• Title/Summary/Keyword: 동산

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Analysis of Prognostic Factors according to WHO Classification for Thymic Epithelial Tumor (흉선종의 WHO 분류에 따른 예후인자의 임상적 고찰)

  • 서영준;금동윤;권건영;박창권
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.684-690
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    • 2004
  • Background: Primary thymic epithelial neoplasm is a type of mediastinal tumors that have various biologic and morphologic features. In this study, we reclassified 59 cases of thymic epithelial tumors by the new WHO classification. We inquired whether the new WHO classification has independent prognostic relevance by analyzing clinical characteristics of thymic epithelial tumors including Masaoka's clinical stage. Material and Method: From December 1986 to August 2003, 59. patients who underwent surgery in the Keimyung University Dongsan Medical Center with definite diagnosis of thymic epithelial tumor were studied. We analyzed the histologic subtype (WHO classification). clinical stage (Masaoka's clinical stage) and patient's characteristics (sex, age, myasthenia gravis, tumor size, invasion. recurrence, metastasis) as prognostic factors. We analyzed the relationship between histologic subtype and clinical stage. Result: 32 patients were male and 27 were female. Mean age was 50.1$\pm$14.2. From WHO A to C, all thymic epithelial tumors were reclassified by the new WHO classification. Six patients (10.2%) had Type A, 7 (11.9%) had Type AB, 7 (11.9%) had Type B$_1$, 10 (16.9%) had Type B$_2$ and 7 (11.9%) had Type B$_3$, 22 (37.3%) had Type C. Two factors were shown by multivariate analysis to be associated with a favorable prognosis: completeness of resection (p=0.003) and non-invasiveness (p=0.001). The overall 5-year survival of the 59 patients was 53%, subtype A and AB were 92.3%, B$_1$ and B$_2$ were 70.2%, and B$_3$ and C were 26.1%. The association between histologic subtype and invasive behavior (stage) was statistically significant (p<0.001). Conclusion: The WHO classfication is not only a histologic classfication of the thymic epithelial tumors but also a significant prognostic factor that influence the survival of thymic epithelial tumors.

The Effects of Maternal HBs antigenemia on the Neonatal Health (산모(産母)의 B형 간염(肝炎) Virus 보유(保有)가 신생아(新生兒) 건강(健康)에 미치는 영향(影響))

  • Park, Jung-Han;Yoon, Sung-Do;Kim, Chang-Youn;Lee, Sung-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.47-55
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    • 1984
  • To study the risk factors associated with maternal HBsAg carrier and the effects of maternal HBs antigenemia on the neonatal health, sera of 729 pergnant women admitted to the Keimyung University Hospital for delivery during the period of February 1-May 30. 1982 were tested for HBsAg by RPHA method and for anti-HBs by PHA method. Among them 43 women (5.9%) had HBsAg and 246 women (33.7%) had anti-HBs giving an infection rate of 39.6%. The interview data for 43 HBsAg positive mothers and randomly selected 210 HBsAg negative mothers showed a statistically significant association between acupuncture history and HBsAg positive rate (p<0.005) which suggest that acupuncture might have contributed significantly to the propagation of viral hepatitis in Korea. The living standard of HBsAg positive mothers was generally lower than that of HBsAg negative mothers which supports the hypothesis that environmental factors are associated with viral hepatitis B infection. None of the 43 neonates born to HBsAg positive mothers had HBsAg in their cord blood. Three months after birth, 35 out of 43 infants were retested and only one infant became HBsAg positive. At six months of age, 32 out of 35 infants were retested and none of them were HBsAg positive except the same infant who was positive at three months. Among 20 control infants of HBsAg negative mothers, all of them were HBsAg negative at three and six months follow-up. These findings are not consistent with the supposition that perinatal infection is a main route of viral hepatitis B transmission in south-east Asia including Korea. HBsAg positive mothers had significantly higher rate of premature delivery (27.9%) than HBsAg negative mothers (11.7%) (p<0.05). Also, the low birthweight incidence rate was higher among HBsAg positive mothers (23.3%) than negative mothers (14.1%) but this was not statistically significant (P=0.16). The premature rupture of membrane was more frequent among HBsAg positive mothers (25.5%) than negative mothers (11.1%) (p<0.05). There were no significant differences in the stillbirth rate and incidence of congenital anomalies between HBsAg positive and negative groups. It was not clarified in this study due to small sample size whether higher incidence of premature delivery and premature rupture of membranes among HBsAg positive mothers was due to HBs antigenemia per so or their lower living standard than HBsAg negative mothers.

