• Title/Summary/Keyword: 사용 경험

Search Result 5,941, Processing Time 0.045 seconds

Increased Peripheral NK Cell Fraction and Their Cytolytic activity in Patients with History of Recurrent Spontaneous Abortion (말초혈액 자연살해세포 분획 및 세포용해 활성도 분석을 통한 습관성 유산 위험군의 진단적 유용성에 관한 연구)

  • Choi, Ji-Young;Hwang, Su-Jin;Han, Ae-Ra;Yoo, Ji-Hee;Park, Dong-Wook;Park, Chan-Woo;Kim, Hye-Ok;Cha, Sun-Hwa;Kim, Jin-Young;Song, In-Ok;Koong, Mi-Kyoung;Kang, In-Soo;Yang, Kwang-Moon
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.37 no.2
    • /
    • pp.115-124
    • /
    • 2010
  • Objective: To testify whether the increased peripheral blood natural killer (pbNK) cells fraction and their cytolytic activity could coincide with patient's history of recurrent spontaneous abortion (RSA) and to evaluate these factors are can be valuable diagnostic markers in RSA. Methods: Women with a history of RSA comprised the patient group (n=35). Normal fertile women, who were experienced at least one healthy term birth without history of infertility or recurrent miscarriage, were included as the healthy control group (n=15). The pbNK cells of $CD3^-/CD56^+/CD16^+$ and their cytolytic activities against K562 cells were measured by flow cytometry and the values were compared between study and control groups. Results: Proportions of pbNK cells among peripheral blood monocytes (PBMC) ($14.2{\pm}5.2$ vs. $9.4{\pm}3.7%$, p=0.002, 95% confidence interval [CI], 1.8 to 7.8) was significantly higher in the patient group. The odds ratio of having RSA history was increased as 8.4 folds (59% of sensitivity, 80% of specificity, and 95% CI: 2.0 to 35.8) in patients who showed pbNK cells fraction above 12.1% which was determined as cut-off value by using ROC curve analysis. The cytolytic activities of pbNK cells which measured by three different ratio of effecter pbNK cells to target K562 cells and calculated by the percent of cytolytic K562 cells, were significantly higher in study group than that of control group (in 50:1 ratio, $48.3{\pm}19.0$ vs. $31.3{\pm}11.9%$, p=0.002; in 25:1 ratio, $37.0{\pm}18.1$ vs. $20.2{\pm}9.2%$, p<0.001; in 12.5:1 ratio, $23.5{\pm}12.7$ vs. $12.4{\pm}7.3%$, p=0.001). With the cut-off values of cytolytic activity of pbNK cells as 43.1% (50:1), 26.9% (25:1), and 17.4% (12.5:1) each, the risk of having RSA history was increased by 10.0, 11.4, and 15.0 folds in patients who had increased in each effector of pbNK to target of K562 cells ratio. Conclusion: The analysis of pbNK cells fraction and their cytolytic activity can be valuable diagnostic markers for RSA. We are going to planning the large scaled studies which include the data of obstetric outcomes in subsequent pregnancies to clarify our results of this study.

Serogroup and Antimicrobial Resistance of Streptococcus pneumoniae Isolated from Oropharynx in Children Attending Day Care Center (유아원 소아의 구인강에서 분리된 폐구균의 혈청군과 항균제 내성에 관한 연구)

