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The Expression of Vascular Endothelial Growth Factor (VEGF) is a Highly Significant Prognostic Factor in Stage IB Carcinoma of the Cervix (병기 IB 자궁경부암에서 혈관내피세포성장인자(VEGF)의 발현이 예후에 미치는 영향)

  • Lee Ik Jae;Park Kyung Ran;Lee Jong Young;Lee Kang Kyoo;Song Ji Sun;Lee Kwang Gil;Cha Dong Soo;Choi Hyun Il
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.335-344
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    • 2001
  • Purpose : The aim of this study was to clarify the role of VEGF expression as an independent prognostic factor and to identify the patients at high risk for poor prognosis in stage IB cervical cancer. Materials and methods : A total of 118 patients with stage IB cervical cancer who had radical hysterectomy and pelvic lymph node dissection were included in the study. All known high risk factors of the patients were pathologically confirmed from the surgical specimen. Of the 118 patients, n patients were treated with postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry in formalin-fixed, paraffin-embedded specimens of post-hysterectomy surgical materials. A semiquantitative analysis was made using a scoring system of 0, +, ++, and +++ for increasing intensity of stain. We classified the patients with scores from 0 to ++ as low VEGF expression and the patients with a score of +++ as high VEGF expression. Results : Of the 118 patients, 35 patients $(29.7\%)$ showed high VEGF expression. Strong correlations were found between the high VEGF expression and both deep stromal invasion (p=0.01) and the positive pelvic node (p=0.03). The 5-year overall and disease-free survival rates for all 118 patients were $95.5\%\;and\;93.8\%$. The 5-year overall (p=0.03) and disease-free survival (p<0.001) rates were $98.5\%\;and\;100%$ for low VEGF expression (0, +, and ++) and $85.5\%\;and\;79.7\%$ for high VEGF expression, respectively. Pelvic and distant failures for low versus high VEGF expression were $1.2\%$ versus $17.1\%$, (p=0.001) and $0\%$ versus $14.3\%$ (p<0.001), respectively. In a Cox multivariate analysis of survival, the high VEGF expression (p=0.02) and the bulky mass (p=0.02) were significant prognostic factors for overall survival. The high VEGF expression (p=0.002), and bulky mass (p=0.01) demonstrated as significant prognostic indicators for disease free survival. Conclusion : These results showed that VEGF expression was a highly significant predictor for pelvic and distant failure and the most significant prognostic factor of overall and disease free survival for the patients with stage IB cervix cancer treated with radical surgery. We strongly suggest that the immune-histochemistry for VEGF expression be performed in a routine clinical setting in order to identify the patients at high risk for poor prognosis in early stage cervical cancer. Furthermore, postoperative and/or chemotherapy did not reduce the pelvic failure and distant metastasis. To improve the cure rate for the patients with high VEGF expression in stage IB cervical cancer, antiangiogenic therapy including anti-VEGF Ab may be new treatment option.

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Therapeutic Angiogenesis by Intramyocardial Injection of pCK-VEGF165 in Pigs (돼지에서 pCK-VEGF165의 심근내 주입에 의한 치료적 혈관조성)