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Cancinoma of Uterine Cervix Treated wvith High Dose Rate Intracavitary Irradiation : 1 Patterns of Failure (자궁경부암의 고선량율 강내치료후 실패양상에 대한 고찰)

  • Kim Ok Bae;Choi Tee Jin;Kim Jin Hee;Lee Ho Jun;Kim Yung Ae;Suh Young Wook;Lee Tae Sung;Cha Soon Do
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.369-376
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    • 1993
  • 226 patients with carcinoma of the uterine cervix treated with curative radiation therapy at the Department of Therapeutic Radiology, Dongsan hospital, Keimyung university, School of medicine, from July,1988 to May,1991 were evaluated. The patients with all stages of the disease were included in this study. The maximum and mean follow up durations were 60 and 43 months. The radiation therapy consisted of external irradiation to the whole pelvis (2700~4500 cGy) and boost parametrial doses (for a total of 4500~6300 cGy)with midline shild $(4{\times}10\;cm),$ and combined with intracavitary irradiation (5700~7500 cGy to point A). The distribution of patients according to the stage was as follows: stage IB 37 $(16.4\%),$ stage IIA 91 $(40.3\%),$ stage IIB 58 $(25.7\%),$ stage III 32 $(13.8\%),$ stage IV 8 $(3.5\%).$ The overall failure rate was $23.9\%$ (54 patients). The failure rate increased as a function of stage from $13.5\%$ in stage IB to $15.4\%$ in stage IIA, $25.9\%$ in stage IIB, $46.9\%$ in stage III, and $62.5\%$ in stage UV. The pelvic failure alone were 32 patients and 11 patients were as a components of other failure, and remaining 11 patients had distant metastasis only. Among the 43 patients of locoregional failure,28 patients were not controlled initially and in other words nearly half of total failures were due to residual tumor. The mean medial paracervical (point A) doses were 6700 cGy in stage IIB,7200 cGy in stage IIA,7450 cGy in stage IIB,7600 cGy in stage III and 8100 cGy in stage IV. The medial paracervical doses showed some correlation with tumor control rate in early stage of disease (stage Ib, IIA), but there were higher central failure rate in advanced stage in spite of higher paracervical doses. In advanced stage, failure were not reduced by simple increment of paracervical doses. To improve a locoregional control rate in advanced stages, it is necessary to give additional treatment such as concomitant chemoradiation.

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Radiation Therapy in Recurrence of Carcinoma of the Uterine Cervix after Primary Surgery (자궁경부암으로 수술 후 재발암의 방사선치료)

