Purpose : To evaluate the effectiveness and tolerance of the postoperative radiation therapy for patients with Stage III thymoma and to define the optimal radiotherapeutic regimen Materials and Methods : We retrospectively analyzed the records of 24 patients with Stage III thymoma who were referred for postoperative radiation therapy in our institution from June, 1987 to May, 1999. Surgical therapy consisted of total resection in one patient, subtotal resection in seventeen, and biopsy alone in six patients. Age of the patients was ranged from 20 to 62 years with mean age of 47 years. Male to female ratio was 14 to 10. Radiation therapy was delivered with linear accelerator producing either 6 MeV or 10 MeV photons. The irradiated volume included anterior mediastinum and known residual disease. The supraclavicular fossae were not irradiated. The delivered total dose was ranged from 30 to 56 Gy. One patient received 30 Gy and eighteen patients received minimum of 50 Gy. Follow up period was ranged from 12 months to 8 years with median follow up of 40 months. Results : The overall local control rate for entire group of patients was $67\%$ at 5 years. The cumulative local failure rates at one, three and five year were $18\%,\;28\%\;and\;33\%$, respectively. In patients treated with subtotal resection and biopsy alone, local control rate was $76\%\;and\;33\%$, respectively. The actuarial observed survival rate at 5 years was $57\%$, and actuarial adjusted survival at 5 years was $72\%$. The difference between 5 year survival rates for patients treated with subtotal resection and biopsy alone was not statistically significant $(62\%\;vs\;30\%)$. Conclusion : We might conclude that postoperative radiation therapy was safe and effective treatment for patients with Stage III thymoma. Postoperative radiation therapy is recommended in cases where tumor margin is close or incomplete resection is accomplished.
Purpose : We observed response to PPD skin test and local side reactions among subjects who received inoculation with Tokyo 172 BCG strain by percutaneous method using multiple puncture device. Methods : 138 infants and young children were enrolled at Yongdong Severance Hospital and 7 private clinics. 5TU PPD skin test were performed at 4 months after inoculation. The local reactions at multiple puncture site were observed in 3 days, 4~6 weeks, 36 weeks, and 48 weeks after inoculations and physical check up was done for evaluation of lymphadenopathy. Results : During 48 weeks of observation period, 96 subjects among 138 who were enrolled were followed up completely with records of PPD skin test and observation of local side reactions, presenting with the photos. The size of the induration after 48 hours of PPD skin test, was less than 5mm in six subjects(6.3%), greater than 10mm in sixty seven subjects(70.0%) and greater than 12mm in forty six subjects(47.9%). All subjects showed inflammatory reaction and pustules at multiple puncture sites and only just small papules, ulcer and pustules remained 4-6 weeks later. Eight to twelve weeks later, all local inflammatory skin reactions disappeared with remaining crust. After 48 weeks, 4(4.2%) subjects showed no scar with only faint stain on the puncture site. More than 70% of subjects showed more than 10 faint pin-point scars on the sites. However, the size of scar was clearly smaller compared to that of intradermal inoculation. There were no cases of lymphadenopathy. Conclusion : We observed good immune response to 5TU PPD skin test among the infant and young children who were immunized with percutanous inoculation of Tokyo 172 BCG strain. We could not find any severe local scar at inoculation sites. A degree of satisfaction of the parents whose children received the percutaneous injection was very high.
Purpose : We tried to find out the clinical parameters which predict the outcome of treatment in children with enuresis. Methods : Enuresis patients who visited our hospital during 2003-2007 were included. Parameters such as age, gender, height, weight, minimal voided volume, maximal voided volume, maximum functional bladder capacity, frequency of voiding, urine S,G. before and after sleep were measured and an enuresis diary was also recorded. The reduction in wetting frequencies were classified into three groups; none(<50%), partial(50-90%) and complete(90%) response groups. We also compared the 'initial responders' who showed improvement(${\ge}50%$) during the 2 weeks of evaluation and behavioral therapy to the 'initial non-responders'. Results : Parameters mentioned above showed no significant relation to the treatment out-come. The response rate during the 2 weeks of the evaluation period was 32%(49/151) [complete in 1.3% (2/151), partial in 29.6% (47/151)]. Two-months' treatment responses were complete in 14(40%), partial in 19(54.3%) and none in 2(5.9%) responders(n=35), while they were 10(13.5%), 46(62.2%) and 18(24.3%), respectively in the non-responders(n=73) (P<0.05). Conclusion : We suggest that initial 'responsiveness' can be used as a predictor for good treatment outcome in patients with enuresis.