  • Kim, Kyung Hyo;Lee, Jong Eun;Whang, Il Tae;Ryu, Kyung Ha;Hong, Young Mi;Kim, Gyoung Hee;Lee, Keun;Kang, Eun-Suk;Hong, Ki-Sook
    • Clinical and Experimental Pediatrics
    • /
    • v.45 no.3
    • /
    • pp.346-353
    • /
    • 2002
  • Purpose : Penicillin- and multidrug-resistant S. pneumoniae poses a serious threat to clinicians because the rate of resistance of S. pneumoniae to penicillin in Korea has surged up to the world's highest level. This study was performed to assess the carriage rate, serogroups and antimicrobial susceptibility of S. pneumoniae isolated from oropharynx in children. Methods : From March to July 1998, 209 children under 5 years of age were recruited from five day care centers. The carriage rate for pneumococci was obtained. Antimicrobial susceptibilities were determined with the E-test and agar dilution methods. Serogrouping was performed on 48 of the pneumococcal isolates by the Quellung reaction. Results : The carriage rate of S. pneumoniae was 30.1%. Antimicrobial susceptibility profiles were available for 59 of the isolates. Sixty-six percent of isolates were not susceptible to penicillin, and multidrug-resistance was observed in 76.3% of the isolates. A high proportion of the penicillin-resistant strains showed associated resistance to trimethoprim-sulfamethoxazole, tetracycline, erythromycin, and oxacillin. The most prevalent oropharyngeal serogroups were 19, 6, 3, 23, and 29. Resistance of the pneumococcal isolates to penicillin was different according to the serogroups. All of the strains of serogroup 19, 23, and 29 was resistant to penicillin but 87.5% of serogroup 3 strains were susceptible to penicillin. Conclusion : The resistance rate of S. pneumoniae isolated from oropharynx in children was very high to penicillin and other antimicrobial agents. For the reduction of the drug-resistant rate of S. pneumoniae, clinicians should be required to be more judicious in their use of antimicrobial agents.

A Study of Factors Associated with Software Developers Job Turnover (데이터마이닝을 활용한 소프트웨어 개발인력의 업무 지속수행의도 결정요인 분석)

  • Jeon, In-Ho;Park, Sun W.;Park, Yoon-Joo
    • Journal of Intelligence and Information Systems
    • /
    • v.21 no.2
    • /
    • pp.191-204
    • /
    • 2015
  • According to the '2013 Performance Assessment Report on the Financial Program' from the National Assembly Budget Office, the unfilled recruitment ratio of Software(SW) Developers in South Korea was 25% in the 2012 fiscal year. Moreover, the unfilled recruitment ratio of highly-qualified SW developers reaches almost 80%. This phenomenon is intensified in small and medium enterprises consisting of less than 300 employees. Young job-seekers in South Korea are increasingly avoiding becoming a SW developer and even the current SW developers want to change careers, which hinders the national development of IT industries. The Korean government has recently realized the problem and implemented policies to foster young SW developers. Due to this effort, it has become easier to find young SW developers at the beginning-level. However, it is still hard to recruit highly-qualified SW developers for many IT companies. This is because in order to become a SW developing expert, having a long term experiences are important. Thus, improving job continuity intentions of current SW developers is more important than fostering new SW developers. Therefore, this study surveyed the job continuity intentions of SW developers and analyzed the factors associated with them. As a method, we carried out a survey from September 2014 to October 2014, which was targeted on 130 SW developers who were working in IT industries in South Korea. We gathered the demographic information and characteristics of the respondents, work environments of a SW industry, and social positions for SW developers. Afterward, a regression analysis and a decision tree method were performed to analyze the data. These two methods are widely used data mining techniques, which have explanation ability and are mutually complementary. We first performed a linear regression method to find the important factors assaociated with a job continuity intension of SW developers. The result showed that an 'expected age' to work as a SW developer were the most significant factor associated with the job continuity intention. We supposed that the major cause of this phenomenon is the structural problem of IT industries in South Korea, which requires SW developers to change the work field from developing area to management as they are promoted. Also, a 'motivation' to become a SW developer and a 'personality (introverted tendency)' of a SW developer are highly importantly factors associated with the job continuity intention. Next, the decision tree method was performed to extract the characteristics of highly motivated developers and the low motivated ones. We used well-known C4.5 algorithm for decision tree analysis. The results showed that 'motivation', 'personality', and 'expected age' were also important factors influencing the job continuity intentions, which was similar to the results of the regression analysis. In addition to that, the 'ability to learn' new technology was a crucial factor for the decision rules of job continuity. In other words, a person with high ability to learn new technology tends to work as a SW developer for a longer period of time. The decision rule also showed that a 'social position' of SW developers and a 'prospect' of SW industry were minor factors influencing job continuity intensions. On the other hand, 'type of an employment (regular position/ non-regular position)' and 'type of company (ordering company/ service providing company)' did not affect the job continuity intension in both methods. In this research, we demonstrated the job continuity intentions of SW developers, who were actually working at IT companies in South Korea, and we analyzed the factors associated with them. These results can be used for human resource management in many IT companies when recruiting or fostering highly-qualified SW experts. It can also help to build SW developer fostering policy and to solve the problem of unfilled recruitment of SW Developers in South Korea.