  • Choi Jae-Sung;Han Woong;Kim Dong Sik;Park Jin Sik;Lee Jong Jin;Lee Dong Soo;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.323-334
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    • 2005
  • Background: Gene therapy is a new and promising option for the treatment of severe myocardial ischemia by therapeutic angiogenesis. The goal of this study was to elucidate the efficacy of therapeutic angiogenesis by using VEGF165 in large animals. Material and Method: Twenty-one pigs that underwent ligation of the distal left anterior descending coronary artery were randomly allocated to one of two treatments: intramyocardial injection of pCK-VEGF (VEGF) or intramyocardial injection of pCK-Null (Control). Injections were administered 30 days after ligation. Seven pigs died during the trial, but eight pigs from VEGF and six from Control survived. Echo-cardiography was performed on day 0 (preoperative) and on days 30 and 60 following coronary ligation. Gated myocardial single photon emission computed tomography imaging (SPECT) with $^{99m}Tc-labeled$ sestamibi was performed on days 30 and 60. Myocardial perfusion was assessed from the uptake of $^{99m}Tc-labeled$ sestamibi at rest. Global and regional myocardial function as well as post-infarction left ventricular remodeling were assessed from segmental wall thickening; left ventricular ejection fraction (EF); end systolic volume (ESV); and end diastolic volume (EDV) using gated SPECT and echocardiography. Myocardium of the ischemic border zone into which pCK plasmid vector had been injected was also sampled to assess micro-capillary density. Result: Micro-capillary density was significantly higher in the VEGF than in Control ($386\pm110/mm^{2}\;vs.\;291\pm127/mm^{2};\;p<0.001$). Segmental perfusion increased significantly from day 30 to day 60 after intramyocardial injection of plasmid vector in VEGF ($48.4\pm15.2\%\;vs.\;53.8\pm19.6\%;\;p<0.001$), while no significant change was observed in the Control ($45.1\pm17.0\%\;vs.\;43.4\pm17.7\%;\;p=0.186$). This resulted in a significant difference in the percentage changes between the two groups ($11.4\pm27.0\%\;increase\;vs.\;2.7\pm19.0\%\;decrease;\;p=0.003$). Segmental wall thickening increased significantly from day 30 to day 60 in both groups; the increments did not differ between groups. ESV measured using echocardiography increased significantly from day 0 to day 30 in VEGF ($22.9\pm9.9\;mL\;vs.\;32.3\pm9.1\;mL;\; p=0.006$) and in Control ($26.3\pm12.0\;mL\;vs.\;36.8\pm9.7\;mL;\;p=0.046$). EF decreased significantly in VEGF ($52.0\pm7.7\%\;vs.\;46.5\pm7.4\%;\;p=0.004$) and in Control ($48.2\pm9.2\%\;vs.\;41.6\pm10.0\%;\;p=0.028$). There was no significant change in EDV. The interval changes (days $30\~60$) of EF, ESV, and EDV did not differ significantly between groups both by gated SPECT and by echocardiography. Conclusion: Intramyocardial injection of pCK-VEGF165 induced therapeutic angiogenesis and improved myocardial perfusion. However, post-infarction remodeling and global myocardial function were not improved.

Pro-inflammatory Cytokine Expression Through NF-${\kappa}B/I{\kappa}B$ Pathway in Lung Epithelial Cells (폐 상피세포에서 NF-${\kappa}B/I{\kappa}B$ 경로에 의한 염증매개 사이토카인의 발현)

  • Park, Gye-Young;Lee, Seung-Hee;HwangBo, Bin;Yim, Jae-Joon;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.332-342
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    • 2000
  • Background : The importance of pro-inflammatory cytokines, especially tumor necrosis factor $\alpha$ (INF-$\alpha$) and interleukin-1$\beta$ (IL-1$\beta$), have been extensively documented in the generation of inflammatory lung disease. Lung epithelial cells are also actively involved in initiating and maintaining inflammation by producing pro-inflammatory mediators. Understanding the mechanism of pro-inflammatory cytokine expression in lung epithelial cells is crucial to the development of new therapeutic modalities for inflammatory lung disease. Transcription of most pro-inflammatory cytokines is dependent on the activation of NF-${\kappa}B$. However, the relationship between pro-inflammatory cytokine expression and NF-${\kappa}B/I{\kappa}B$ pathway in lung epithelial cells is not clear. Methods : BEAS-2B, A549, Na-H157, NCI-H719 cells were stimulated with IL-$1{\beta}$ or TNF-$\alpha$ at various times, and then IL-8 and TNF-$\alpha$mRNA expressions were assayed by Northern blot analysis. IL-$1{\beta}$ or TNF-$\alpha$-induced NF-${\kappa}B$ activation was assessed by the nuclear translocation of p65 NF-${\kappa}B$ subunit. The degradation of $I{\kappa}B{\alpha}$ and $I{\kappa}B{\beta}$ by IL-$1{\beta}$ or TNF-$\alpha$stimulation was assayed by Western blot analysis. The phosphorylation of $I{\kappa}B{\alpha}$ was evaluated by Western blot analysis after pre-treating cells with proteasome inhibitor followed by IL-$1{\beta}$ or TNF-$\alpha$ stimulation. The basal level of IKK $\alpha$ expression was evaluated by Western blot analysis. Results: $I{\kappa}B{\alpha}$ and $I{\kappa}B{\alpha}$ was rapidly degraded after 5 minutes of incubation with IL-$1{\beta}$ or TNF-$\alpha$ in BEAS-2B, A549, and NCI-H157 cells. The activation of NF-${\kappa}B{\alpha}$ and the induction of IL-8 and TNF-$\alpha$ mRNA expression were observed by IL-$1{\beta}$ or TNF-$\alpha$ stimulation in these cells. In contrast, neither the changes in NF-${\kappa}B/I{\kappa}B$ pathway nor IL-8 and TNF-$\alpha$mRNA expression was induced by IL-$1{\beta}$ or TNF-$\alpha$ stimulation in NCI-H719 cells. IL-$1{\beta}$ and TNF-$\alpha$-induced $I{\kappa}B$ phosphorylation was observed in BEAS-2B, A549, and NCI-H157 cells, but not in NCI-H719 cells. The basal level of IKK$\alpha$ expression was not different between cell. Conclusion : NF-${\kappa}B/I{\kappa}B$ pathway plays an important role in the expression of pro-inflammatory cytokine in most lung epithelial cells. The absence of the effect on NF-${\kappa}B/I{\kappa}B$ pathway in NCI-H719 cells sæms to be due to the defect in the intracellular signal transduction pathway upstream to IKK.