In the present investigation, we analyzed the data of 1,318 patients (2,636 images) who underwent mammographic examinations and obtained the distribution of the patient age and compressed breast thickness. We measured also average glandular doses (AGD) as function of compressed breast thickness. In order to obtain the values of AGD, we measured half value layer (HVL) and tube output (mR/mAs) for each kVp and target/filter combination. Entrance surface air kerma (ESAK) was calculated from the tube output as measured for each voltage used under clinical conditions and from the tube loading (mAs). AGD per exposure were calculated by multiplying the ESAK values by the conversion factors tabulated by Dance. We obtained in this study the following conclusions. The mean value of compressed breast thickness for cranio-caudal (CC) view was 35.8mm and that for medio-lateral oblique (MLO) view was 43.3 mm. The mean value of AGD for CC view was 1.55 mGy and that for MLO view was 1.70 mGy. The AGD for MLO view was 0.15 mGy (10%) higher than that for CC view because the thickness for MLO view was on average 4.8 mm higher than that for CC view. The values of AGD increased with increasing compressed brest thickness. The increased AGD value was on average 0.34 mGy per 10 mm in the thickness ranges $10{\sim}80\;mm$, therefore differences between the AGD values of each thickness were relative large. Thus, it is considered to need limited doses for mammography with the upper end of exposure range at several different compressed brest thickness.
Purpose: To localize and compare the neural basis of verbal and visual human working memory, we performed functional activation study using $H_2^{15}O$ PET. Materials and Methods: Repeated $H_2^{15}O$ PET scans with one control and three different activation tasks were performed on six right-handed normal volunteers. Each activation task was composed of 13 match-ing trials. On each trial, four targets, a fixation dot and a probe were presented sequentially and subject's task was to press a response button to indicate whether or not the probe was one of the previous targets. Short meaningful Korean words, simple drawings and monochromic pictures of human faces were used as matching objects for verbal or visual memory. All the images were spatially normalized and the differences between control and activation states were statistically analyzed using SPM96. Results: Statistical analysis of verbal memory activation with short words showed activation in the left Broca's area, promoter cortex, cerebellum and right cingulate gyrus. In verbal memory with simple drawings, activation was shown in the larger regions including where activated with short words and left superior temporal cortex, basal ganglia, thalamus, prefrontal cortex, anterior portion of right superior temporal gyrus and right infero-lateral frontal cortex. On the other hand, the visual memory task activated predominantly right-sided structures, especially inferior frontal cortex, supplementary motor cortex and superior parietal cortex. Conclusion: The results are consistent with the hypothesis of the laterality and dissociation of the verbal and visual working memory from the invasive electrophysiological studies and emphasize the pivotal role of frontal cortex and cingulate gyrus in working memory system.