Training, Working State and Ways of Improving Work of Sex Education Counselors in Health Centers (대구·경북지역 보건소 성교육 담당자의 훈련 및 업무현황과 개선방안)

  • Yeom, Seok-Hun;Kim, Chang-Yoon;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
    • /
    • v.27 no.2
    • /
    • pp.159-175
    • /
    • 2002
  • This present study was conducted to reduce problems by analyzing training and work of sex education counselors and to come up with ways of improving sex education counseling. A survey was performed in 57 subjects at health centers who finished training on sex education counseling in Taegu Metropolitan City and cities, kuns, and gus of Kyongsangbuk Province from December, 1999 to February, 2000 on general characteristics, items relating to the work of sex education, and ways of improving work. The results are as follows. Out of the sex education counselors, there were 55 females, taking 99% out of the total counselors, and the average age of these counselors was 42 years. There were 26 nurses, and their government grade was level 7 in 36 and level 6 in 14. The members who had finished sex education counseling at each public health center was 2.1 counselors at an average. Among those had finished sex education training, 30 was not in sex counseling. When analyzed the answers given by 27 sex counselors who were counseling at the time and the results are as follows. As for the amount of work, 15 answered to have too much work and 1 little; as for having pride on being a sex education counselor, 18 answered to felt pride and 7 so-so; as for materials for sex education and counseling, 25 answered to use videos, 23 books, 10 pictures, 8 beam projectors, and 7 slides. All of the subjects answered to have other responsibilities besides sex education and counseling, and the satisfaction felt on having other responsibilities was 6 satisfied, 12 average, and 2 dissatisfied. The proportion of work load in sex education counselors was other work besides sex education 76.2%, sex education at schools 7.6%. collecting sex education materials 5.7%, counseling of adolescents 4.9%. development of sex education materials 3.5%, and administrative work related to sex education 3.1%. The biggest problem of their work was over-load in 9 respondents, lack of sex education materials in 8, lack of training in 6, and shortage of professionals in 2. As for the answer on the ways of improving matters related to work of sex education counselors, the most frequent answer was that the organizations responsible for sex education needs to be more professional and systematic, followed by dividing the work load so that they could concentrate on developing education materials and sex education and counseling. Thus, the results of the present study indicated that in order to utilize human resources efficiently, the speciality of counselors needs to be considered when making personnel transfers among health centers, and continued activity as a sex education counselor needs to promoted by reducing other overloading tasks. And systematic re-training of the counselors needs to be done, and education manuals that are diverse and realistic to applicable to the children, who are to be the subjects of sex education, need to be developed and distributed.

  • PDF

A Clinical Study on Transpulmonary Leukostasis and Prophylactic Effects of Steroid in Cardiac Surgery (심장수술시 백혈구의 폐내정체와 스테로이드의 예방적 효과에 관한 연구)

