We retrospectively reviewed lung cancer patients who were treated with stereotactic ablative radiotherapy (SABR). We investigated the value of response evaluation after treatment by measuring the volume change of tumors on serial chest computed tomography (CT) examinations. The study included 11 consecutive patients with early-stage (T1-T2aN0M0) non-small cell lung cancer (NSCLC) who were treated with SABR. The median dose of SABR was 6,000 cGy (range 5,000~6,400) in five fractions. Sequential follow-up was performed with chest CT scans. Median follow-up time was 28 months. Radiologic measurement was performed on 51 CT scans with a median of 3 CT scans per patient. The median time to partial response ($T_{PR}$) was 3 months and median time to complete remission ($T_{CR}$) was 5 months. Overall response rate was 90.9% (10/11). Five patients had complete remission, five had partial response, and one patient developed progressive disease without response. On follow-up, three patients (27.2%) developed progressive disease after treatment. We evaluated the the response after SABR. Our data also showed the timing of response after SABR.
Curricular noticing is about how teachers understand the content and pedagogical opportunities inherent in curriculum materials. Since the enacted curriculum differs depending on which aspect of the curriculum material is paid attention to and how to interpret it, it is necessary to focus on Curricular Attending and Curricular Interpreting in Curricular Noticing for enhancing the teaching expertise of preservice teachers. First, this study categorized the objects that preservice elementary mathematics teachers attended when planning the lesson for rate. Second, in order to find out the reason for paying attention to those objects, it was analyzed what factors were related to interpret. By discussing the results, implications were drawn on how to use Curricular Noticing in preservice teacher education to enhance the pedagogical design competency of preservice elementary mathematics teachers.
Cis-Platinum (DDP) was utilized as a radiosensitizer in a pilot study for stage III and IV squamous cell carcinoma between 1984-1987, and DDP 20 $mg/M^2$/day was administered for 4 days at 3 week interval with concurrent radiotherapy. This study consisted of three phases: cytoreduction phase, eradicative treatment phase and adjuvant phase. Total 59 patients were subjected to evaluate a tumor response and its toxicity. During the eradicative phase,27 patients underwent surgery (group I ), 29 patients were treated with radiotherapy only (group II) and 3 patients did not complete the second phase of therapy. At the cytoreduction phase, $95\%$ response rate with complete response (CR) $47.5\%$ and partial response (PR) $47.5\%$ was observed. Complete tumor clearance (CTC) rate following 2nd phase of therapy was $84\%$ (47/56) with 26/27($96\%$) in group I achieved CTC with surgery and 21/29 ($72\%$) patients In group II achieved CTC following 2nd phase. $67\%$ of primary lesions and $70\%$ of nodal diseases in group I showed no tumor in the surgical specimen. $34\%$ of patiets who achieved CTC at 2nd phase developed recurrence and median time to recur was 8 months. Actuarial disease free survival at 4 years was $59\%$ and $51\%$(24/27) of patients who achieved CTC at 2nd phase were alive without any evidence of disease at median follow-up 31 months (range, 10-48 months). There was no significant difference in overall and disease free survival between group I and II between CR and PR group following 1st Phase. Only significant Prognostic factor in this study was the complete tumor clearance following 2nd phase theapy. In general, toxicity was not excessive. Author concludes that this study confirmed the significant radiosensitizing effect of DDP with the acceptable toxicity and warrant the prospective study to determine optimum scheduling for DDP and radiotherapy which maximizes the therapeutic gain.
Purpose : To improve treatment modality and results by analysis of clinical characteristics, local control, survival and recurrence rate in limited stage small cell lung cancer. Materials and Methods : patients with limited stage small cell lung cancer were treated with combined radiation and chemotherapy from Feb. 1986 to Dec. 1992 at the National Medical Center We followed up on 21 patients ($81\%$), who were mostly irradiated with 4,000-5.000cGy ($75\%$ of all Patients) in the results by the analysis retrospectively. Survival rate was evaluated by the Kaplan-Meier method Results : Mean survival of irradiated patients with limited small cell lung cancer was 12 months. 1-rear and 2-rear survival rate were $65.3\%$ and $15.4\%$ Tumor response rate and median survival after combined chemotherapy and irradiation were the following: $50\%$ and 15 months of complete response, and $23\%$ and 11 months of partial response respectively. Response rates by radiation dose were $66\%$ for below 4,000cGy $69\%$ for between 4,000-5,000cGy and $86\%$ for above 5,000cGy. 21 of all patients showed treatment failure($81\%$) which as appeared 9 of local failure.9 of distant failure and 3 of local and distant failure. Conclusion : Local response rate after induction chemotherapy alone in limited stage of small cell lung cancer was $54\%$. Furthermore it was increased to $73\%$ after adding of radiation. We have to increase radiation dose above 5,000cGy and need to try new effective chemotherapy agents for the improvement of local control and survival rate and also will try concurrent chemoradiotherapy in near time.