The therapeutic efficacy of antipsychotic drugs is generally attributed to their ability to block dopamine $D_2$ receptors. Classical $D_2$ antagonists are not effective to treat negative symptoms and produce extrapyramidal side effects On the other hand, atypical antipsychotic agents ameliorate negative symptoms without producing extra-pyramidal side effects, and it is reported to be associated with blockade of serotonin $5-HT_2$ receptors. The purpose of this study was to evaluate the effect of risperidone on neuroreceptors in the rat brain by Quantitative autoradiography method. In acute treatment group, risperidone was injected into Peritoneal cavity of male Wistar rats with dose of 0, 0.1, 0.25, 0.5, 1.0 and 2.0mg/kg in each group(5/group), and they were decapitated after 2 hours. In chronic treatment group, risperidone was injected with dose of 0, 0.1, and 1mg/kg(I.P.) for 21 days and decapitated after 24 hours following last treatment. The effect of risperodone on the binding of [$^3H$]spiperone to $5-HT_2$ and $D_2$ receptors were analysed in 4 discrete regions of the striatum, nucleus accumbens, and frontal cortex by quantitative autoradiography Acute treatment with risperidone reduced cortical $5-HT_2$ specific [$^3H$]spiperone binding to 32% of vehicle-treated control. Subcortical $5-HT_2$ specific [$^3H$]spiperone binding was not affected at all dose groups whereas a significant reduction (57%) in $D_2$ specific [$^3H$]spiperone binding was observed in risperidone treated group at doses of 1-2mg/kg. Chronic treatment with risperidone produced a decrease in the maximal number of cortical $5-HT_2$ receptors to 51% and 46% of control in 0.1mg/kg & 1mg/kg treated group respectively. In conclusion, risperidone is a cortical serotonin receptor antagonist with relatively weak antagonistic action on dopamine receptors. These effects oil neuroreceptors may explain the therapeutic effect of risperidone as a atypical antipsychotic agents.
Purpose: Helicobacter (H) pylori infection has been considered the most important cause of gastritis, dyspepsia, and gastroduodenal ulcer. Radioiodine can be accumulated in the remaining thyroid tissue, salivary gland, and stomach. We investigated if the high radiation induced by radioiodine in the stomach after high dose radioiodine therapy (HD-RIT) is effective in the eradication of H. pylori infection. Materials and Methods: One hundred ninety nine patients (M:F=33:166, age $46.7{\pm}12.3$ years) who had HD-RIT (dose $159.1{\pm}25.9\;mCi$, range 120-250 mCi) after thyroidectomy due to well differentiated thyroid cancer were enrolled. To detect H. pylori infection, the urea breath tests (UBT) were performed at 1 hour before HD-RIT and at 4 weeks after HD-RIT. The results of UBT were classified as positive (${\geq}50\;dpm$) or negative (<50 dpm), and analyzed its values. Results: Of 199 patients, 103 (51.8%) patients had positive UBT before HD-RIT. Of these, 80 patients had follow-up UBT after HD-RIT. Among them, 76 (95.0%) patients had persistent positive UBT and only 4 (5.0%) patients were changed negative UBT. Among 76 patients with persistent positive UBT, 26 (34.2%) patients had increased the values of follow-up UBT, 49 (64.5%) had decreased them, and 1 (1.3%) had shown the same value. The different values of UBT between before and after HD-RIT were $62{\pm}66.1\;dpm$ in increased one of follow-up UBT, and $153.3{\pm}157.1\;dpm$ in decreased one of follow-up UBT. Conclusion: We conclude that the radiation induced by HD-RIT is ineffective in the eradication of H. pylori infection. However, it could be influential the degree or distribution of H. pylori infection.
The sustainability of Cypripedium japonicum, a rare plant designated by the Korea Forest Service, is threatened due to artificial factors such as habitat loss and climate change etc. and internal factors such as changes in biological properties of the habitat etc. but conservation research has not been performed in South Korea. The objective of this study is to establish the species conservation strategies by analyzing the characteristics of their habitats, including: 1) Population characteristics, and 2) habitat analysis of the vegetation and abiotic environments. From April to September, 2014, population characteristics [density (stems $m^{-2}$), flowering rate (%), and leaf area ($cm^2$)] in Cypripedium japonicum habitats such as Chuncheon (CC), Hwacheon (HC), Muju (MJ), and Gwangyang (GY) and vegetation characteristics (plant sociological research and ordination analysis), and abiotic environments [temperature ($^{\circ}C$), relative humidity (%), transmitted light ($mol{\cdot}m^{-2}{\cdot}d^{-1}$) and canopy openness (%)] were measured. Cypripedium japonicum was mainly distributed at elevation 450 to 990 m and 5 to $30^{\circ}$ slope. Slope direction was shown as 0 to $110^{\circ}$. Habitats temperature (mean $18.94^{\circ}C$) was well matched to seasonal changes. Differences among sites showed greater level according to latitude difference. It showed the highest in habitat, GY located in the South. On the other hand, relative humidity (77.38%) didn't show much difference among sites. The average degree of canopy openness was 18.17%. It showed the highest at HC (22.1%) and the lowest at MJ (16.1%). The average degree of transmitted light was $9.1mol{\cdot}m^{-2}{\cdot}d^{-1}$. It showed the highest at CC ($10.6mol{\cdot}m^{-2}{\cdot}d^{-1}$) and the lowest at GY ($6.87mol{\cdot}m^{-2}{\cdot}d^{-1}$). Chlorophyll content showed average 26.12 SPAD. It showed the highest at MJ (30.64 SPAD value) and the lowest at HC (23.69 SPAD value). Leaf area was average $253.35cm^2$. It showed the highest at CC ($281.51cm^2$) and the lowest at HC ($238.23cm^2$).