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A study on the gratification of the patient in the Dental Hospital (치과병원 내원환자의 만족도 조사분석)

  • Kim, Min-Young;Lee, Keun-Woo;Moon, Hong-Suk;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.65-82
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    • 2008
  • Statement of problem : Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers ' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations' medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. Purpose : The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. Material and method : This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. Result : It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers 'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. Conclusion : The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients' satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.

A New Approach to Automatic Keyword Generation Using Inverse Vector Space Model (키워드 자동 생성에 대한 새로운 접근법: 역 벡터공간모델을 이용한 키워드 할당 방법)

  • Cho, Won-Chin;Rho, Sang-Kyu;Yun, Ji-Young Agnes;Park, Jin-Soo
    • Asia pacific journal of information systems
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    • v.21 no.1
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    • pp.103-122
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    • 2011
  • Recently, numerous documents have been made available electronically. Internet search engines and digital libraries commonly return query results containing hundreds or even thousands of documents. In this situation, it is virtually impossible for users to examine complete documents to determine whether they might be useful for them. For this reason, some on-line documents are accompanied by a list of keywords specified by the authors in an effort to guide the users by facilitating the filtering process. In this way, a set of keywords is often considered a condensed version of the whole document and therefore plays an important role for document retrieval, Web page retrieval, document clustering, summarization, text mining, and so on. Since many academic journals ask the authors to provide a list of five or six keywords on the first page of an article, keywords are most familiar in the context of journal articles. However, many other types of documents could not benefit from the use of keywords, including Web pages, email messages, news reports, magazine articles, and business papers. Although the potential benefit is large, the implementation itself is the obstacle; manually assigning keywords to all documents is a daunting task, or even impractical in that it is extremely tedious and time-consuming requiring a certain level of domain knowledge. Therefore, it is highly desirable to automate the keyword generation process. There are mainly two approaches to achieving this aim: keyword assignment approach and keyword extraction approach. Both approaches use machine learning methods and require, for training purposes, a set of documents with keywords already attached. In the former approach, there is a given set of vocabulary, and the aim is to match them to the texts. In other words, the keywords assignment approach seeks to select the words from a controlled vocabulary that best describes a document. Although this approach is domain dependent and is not easy to transfer and expand, it can generate implicit keywords that do not appear in a document. On the other hand, in the latter approach, the aim is to extract keywords with respect to their relevance in the text without prior vocabulary. In this approach, automatic keyword generation is treated as a classification task, and keywords are commonly extracted based on supervised learning techniques. Thus, keyword extraction algorithms classify candidate keywords in a document into positive or negative examples. Several systems such as Extractor and Kea were developed using keyword extraction approach. Most indicative words in a document are selected as keywords for that document and as a result, keywords extraction is limited to terms that appear in the document. Therefore, keywords extraction cannot generate implicit keywords that are not included in a document. According to the experiment results of Turney, about 64% to 90% of keywords assigned by the authors can be found in the full text of an article. Inversely, it also means that 10% to 36% of the keywords assigned by the authors do not appear in the article, which cannot be generated through keyword extraction algorithms. Our preliminary experiment result also shows that 37% of keywords assigned by the authors are not included in the full text. This is the reason why we have decided to adopt the keyword assignment approach. In this paper, we propose a new approach for automatic keyword assignment namely IVSM(Inverse Vector Space Model). The model is based on a vector space model. which is a conventional information retrieval model that represents documents