Purpose : To report the clinical experience with amitriptyline for managing children with cyclic vomiting syndrome (CVS). Methods : Totally, eleven children (eight males) were diagnosed with CVS. Of these, medical records were reviewed for eight children treated with amitriptyline; three children were not treated because one was not followed up and two were kept under observation to study the natural course without medication, because the frequency of vomiting had recently decreased to less than one episode per year. The eight amitriptyline-treated children were divided into three groups by the therapeutic response: (1) complete remission (CR), with no recurrence of symptoms after treatment; 2) partial remission (PR), in which the frequency of symptoms decreased by almost 50% after treatment; and (3) no response. Results : For the eight amitriptyline-treated children, the mean age of symptom onset was 4.7 (0.3-7) yr and mean age at diagnosis was 8.9 (6.0-11.3) yr. The mean number of vomiting episodes was 8.8 (2-25) per year, and the duration of vomiting in each episode ranged from 3 hours to 5 days. CR was achieved in five (62.5%) of the eight amitriptyline-treated children (0.2-0.8 mg/kg/day orally, at night) and PR was achieved in three children (37.5%). Two children relapsed on discontinuation of amitriptyline by their parents decision but showed improvement on remedication. No adverse effects were noted throughout the study period. Conclusion : Amitriptyline can be used in long-term prophylaxis for the management of children with CVS aged over 6 yr. However, a large-scale study is needed to ascertain its effects.
Kang, Hee;Yoo, Young;Yu, Jinho;Park, Yang;Koh, Young Yull
Clinical and Experimental Pediatrics
/
v.46
no.10
/
pp.1013-1018
/
2003
Purpose : Bronchial hyperresponsiveness(BHR) in asthma is thought to be a consequence of underlying airway inflammation. But the mechanism responsible for persistent BHR in adolescents with long-term asthma remission is poorly understood. The aim of this study was to examine whether BHR in adolescents with asthma remission is associated with peripheral blood eosinophilia and/or increased serum levels of eosinophil cationic protein(ECP). Methods : We studied 35 adolescents with long-term asthma remission(neither symptoms nor medication during the previous two years) who have persistent BHR(remission group) and 35 adolescents with symptomatic asthma(symptomatic group) who were matched for methacholine provocative concentration producing a 20% fall in $FEV_1(PC_{20})$ with subjects in the remission group. The peripheral blood eosinophil counts and serum ECP concentrations were compared between these two groups. Correlations between $PC_{20}$ and peripheral blood eosinophil counts or serum ECP concentrations were assessed in these two groups. Results : Peripheral blood eosinophil counts and serum ECP concentrations were significantly lower in the remission group than in the symptomatic group($273{\pm}108$ vs. $365{\pm}178/{\mu}L$; $16.3{\pm}9.4$ vs. $26.5{\pm}15.1{\mu}g/L$, both, P<0.05). $PC_{20}$ was correlated with peripheral blood eosinophil counts and serum ECP concentrations in the symptomatic group(r=-0.385, P=0.022; r=-0.439, P=0.008), but not in the remission group(r=-0.292, P=0.089; r=-0.243, P=0.159). Conclusion : BHR in adolescents with long-term asthma remission is not associated with peripheral blood eosinophilia or an increase in serum ECP concentration, which suggests that BHR in this clinical setting may not be attributed to airway eosinophilic inflammation. Further studies including direct assessment of airway inflammation are needed to confirm this conclusion.