  • Kim, Jin-Hee;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.143-148
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    • 2003
  • Purpose: The purpose of this study was to evaluate treatment results in terms of the survival and failure patterns subsequent to radiation therapy in recurrent cervical cancer, fellowing primary surgery. Material and Methods: Between January 1990 and December 1999, 27 patients, with recurrent cervical cancer following primary surgery, were subsequently treated with radiation in the Department of Radiation Oncology, at the Keimyung University Dongsan Medical Center. Their median age was 48, ranging from 31 to 70 years old. With regard to the Initial FIGO stage on presentation, 20 and 7 patients were stages I and II, respectively. Twenty three patients had squamous cell carcinomas and 4 had adenocarcinomas. The time interval from the primary surgery to the recurrence ranged from 2 to 90 months with a median of 29 months. The recurrent sites were the vaginal cuff alone, the pelvic cavity and combined recurrence in 14, 9 and 4 patients, respectively. Radiation was peformed, with external and vaginal intracavitary radiation in 13 patients, external radiation alone in 13 and vaginal intracavitary radiation alone in another one. The median follow-up period was 55 months, ranging from 6 to 128 months. Results: The five year disease free survival (5y DFS) and five year overall survival (5y OS) rates were 68.2 and 71.9$\%$, respectively. There was a marginal statistically significant difference in the 5y DFS in relation to the recurrent site (5y DFS, 85.7$\%$ in vaginal cuff recurrence alone, 53.3$\%$ in pelvic cavity recurrence, p=0.09). There was no difference in the survival according to the time interval between the primary surgery and a recurrence. There was only a 7$\%$ local failure rate in the patients with a vaginal cuff recurrence. The major failure patterns were local failure in the patients with pelvic cavity recurrence, and distant failure in the patients with a combined recurrence. There were no complications above grade 3 after the radiation therapy. Conclusion: Radiation therapy was safe and effective treatment for a recurrent carcinoma of the uterine cervix following primary surgery, especially the external beam radiation and vaginal intracavitary irradiation achieved the best results in the patients with a vaginal cuff recurrence following primary surgery.

Hyperfractionation Radiation Therapy in Advanced Head and Neck Cancer (진행된 두경부암에서 다분할 방사선치료)

  • Kim, Jin-Hee;Ye, Ji-Won
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.112-117
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    • 2003
  • Purpose: The effects of hypefractionation radiation therapy, such as the failure pattern and survival, on the treatment results in advanced stage head and neck cancer were studied. Materials and Methods: Between September 1990 and October 1998, 24 patients with advanced stage (III, IV) head and neck cancers, were treated using hyperfractionation radiation therapy in the Department of Radiation Oncology at the Keimyung University Dongsan Medical Center. The male to female ratio was 7 : 1, and the age range from 38 to 71 years with the median of 56 years. With regard to the TNM stage, 11 patients were stage III and 13 were stage IV. The sites of primary cancer were the nasopharynx in six, the hypopharynx in 6, the larynx in five, the oropharynx in three, the maxillary sinus in three, and the oral cavity in one patient. The radiotherapy was delivered by 6 MV X-ray, with a fraction size of 1.2 Gy at two fractions a day, with at least 6 hours inter-fractional interval. The mean total radiation doses was 72 Gy, (ranging from 64.4 to 75.8 Gy). Follow-up periods ranged between 3 and 136 months, with the median of 52 months. Results: The overall survival rates at 3 and 5 years in all patients were 66.7$\%$, and 52.4$\%$. The disease-free survival rates at 3 and S years (3YDFS, 5YDFS) in all patients were 66.7$\%$ and 47.6$\%$. The 3YDFS and 5YDFS in stage III patients were 81.8$\%$ and 63.6$\%$, and those in stage IV patients were 53.8$\%$ and 32.3$\%$. Ten patients were alive with no local nor distant failures at the time of analyses. Six patients (25$\%$) died due to distant metastasis and 12.5$\%$ died due to local failure. Distant metastasis was the major cause of failure, but 2 patients died due to unknown failures and 3 of other diseases. The distant metastasis sites were the lung (3 patients), the bone (1 patient), and the liver (2 patients). One patient died of second esophageal cancer. There were no severe late complications, with the exception of 1 osteo-radionecrosis of the mandible 58 months after treatment. Conclusion: Although this study was peformed on small patients group, we considered hypefractionated radiation therapy for the treatment of advanced stage head and neck cancer might improve the disease free survival and decrease the local failure with no increase in late complications despite of the slight Increase in acute complications.