  • 최석철
    • Biomedical Science Letters
    • /
    • v.2 no.2
    • /
    • pp.133-151
    • /
    • 1996
  • After cardiac surgery, it has been recognized that various complications were associated with injured humoral and cellular immunity by cardiopulmonary bypass(CPB). Especially, in postoperative pulmonary dysfunction, transpulmonary leukostasis followed complement activation and inflammatory responses are major pathogen. Some studies have showed that pretreated-corticosteroids before CPB protected postoperative pulmonary dysfunction. Corticosteroids may inhibit complement and leukocyte activation. On based previous studies, present investigator determined changes of leukocyte counts and transpulmonary leukostasis during cardiac surgery and postoperative periods. For the evaluation of postoperative pulmonary function and edema, $PaO_2$ and chest X-ray were compared between pre-CPB and post-CPB. Fever and other parameters were also observed postoperatively. The aim of this study was to define for the prophylactic effects of corticosteroid(Solu-Medrol: 30mg/kg) on all the researched parameters. This study was prospectively designed with randomized-blind fashion for 50 patients undergoing cardiac surgery. According to the purpose of study, all patients were divided into placebo and steroid group. : Placebo group was 25 patients received normal saline(not corticosteroid), and steroid group was 25patients received corticosteroid(Solu-Medrol: 30mg/kg) before initiation of CPB. The results of study were summarized as follows. 1. Total peripheral leukocyte counts decreased significantly at 5 minutes of CPB in all patients(P<0.01), and began to increase progressively at later periods of CPB with neutrophilia. The significant rise remained at postoperative 7th day(P<0.05). 2. During partial CPB, transpulmonary leukostasis occurred in placebo group(P<0.001), whereas it was prevented in steroid group. 3. In both groups, peripheral lymphocyte counts were stable during CPB, but began to reduce at time of intensive care unit(ICU) and the lymphocytopenia remained until postoperative 3rd day. The lymphocyte counts recovered on postoperative 7th day. 4. In both groups, peripheral counts of monocyte were relatively stable in the early peroid of CPB, and increased gradually in the later periods of CPB. This significant monocytosis remained throughout postoperlative periods(P<0.05). 5. The mean value of postoperative $paO)_2$ was lower than that of pre-CPB in placebo group(P=0.01) but didn't significant in steroid group(P=0.90). In the incidence of pulmonary edema signs and fever, placebo group was higher than steroid group(P=0.001, p=0.01, respectively). However mechanical respiratory supporting and care periods at intensive care unit were not significant difference between two groups(P>.0.05).With the above results, the investigator concluded that leukocyte activation and pulmonary sequestration were caused by cardiac surgery with CPB and demonstrated that high dose corticosteroid will provide prophylactic effect for pulmonary leukostasis and higher neutrophilia. These effects may ameliorate postoperative pulmonary dysfunction and contribute to postoperative less morbidity. However, further study should be performed because postoperative lymphocytopenia continued for 3 days in both groups, which may suspected damage or suppression of cell-mediated immunity with used corticosteroid.

  • PDF

Utility of Wide Beam Reconstruction in Whole Body Bone Scan (전신 뼈 검사에서 Wide Beam Reconstruction 기법의 유용성)

  • Kim, Jung-Yul;Kang, Chung-Koo;Park, Min-Soo;Park, Hoon-Hee;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.14 no.1
    • /
    • pp.83-89
    • /
    • 2010
  • Purpose: The Wide Beam Reconstruction (WBR) algorithms that UltraSPECT, Ltd. (U.S) has provides solutions which improved image resolution by eliminating the effect of the line spread function by collimator and suppression of the noise. It controls the resolution and noise level automatically and yields unsurpassed image quality. The aim of this study is WBR of whole body bone scan in usefulness of clinical application. Materials and Methods: The standard line source and single photon emission computed tomography (SPECT) reconstructed spatial resolution measurements were performed on an INFINA (GE, Milwaukee, WI) gamma camera, equipped with low energy high resolution (LEHR) collimators. The total counts of line source measurements with 200 kcps and 300 kcps. The SPECT phantoms analyzed spatial resolution by the changing matrix size. Also a clinical evaluation study was performed with forty three patients, referred for bone scans. First group altered scan speed with 20 and 30 cm/min and dosage of 740 MBq (20 mCi) of $^{99m}Tc$-HDP administered but second group altered dosage of $^{99m}Tc$-HDP with 740 and 1,110 MBq (20 mCi and 30 mCi) in same scan speed. The acquired data was reconstructed using the typical clinical protocol in use and the WBR protocol. The patient's information was removed and a blind reading was done on each reconstruction method. For each reading, a questionnaire was completed in which the reader was asked to evaluate, on a scale of 1-5 point. Results: The result of planar WBR data improved resolution more than 10%. The Full-Width at Half-Maximum (FWHM) of WBR data improved about 16% (Standard: 8.45, WBR: 7.09). SPECT WBR data improved resolution more than about 50% and evaluate FWHM of WBR data (Standard: 3.52, WBR: 1.65). A clinical evaluation study, there was no statistically significant difference between the two method, which includes improvement of the bone to soft tissue ratio and the image resolution (first group p=0.07, second group p=0.458). Conclusion: The WBR method allows to shorten the acquisition time of bone scans while simultaneously providing improved image quality and to reduce the dosage of radiopharmaceuticals reducing radiation dose. Therefore, the WBR method can be applied to a wide range of clinical applications to provide clinical values as well as image quality.

