar body and nematosome were not found. A few axosomatic synapses in the subtype I and II were shown to be symmetric or asymmetric. The ratios of the symmetric synapse to the asymmetric one were investigated to be 1 : 2 and 1 : 4 in the subtype I and II, respectively. The axodendritic ones were almost asymmetric. But, the fusiform and triangular immunoreactive nerve cells were shown only to be subtype I. According to observations in this study, it is considered that the ultrastructural characterization in the 2 subtypes of each cell type may reflect the differences of the metabolic activities and projecting distances to the target cells.

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Interannual and Seasonal Variations of Water Quality in Terms of Size Dimension on Multi-Purpose Korean Dam Reservoirs Along with the Characteristics of Longitudinal Gradients (우리나라 다목적댐 인공호들의 규모에 따른 연별.계절별 수질변이 및 상.하류간 종적구배 특성)

  • Han, Jeong-Ho;Lee, Ji-Yeoun;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.43 no.2
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    • pp.319-337
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    • 2010
  • Major objective of this study was to determine interannual and seasonal water quality along with characteristics of longitudinal gradients along the reservoir axis of the riverine zone (Rz)-to-lacustrine zone (Lz). Water quality dataset of five years during 2003~2007 used here were obtained from Ministry of Environment, Korea and ten physical, chemical and biological parameters were analyzed in the study. Similarity analysis, based on moropho-hydrological variables of reservoir surface area, watershed area, total inflow, and outflow, showed that the reservoirs were categorized as three groups of large-dam reservoirs (Chungju Reservoir, Daecheong Reservoir and Soyang Reservoir), mid-size reservoirs (Andong Reservoir, Yongdam Reservoir, Juam Reservoir and Hapcheon Reservoir), and small-size reservoirs (Hoengseong Reservoir and Buan Reservoir). According to the data comparison of high-flow year (2003) vs. lowflow year (2005), dissolved oxygen (DO), pH, biological oxygen demand (BOD), suspended solids (SS), total nitrogen (TN), total phosphorus (TP), chlorophyll-a (CHL) and electrical conductivity (EC) declined along the longitudinal axis of Rz to Lz and water transparency, based on Secchi depth (SD), increased along the axis. These results indicate that transparency was a function of Values of pH, DO, SS, SD, and EC at each site were greater in the low-flow year (2005) than the high-flow year (2003), whereas values of BOD, COD, TN, TP and CHL were greater in the high-flow year (2003). When values of TN, TP, CHL and SD in nine reservoirs were compared in the three zones of Rz, Tz, and Lz, values of TN, TP and CHL declined along longitudinal gradients and SD showed the opposite due to the sedimentation processes from the water column. Values of TN were not statistically correlated with TP values. The empirical linear models of TP-CHL and CHL-SD showed significant (p<0.05, $R^2$>0.04). In the mid-size reservoirs, the variation of CHL was explained ($R^2$=0.2401, p<0.0001, n=239) by the variation of TP. The affinities in the correlation analysis of mid-size reservoirs were greater in the CHL-SD model than any other empirical models, and the CHL-SD model had an inverse relations. In the meantime, water quality variations was evidently greater in Daecheong Reservoir than two reservoirs of Andong Reservoir and Hoengseong Reservoir as a result of large differences of water quality by long distance among Rz, Tz and Lz.