Result of Radiation Therapy of Sino-nasal Cancers Using Partial Attenuation Filter (투과성 필터를 이용하여 방사선 치료를 받은 부비동 및 비암의 치료 결과)

  • Kim, Jin-Hee;Kim, Ok-Bae;Choi, Tae-Jin
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.118-124
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    • 2007
  • [ $\underline{Purpose}$ ]: This study was to evaluate the survival and pattern of failure after radiation therapy of sino-nasal cancer using partial attenuation filer and wedged beams and to help radiotherapy planning of sino-nasal cancer. $\underline{Materials\;and\;Methods}$: Between February 1992 and March 2003, 17 patients with sino-nasal cancers underwent radiation therapy using partial attenuation filter at Dongsan Medical Center, Keimyung university. There were 9 male and 8 female patients. Patients' age ranged from 40 to 75 years (median 59 years). There were 10 patients of maxillary sinus cancer, 7 patiens of nasal cancer. The histologic type was squamous cell carcinoma in 11, adenoid cystic carcinoma in 4 and olfactory neuroblastoma in 2. The distribution of clinical stage by the AJCC system was 3 for stage II, 7 for III and 6 for IV. The five patients were treated with radiation alone and 12 patients were treated with surgery and postoperative radiation therapy. The range of total radiation dose delivered to the primary tumor was from 44 to 76 Gy (median 60 Gy). The follow-up period ranged from 3 to 173 months with median of 78 months. $\underline{Results}$: The overall 2 year survival rate and disease free survival rate was 76.4%. The 5 year and 10 year survival rate were 76.4% and 45.6% and the 5 year and 10 year disease free survival rate was 70.6%. The 5 year disease free survival rate by treatment modality was 91.6% for postoperative radiation group and 20% for radiation alone group, statistical significance was found by treatment modality (p=0.006). There were no differences in survival by pathology and stage. There were local failure in 5 patients (29%) but no distant failure and no severe complication required surgical intervention. $\underline{Conclusion}$: Radiation therapy of sino-nasal cancer using partial attenuation filter was safe and effective. Combined modality with conservative surgery and radiation therapy was more advisable to achieve loco-regional control in sino-nasal cancer. Also we considered high precision radiation therapy with dose escalation and development of multi-modality treatment to improve local control and survival rate in advanced sino-nasal cancer.

Radiation Therapy in Elderly Skin Cancer (노령의 피부암에서 방사선치료)

  • Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.113-117
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    • 2008
  • Purpose: To evaluate the long term results(local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. Material and Methods: The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma(10 patients), basal cell carcinoma(3 patients), verrucous carcinoma(1 patient) and skin adnexal origin carcinoma(1 patient). The most common tumor location was the head(13 patients). The mean tumor diameter was 4.9 cm(range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from $50{\sim}80$ Gy(mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. Results: The local control rates were 100%(15/15). In addition, the five year disease free survival rate(5YDFS) was 80% and twelve patients(80%) had no recurrence and skin cancer recurrence occurred in 3 patients(20%). Three patients have lived an average of 90 months($68{\sim}120$ months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. Conclusion: The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin cancer in elderly patients who achieved a good survival rate and few minor complications.

Imaging Inner Structure of Bukbawi at Mt. Palgong Provincial Park Using Ground Penetrating Radar (지하투과레이더를 활용한 팔공산 도립공원 북바위 내부구조 연구)

  • Kim, Hyeong-Gi;Baek, Seung-Ho;Kim, Seung-Sep;Lee, Na Young;Kwon, Jang-Soon
    • Economic and Environmental Geology
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    • v.50 no.6
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    • pp.487-495
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    • 2017
  • A granite rock body, called 'Bukbawi', located on a mountaineering trail at Mt. Palgong Provincial Park is popular among the public because it resembles a percussion instrument. If someone hits the specific surface area of this rock body, people can hear drum-like sound. Such phenomenon may be geologically associated with exfoliation process of the granite body or miarolitic cavity developed after gasses escaped during formation of granite. To understand better the inner structure causing drum-like sound, we carried out a non-destructive ground-penetrating radar survey. In this study, as our primary target is very close to the surface, we utilized 1 GHz antennas to produce high-resolution near-surface images. In order to construct 3-D internal images, the measurements were conducted along a pre-defined grid. The processed radargrams revealed that the locations associated with 'drum' sound coincide with strong reflections. In addition, both reflection patterns of fracture and cavity were observed. To further quantify the observed reflections, we simulated GPR scans from a synthetic fracture in a granite body, filled with different materials. The simulated results suggest that both exfoliation process and miarolitic cavity may have contributed to the 'drum' phenomena. Furthermore, the radargrams showed a well-developed cavity signature where two major reflection planes were crossed. Thus, our study is an example of non-destructive geophysical studies that can promote Earth Science in the broader community by examining geological structures attracting the public.