The effect of weir construction (2009~2011) was investigated on algal bloom dynamics and surrounding conditions in the Youngsan River by analyzing the long-term (2001~2014) data provided by the Water Information System, Ministry of Environment. The data include chlorophyll a and water properties such as total suspended solids (TSS), ammonium ($NH_4{^+}$), nitrate ($NO_3{^-}$), orthophosphate ($PO{_4}^{3-}$), total nitrogen (TN), total phosphorus (TP) and DIN/DIP molar ratio collected from 12 stations along the channel of the river. Temporal variations were examined using data collected monthly from 2001~2014 and Box-Whisker plot was used to examine the difference in algal bloom dynamics between before (2006~2008) and after (2012~2014) the weir construction. Pearson's correlation analysis was also used to analyze the correlation of parameters. The results showed that TSS affecting water turbidity increased during the construction but decreased especially at the stations located in the upper and middle regions of the river after the construction. Ammonium concentrations increased whereas the concentrations of other nutrients decreased after the construction inducing an increase in N:P molar ratio. Chlorophyll a decreased suddenly during the construction but increased clearly after the construction at the stations where TSS decreased. This indicates that algal blooms can develop in the Youngsan River due to a decrease in turbidity that increases light penetration in water column although the concentrations of nutrients such as orthophosphate were reduced after the weir construction.
Asthma is a chronic inflammatory disorder of the airways, which characterized by bronchial hyperresponsiveness, reversible airflow limitation and respiratory symptoms. Internationally, the prevalence of asthma has been increased over last 3 decades. Recently, several studies of asthma have been reported with gradually increasing importance. To tesify the hypothesis that interleukin (IL)-4 and IL-10 may be an important determinant of the severity of airway inflammation, their expression was studied in mouse model of asthma. BALB/c mouse, IL-4 Knockout (KO) mouse and IL-10 KO mouse were sensitized with intraperitoneal injection of ovalbumin adsorbed to aluminum potassium sulfate, followed by challenges with intranasal ovalbumin on 3 consecutive days. The severity of pulmonary inflammation was assessed by eosinophilia in BAL fluid, number of total BAL cells, histopathological changes in lung tissues, and immunohistochemical staining against IL-4 and IL-10. In BAL fluid, the number of total cells was significantly increased in asthma induced mouse compare to the control. In asthma induced mouse, eosinophil was increased to 56% and neutrophil was 0.2%. In H &E stains, eosinophilic infiltration and epithelium hyperplasia were clearly noticed in asthma induced mouse. In immunohistochemical staining for IL-4 and IL-10, there was no positive reaction in control group. However, very strong reactions were appeared in asthma induced group. In this research, IL-4 and IL-10, which seem to play a central role in allergic asthma, KO mouse was utilized to test the causative relationship between airway inflammation and role of specific cytokine. Asthma induced IL-4 and IL-10 KO mice showed much decreased inflammatory reactions in the number of total BAL cells, in eosinophilic infiltration, and in immunohistochemical stains against diverse inflammatory proteins. These results suggest that IL-4 and IL-10 increase the asthmatic reactions in vivo mice model.
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