Lee Kyoung-Jae;Han Jae-Hyuk;Lee Young-Mock;Kim Ji-Hong;Kim Pyung-Kil
Childhood Kidney Diseases
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v.5
no.2
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pp.117-124
/
2001
Purpose : Since Mendoza(1990)'s report that long term methylprednisolone pulse therapy by Mendoza protocol (MP therapy) is a good treatment option in focal segmental glomerulosclerosis(FSGS), there have been reports of the effects of this therapy in steroid-resistant nephrotic syndrome. However, no studies have been performed on the effects of MP therapy in steroid- dependent nephrotic syndrome and secondary nephrotic syndrome. In this study, we investigated the effects of long term MP therapy in primary and secondary nephrotic syndrome in which previous treatment options were not effective. Methods : We chose 10 children who were diagnosed with steroid-dependent minimal change nephrotic syndrome(SD-MCNS), who had shown frequent relapse during the immunocompromised or cytotoxic therapy Period, and 6 children with FSGS and 5 children with secondary nephrotic syndrome children, who had shown no response during the previous therapy period. We treated these patients according to Mendoza protocol involving infusions of high doses of methylprednisolone, often in combination with oral cyclophosphamide for 82 weeks. Results : In all the 10 children with SD-MCNS, complete remission was visible on average of $18{\pm}9$ days after MP therapy was started. However, all these children relapsed during or after MP therapy. In these children, the mean relapse rate prior to MP therapy was $2.1{\pm}1.0$ relpases/year, which was reduced to $1.4{\pm}0.9$ relapses/year during MP therapy(P>0.05) and rose to $2.7{\pm}1.0$ relapse/year after MP therapy. Of the 6 children with FSGS, 4 children($67\%$) showed complete remission, of whom 3 children($50\%$) remained in the remission status during the follow up period, $1.2{\pm}0.7$ years, after the end of MP therapy. 2 children($33\%$) showed no response. All of the 5 children with secondary nephrotic syndrome showed remission and remained in the remissiom status during the follow up period, $1.7{\pm}0.6$ years The only side effect of MP therapy was transient hypertension in 10 children of ail subjects during the intravenous infusion of methylprednisolone. Conclusion : We conclude that although long term MP therapy is not effective in the treatment of SD-MCNS, it is an effective therapy against intractable FSGS and secondary nephrotic syndrome. (J Korean Soc Pediatr Nephrol 2001 ; 5 : 117-24)
Since Jan. 1991 a prospective randomized study for Stage III unresectable non small cell lung cancer (NSCLC) has been conducted to evaluate the response rate and tolerance of induction chemotherapy with MVP followed by hyperfractionated radiotherapy and evaluate the efficacy of maintenance chemotherapy in Asan Medical Center. All patients in this study were treated with hyperfractionated radiotherapy (120 cGy/fx BID, 6480 cGy/54 fx) following 3 cycles of induction chemotherapy, MVP (Mitomycin C 6 $mg/m^2,$ Vinblastin 6 $mg/m^2,$ Cisplatin 60 $mg/m^2$) and then the partial and complete responders from induction chemotherapy were randomized to 3 cycles of adjuvant MVP chemotherapy group and observation group. 48 patients were registered to this study until December 1992; among 48 patients 3 refused further treatment after induction chemotherapy and 6 received incomplete radiation therapy because of patient's refusal, 39 completed planned therapy. Twenty-three $(58\%)$ patients including 2 complete responders showed response from induction chemotherapy. Among the 21 patients who achieved a partial response after induction chemotherapy,1 patient rendered complete clearance of disease and 10 patients showed further regression of tumor following hyperfractionated radiotherapy. Remaining 10 patients showed stable disease or progression after radiotherapy. Of the sixteen patients judged to have stable disease or progression after induction chemotherapy, seven showed more than partial remission after radiotherapy but nine showed no response in spite of radiotherapy. Of the 39 patients who completed induction chemotherapy and radiotherapy, 25 patients $(64\%)$ including 3 complete responders showed more than partial remission. Nineteen patients were randomized after radio-therapy. Nine Patients were allocated to adjuvant chemotherapy group and 4/9 showed further regression of tumor after adjuvant chemotherapy. For the time being, there is no suggestion of a difference between the adjuvant chemotherapy group and observation group in distant metastasis rate and survival. Median survival time was 13 months. Actuarial survival rates at 6,12 and 18 months of 39 patients who completed this study were $84.6\%,\;53.7\%\;and\;40.3\%,$ respectively. The partial and complete responders from induction chemotherapy showed significantly better survival than non-responders (p=0.028). Incidence of radiation pneumonitis in this study group was less than that in historical control group inspite of induction chemotherapy. All patients tolerated hypertractionated radiotherapy without definite increase of acute complications compared with conventional radiotherapy group. The longer follow up is needed to evaluate the efficacies of induction and maintenance chemotherapy and survival advantage by hyperfractionated radiotherapy but authors are encouraged with an excellent tolerance, higher response rate and improvement of one year survival rate in patients of this study.