Validity of Peak Expiratory Flow for Assessing Reversible Airflow Obstruction (기류 가역성 평가에 있어서 최대호기유속 측정의 유용성)

  • Chol, Won-Il;Kwak, Jin-Ho;Kwon, Doo-Young;Han, Seung-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.522-529
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    • 2000
  • Backgrounds : Assessment of the presence and degree of reversibility of airflow obstruction is clinically important in patients with asthma or chronic obstructive pulmonary disease. The measurement of peak expiratory flow(PEF) is a simple, fast, and cheap method to assess the severity of obstruction and its degree of reversibility. Assessing the reversibility of airflow obstruction by peak expiratory flow(PEF) measurements is practicable in general practice, but its usefulness has not been well investigated. We compared PEF and $FEV_1$ in assessing reversibility of airflow obstruction in patients with chronic obstructive pulmonary disease or asthma and developed a practical criterion for assessing the presence of reversibility in general practice. Methods : PEF measurements were performed (Spirometry) in 80 patients(aged 24-78) with a history of asthma or chronic obstructive lung disease before and after the inhalation of 200 g salbutamol. The change in PEF was compared with the change in forced expiratory volume in one second($FEV_1$). Reversible airflow obstruction was analyzed according to American Thoracic Society(ATS) criteria. Results : A 12% increase above the prebronchodilator value and a 200ml increase in either FVC or $FEV_1$ reversibility were observed in 45%(36) of the patients. Relative operating characteristic(ROC) analysis showed that an absolute improvement in PEF of 30 l/min gave optimal discrimination between patients with reversible and irreversible airflow obstruction(the sensitivity and specificity of an increase of 30 l/min in detecting a 12% increase above the prebronchodilator value and a 200ml increase in either FVC or $FEV_1$ were 72.2% and 72.7% respectively, with a positive predictive value of 68.4%). Conclusions : Absolute changes in PEF can be used to diagnose reversible airflow obstruction.

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Prediction Model of Weed Population in Paddy Fields - II. Simple Prediction Method of Weed Population and Prediction Model of Weed Species (논 잡초(雜草) 발생예측(發生豫測) 모델 개발연구(開發硏究) - II. 간역(簡易) 잡초발생(雜草發生) 예측법(豫測法) 및 잡종별(雜種別) 예측(豫測)모델)

  • Lee, Han-Gyu;Lee, I.Y.;Ryu, G.H.;Lee, J.O.;Lee, E.J.
    • Korean Journal of Weed Science
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    • v.14 no.3
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    • pp.163-170
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    • 1994
  • The experiment was conducted in 1993 to find out a simple prediction method of weeds and to make the prediction models of weeds in paddy fields. The annuals producing fine seeds were apt to emerge at sampling soil only, on the contrary the perennials and the annuals producing large seeds tended not to emerge at sampling soil due to the miss of seeds at sampling. There was no appropriate regression between a total number of weeds emerged at sampling soil and that of weeds occurred in fields. The important annual weeds occurring in fields were able to predict by the number of weeds emerged at sampling soil, but it was difficult to predict the important perennial weeds. In case of Bidens tripartita producing large seeds and Eleocharis kuroguwai producing large tubers, the prediction coefficients were high as above 1.0, and that of Echinochloa crus-galli and Sagittaria pygmaea were comparatively high as 0.175 and 0.172, respectively. However the coefficients of the other weeds were much low as below 0.08. The prediction models for 9 species were made. The model of six species including E. crus-galli, M. vaginalis, R. indica, B. tripartita, E. triandra and S. pygmaea were linear regression with high significance, however that of 3 species including C. difformis, S. juncoides and E. kuroguwai were curve regression with high significance.

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