  • PDF

The Difference between Career Barrier Recognition and Career Preparation Behavior by Mandatory military service Planning Level among Male College Students (남자대학생의 군 의무복무계획 수준에 따른 진로장벽인식과 진로준비행동의 차이)

  • Hong, Hye-Young;Kang, Hye-Young
    • 대한공업교육학회지
    • /
    • v.38 no.2
    • /
    • pp.218-239
    • /
    • 2013
  • This study aims to understand the status of mandatory military service planning and career barrier recognition as well as to analyze the difference between how students perceive mandatory military service as a potential barrier to their future careers(career barrier recognition) and career preparation behavior by the mandatory military service planning level among male college students. For the purpose, inquiries for the subject were set up as follows. 1. What are the levels of mandatory military service planning and career barrier recognition? 2. Is there a difference in career barrier recognition depending on the level of mandatory military service planning? 3. Is there a difference in career preparation behaviour depending on the level of mandatory military service planning? This study found out the level of mandatory military service, military barrier recognition and career preparation behavior of 284 male students from 4 universities in Daejeon and Chungnam area. Along with that, descriptive statistic, correlation analysis and t-test were conducted with SPSS 17.0 program The results of this study are as follows: First, 79.2% of male students have higher mandatory military service planning than the average value. Meanwhile, considering 3 sub-factors of mandatory military service planning, the ratio of those with high scores in practicality is lower than importance and concreteness. Based on this, it is assumable that they have a low perception for practical and concrete behaviors such as data collection in mandatory military service planning, which indicates their awareness has not developed into concrete behaviors even though they recognize the importance of planning. Also 73.9% of male students responded higher career barrier recognition than the average value shows that they recognize mandatory military service as a barrier relatively highly. Especially, those who answered "Very much" (7 scores) for every inquiry in career barrier recognition accounted for 16.9%, which forms the biggest group. and considering the response by each inquiry, it is ascertained that they consider the absence by mandatory military service time or military service as the biggest difficulty. Second, the difference in career barrier recognition between the top 30% and bottom 30% of mandatory military service planning is not statistically significant. However, in terms of importance and the sub-factor of mandatory military service planning, a significant inter-group difference in career barrier recognition is shown. In other words, to join the military is recognized as an obstacle in their career barrier recognition regardless of the mandatory military service planning level. Also, a group which considers the importance of the mandatory military service planning highly recognizes the military as the bigger obstacle compared to the other groups which are not considered in this way. Third, the difference in career barrier recognition between the top 30% and the bottom 30% of the mandatory military service planning is statistically significant. The need of mandatory military service planning is marked by the fact that those with a high level of mandatory military service planning show stronger career barrier recognition than those without plans. Through the study, the need of mandatory military service planning is suggested to both male students and career consultants considering the mandatory military service from a perspective of career based on Korean reality. Also, as precedent studies on pre-inducted men can be hardly found currently, this study is significant in accumulating empirical data about mandatory military service, a unique characteristic of the Korean career development process.