and queries by vectors in a multidimensional space. IVSM generates an appropriate keyword set for a specific document by measuring the distance between the document and the keyword sets. The keyword assignment process of IVSM is as follows: (1) calculating the vector length of each keyword set based on each keyword weight; (2) preprocessing and parsing a target document that does not have keywords; (3) calculating the vector length of the target document based on the term frequency; (4) measuring the cosine similarity between each keyword set and the target document; and (5) generating keywords that have high similarity scores. Two keyword generation systems were implemented applying IVSM: IVSM system for Web-based community service and stand-alone IVSM system. Firstly, the IVSM system is implemented in a community service for sharing knowledge and opinions on current trends such as fashion, movies, social problems, and health information. The stand-alone IVSM system is dedicated to generating keywords for academic papers, and, indeed, it has been tested through a number of academic papers including those published by the Korean Association of Shipping and Logistics, the Korea Research Academy of Distribution Information, the Korea Logistics Society, the Korea Logistics Research Association, and the Korea Port Economic Association. We measured the performance of IVSM by the number of matches between the IVSM-generated keywords and the author-assigned keywords. According to our experiment, the precisions of IVSM applied to Web-based community service and academic journals were 0.75 and 0.71, respectively. The performance of both systems is much better than that of baseline systems that generate keywords based on simple probability. Also, IVSM shows comparable performance to Extractor that is a representative system of keyword extraction approach developed by Turney. As electronic documents increase, we expect that IVSM proposed in this paper can be applied to many electronic documents in Web-based community and digital library.

Effect on In­Vitro Fertilization of Pig Oocytes Matured in Different In­Vitro Maturation Media according to Sperm Concentration of Liquid Boar semen (돼지 액상정액의 정자 주입농도가 서로 다른 체외성숙배지에서 배양된 난포란의 체외수정에 미치는 영향)

  • 박창식;이영주;고현진;양창범;손동수;서길웅;이규승
    • Korean Journal of Animal Reproduction
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    • v.26 no.1
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    • pp.1-7
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    • 2002
  • The present study was carried out to investigate the effects of maturation media on penetrability of pig oocytes by liquid boar sperm coincubated with different sperm concentrations in a modified Tris­buffered medium (mTBM). Follicular oocytes collected from ovaries of prepubertal gilts were matured in a modified TCM-199 (mTCM-199) medium, modified Waymouth MB 752/1 (mWaymouth MB 752/1) medium or NCSU-23 medium. Oocytes (30~40) were transferred into each well of a Nunc 4-well multidish containing 0.5 $m\ell$ maturation medium. The sperm­ich portion of ejaculates with greater than 90% motile sperm were used in the experiment. The semen was cooled 22 to 24$^{\circ}C$ over 2 h period. The semen was diluted with Beltsville Thawing Solution (BTS) extender at room temperature to give 2$\times$10$^{8}$ sperm/$m\ell$ in 100 $m\ell$ plastic bottle. Liquid boar semen of 30 $m\ell$ in 100 $m\ell$ plastic bottle was kept at 17$^{\circ}C$ far 5 days. The sperm with greater than 70% motility after day 5 of storage were used for in-vitro fertilization (IVF). After 44 h maturation of immature oocytes in 5% $CO_2$in air at 38.5$^{\circ}C$, cumulus cells were removed and oocytes (30~40) were coincubated for 6 h in 0.5 $m\ell$ mTBM fertilization medium with five different (1$\times$10$^{6}$ , 2$\times$10$^{6}$ , 4$\times$10$^{6}$ , 6$\times$10$^{6}$, 10$\times$10$^{6}$ $m\ell$) sperm concentrations. At 6 h after IVF, oocytes were transferred into 0.5 $m\ell$ NCSU-23 culture medium fur further culture of 6 h. At 12 h after IVF, sperm penetration, polyspermy and male pronuclear formation of oocytes were evaluated. Oocytes of NCSU-23 maturation medium decreased polyspermy and increased male pronuclear formation compared to those of mTCM­199 and mWaymouth MB 752/1 maturation media. Of oocytes matured in NCSU-23 medium and inseminated in mTBM medium with 2~4$\times$10$^{6}$ $m\ell$ sperm concentrations, 50.8~50.9% showed sperm penetration, 13.3~19.5% polyspermy and 43.9~45.4% male pronuclear formation. In conclusion, we found out that oocytes matured in NCSU­23 medium and inseminated in mTBM medium showed superior in­vitro fertilization compared to those matured in mTCM­199 and mWaymouth MB 752/1 maturation media and inseminated in mTBM medium. The optimum sperm concentrations for in-vitro fertilization of oocytes matured in NCSU-23 medium by liquid boar semen stored at 17$^{\circ}C$ for 5 days were 2~4$\times$10$^{6}$ $m\ell$.