본 논문에서는 FTTC/VDSL (Fiber-to-the-Curb/Very High-speed Digital Subscriber Line) 전송시스템의 개발동향과 ANSI, ETSI, ITU등의 표준화 위원회에서 현재 진행중인 VDSL 시스템의 표준화 작업에 대해 기술하였다. 특히, POTS (Plain Old Telephone Service), BA-ISDA(Basic Access Integrated Services Digital Network), HDSL(High-rate Digital Subscriber Line), SDSL (Single-pair HDSL), ADSL(Asymmetric Digital Subscriber Line) 등의 다양한 xDSL (Digital Subscriber Line) 서비스들에서 발생하는 NEXT (Near-end Crosstalk)/FEXT (Far-end Crosstalk)와 같은 crosstalk를 최소화하기 위해 제안된 VDSL시스템의 주파수 대역과 PSD (Power Spectral Density) mask에 관해 설명하고, 순방향(down-stream) 채널과 역방향(upstream) 채널의 데이터 전송률이 대칭적인 VDSL전송시스템과 비대칭적인 VDSL 전송시스템 간의 주파수대역의 호환성 문제, RFI(Radio Frequency Interference) ingress/egress 문제의 해결 방안에 관해 기술하였다. 또한, 현재 VDSL Coalition과 VDSL Alliance 간에 논의 중인 VDSL 전송시스템의 변복조 방식에 관한 표준화 작업과정 및 순방향과 역방향에 할당될 band 개수에 따른 시스템 성능의 장단점 등에 관해 살펴보았다. 끝으로 현재 국내에서 개발되고 있는 FTTC/VDSL 전송시스템의 전체구조를 요약하고, 네트워크에서 가입자쪽으로 순방향 데이터 전송에 사용된 51.84 Mb/s 19-CAP (Carrierless Amplitude/Phase Modulation) 전송시스템과 가입자 댁내에서 네트워크 방향으로 역방향 데이터 전송에 사용된 1.62 Mb/s QPSK (Quadrature Phase Shift Keying) burst-mode TDMA (Time Division Multiple Access) 전송시스템 등의 동작 원리 및 구조를 기술하였다.
The Journal of the Korean bone and joint tumor society
/
v.17
no.2
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pp.58-64
/
2011
Purpose: The purpose of this study is to observe unicameral bone cyst (UBC) outcome after the fracture has healed and if there is any identifiable prognostic factors. Materials and Methods: 13 UBC patients with pathologic fracture from 2001 to 2010 were reviewed. The mean follow up were 26 months (3-90 months). There were 11 male and 2 female patients and the mean age of the patients were 10.2 years old (6-16 years). 9 involved proximal humerusand 2 involved humerus shaft and 1 involved proximal femur and 1 involved proximal tibia. The treatment of UBC fracture was conservative cast application to heal the fracture initially, and 1 patient was treated with primary auto bone graft and open reduction with internal fixation. 5 patients were treated with steroid injection during follow up period and 2 patients with auto bone graft. We analyzed the change of UBC during pathologic fracture healing period and prognostic factor about age, the size of UBC, the involvement of physis. Results: The mean duration of the fracture healing was 8.2 months. Complete healing were occurred at 4 patients (31%). No statiscal difference was checked with age about UBC healing (p=0.42). But, more larger size about UBC and more closer to physis, the healing was difficult (p=0.05, p=0.03). Conclusion: While pathologic fracture of UBC was possibly healed, active treatment should be applied especially those cysts that involvescloser area of the physis or large size.
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