Deep Neck Abscesses in Korean Children (소아 심부 경부 농양에 대한 임상적 고찰)

  • Lee, Dae Hyoung;Kim, Sun Mi;Lee, Jung Hyun;Kim, Jong Hyun;Hur, Jae Kyun;Kang, Jin Han
    • Pediatric Infection and Vaccine
    • /
    • v.11 no.1
    • /
    • pp.81-89
    • /
    • 2004
  • Purpose : Retropharyngeal and parapharyngeal abscesses are often distinguishable from other head and neck abscesses on clinical grounds, but these infections can combine and the presentations are similar to one another. Because of the advances of antibiotic therapy, the frequency of the diseases decreased considerably, but recently the incidence of neck abscesses has increased. We sought to describe the clinical presentation of patients with deep neck abscess, and implications on management. Methods : For 10 year periods, 94 cases of charts were reviewed retrospectively, who were diagnosed as neck abscesses aged below 16 years old(between January 1993 to August 2003) in 4 hospitals. Deep neck abscesses were diagnosed by surgical pus drainage, neck CT (homogenous, hypodense area with ring enhancement) and neck sono findings. Results : The annual incidence of deep neck abscess has been increased since 2000. The median age of the patients was 4 years(range, 26 days~15 years); 63% of the patients were younger than 5 years. Abscesses in the submandibular space(34%) were most common, followed by peritonsillar space(29.7%), retropharyngeal space(11.7%), combined(10.8%), parotid space(7.4%) and parapharyngeal space(6.4%). Fever(73.4%), sore throat(37.2%), decreased oral intake(34%) and neck pain(27.7%) were the most common symptoms. In 6 children(6.4%), there was refusal to move neck, in 6(6.4%) headache, and in 4(4.3%) torticollis. Respiratory distress was observed in only 1 patient(2.1%) and stridor in 1 other(2.1%). The most common physical examinations were neck swelling/mass(67%), pharyngitis(46.8%), tonsillitis(36.2 %), and cervical lymphadenopathy(28.7%). Neck stiffness was observed in 4 patients(4.3%). Total 35 organisms were isolated in 33 patients. The most common organisms cultured by patients' blood or pus were S. aureus(34%) and S. pyogenes(28.6%). Most organisms were gram positive, and had sensitivities in vancomycin(96.4%), cefotaxime(88.9%), cephalothin (86.4%), trimethoprime-sulfamethoxazole(83.3%), and clindamycin(77.8%). 77 patients(81.9%) underwent surgery plus antibiotics; 17 patients(18.1%) were treated with antibiotics only. There is no significant differences between two groups. In duration of admission, fever after admission, and antibiotic treatment. Conclusion : The incidence of deep neck abscess has increased recently and the major symptoms have been changed. The incidence of respiratory distress or stridor is decreasing, while the incidence of abnormal head and neck symptoms and signs like headache, neck stiffness, refusal to move neck, or torticollis are increasing. Gram positive organisms are predominant, S. aureus is the most common followed by S. pyogenes. 1st generation cephalosporin has high sensitivity on gram positive organisms. Treatment with surgery plus antibiotics dose not significantly decrease total duration of antibiotic treatment or admission compared to treatment with antibiotics alone.

  • PDF

Analysis of the Causes of Subfrontal Recurrence in Medulloblastoma and Its Salvage Treatment (수모세포종의 방사선치료 후 전두엽하방 재발된 환자에서 원인 분석 및 구제 치료)

  • Cho Jae Ho;Koom Woong Sub;Lee Chang Geol;Kim Kyoung Ju;Shim Su Jung;Bak Jino;Jeong Kyoungkeun;Kim Tae_Gon;Kim Dong Seok;Choi oong-Uhn;Suh Chang Ok
    • Radiation Oncology Journal
    • /
    • v.22 no.3
    • /
    • pp.165-176
    • /
    • 2004
  • Purpose: Firstly, to analyze facto in terms of radiation treatment that might potentially cause subfrontal relapse in two patients who had been treated by craniospinal irradiation (CSI) for medulloblastoma, Secondly, to explore an effective salvage treatment for these relapses. Materials and Methods: Two patients who had high-risk disease (T3bMl, T3bM3) were treated with combined chemoradiotherapy CT-simulation based radiation-treatment planning (RTP) was peformed. One patient who experienced relapse at 16 months after CSI was treated with salvage surgery followed by a 30.6 Gy IMRT (intensity modulated radiotherapy). The other patient whose tumor relapsed at 12 months after CSI was treated by surgery alone for the recurrence. To investigate factors that might potentially cause subfrontal relapse, we evaluated thoroughly the charts and treatment planning process including portal films, and tried to find out a method to give help for placing blocks appropriately between subfrotal-cribrifrom plate region and both eyes. To salvage subfrontal relapse in a patient, re-irradiation was planned after subtotal tumor removal. We have decided to treat this patient with IMRT because of the proximity of critical normal tissues and large burden of re-irradiation. With seven beam directions, the prescribed mean dose to PTV was 30.6 Gy (1.8 Gy fraction) and the doses to the optic nerves and eyes were limited to 25 Gy and 10 Gy, respectively. Results: Review of radiotherapy Portals clearly indicated that the subfrontal-cribriform plate region was excluded from the therapy beam by eye blocks in both cases, resulting in cold spot within the target volume, When the whole brain was rendered in 3-D after organ drawing in each slice, it was easier to judge appropriateness of the blocks in port film. IMRT planning showed excellent dose distributions (Mean doses to PTV, right and left optic nerves, right and left eyes: 31.1 Gy, 14.7 Gy, 13.9 Gy, 6.9 Gy, and 5.5 Gy, respectively. Maximum dose to PTV: 36 Gy). The patient who received IMRT is still alive with no evidence of recurrence and any neurologic complications for 1 year. Conclusion: To prevent recurrence of medulloblastoma in subfrontal-cribriform plate region, we need to pay close attention to the placement of eye blocks during the treatment. Once subfrontal recurrence has happened, IMRT may be a good choice for re-irradiation as a salvage treatment to maximize the differences of dose distributions between the normal tissues and target volume.

Bladder Preserving Treatment in Patients with Muscle Invasive Bladder Cancer (근침윤성 방광암 환자의 방광 보존적 치료 결과)

  • Yu, Jeong-Il;Oh, Dong-Ryol;Huh, Seung-Jae;Choi, Han-Yong;Lee, Hyon-Moo;Jeon, Seong-Soo;Yim, Ho-Young;Kim, Won-Suk;Lim, Do-Hoon;Ahn, Yong-Chan;Park, Won
    • Radiation Oncology Journal
    • /
    • v.25 no.2
    • /
    • pp.70-78
    • /
    • 2007
  • [ $\underline{Purpose}$ ]: This study analyzed the tumor response, overall survival, progression free survival and related prognostic factors in patients with muscle invasive bladder cancer subjected to bladder preserving treatment. $\underline{Materials\;and\;Methods}$: Between August 1995 and June 2004, 37 patients with muscle invasive (transitional cell carcinoma, clinically stage T2-4) bladder cancer were enrolled for the treatment protocol of bladder preservation. There were 33 males and 4 females, and the median age was 67 years (range $38{\sim}86\;years$). Transurethral resection of the bladder (TURB) was performed in 17 patients who underwent complete resection. The median radiation dose administered was 64.8 Gy (range $55.8{\sim}67\;Gy$). The survival rate was calculated by the Kaplan-Meier method. $\underline{Results}$: An evaluation of the response rate was determined by abdomen-pelvic CT and cystoscopy at three months after radiotherapy. A complete response was seen in 17 patients (46%). The survival rate at three years was 54.7%, with 54 months of median survival (range $3{\sim}91$ months). During the study, 17 patients died and 13 patients had died from bladder cancer. The progression free survival rate at three years was 37.2%. There were 24 patients (64.9%) who had disease recurrence: 16 patients (43.2%) had local recurrence, 6 patients (16.2%) had a distant recurrence, and 2 patients (5.4%) had both a local and distant recurrence. The survival rate (p=0.0009) and progression free survival rates (p=0.001) were statistically significant when compared to the response rate after radiotherapy. $\underline{Conclusion}$: The availability of complete TURB and appropriate chemoradiotherapy were important predictors for bladder preservation and survival.