The Role of the Soft Law for Space Debris Mitigation in International Law (국제법상 우주폐기물감축 연성법의 역할에 관한 연구)

  • Kim, Han-Taek
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.469-497
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    • 2015
  • In 2009 Iridium 33, a satellite owned by the American Iridium Communications Inc. and Kosmos-2251, a satellite owned by the Russian Space Forces, collided at a speed of 42,120 km/h and an altitude of 789 kilometers above the Taymyr Peninsula in Siberia. NASA estimated that the satellite collision had created approximately 1,000 pieces of debris larger than 10 centimeters, in addition to many smaller ones. By July 2011, the U.S. Space Surveillance Network(SSN) had catalogued over 2,000 large debris fragments. On January 11, 2007 China conducted a test on its anti-satellite missile. A Chinese weather satellite, the FY-1C polar orbit satellite, was destroyed by the missile that was launched using a multistage solid-fuel. The test was unprecedented for having created a record amount of debris. At least 2,317 pieces of trackable size (i.e. of golf ball size or larger) and an estimated 150,000 particles were generated as a result. As far as the Space Treaties such as 1967 Outer Space Treaty, 1968 Rescue Agreement, 1972 Liability Convention, 1975 Registration Convention and 1979 Moon Agreement are concerned, few provisions addressing the space environment and debris in space can be found. In the early years of space exploration dating back to the late 1950s, the focus of international law was on the establishment of a basic set of rules on the activities undertaken by various states in outer space.. Consequently environmental issues, including those of space debris, did not receive the priority they deserve when international space law was originally drafted. As shown in the case of the 1978 "Cosmos 954 Incident" between Canada and USSR, the two parties settled it by the memorandum between two nations not by the Space Treaties to which they are parties. In 1994 the 66th conference of International Law Association(ILA) adopted "International Instrument on the Protection of the Environment from Damage Caused by Space Debris". The Inter-Agency Space Debris Coordination Committee(IADC) issued some guidelines for the space debris which were the basis of "the UN Space Debris Mitigation Guidelines" which had been approved by the Committee on the Peaceful Uses of Outer Space(COPUOS) in its 527th meeting. On December 21 2007 this guideline was approved by UNGA Resolution 62/217. The EU has proposed an "International Code of Conduct for Outer Space Activities" as a transparency and confidence-building measure. It was only in 2010 that the Scientific and Technical Subcommittee began considering as an agenda item the long-term sustainability of outer space. A Working Group on the Long-term Sustainability of Outer Space Activities was established, the objectives of which include identifying areas of concern for the long-term sustainability of outer space activities, proposing measures that could enhance sustainability, and producing voluntary guidelines to reduce risks to long-term sustainability. By this effort "Guidelines on the Long-term Sustainability of Outer Space Activities" are being under consideration. In the case of "Declaration of Legal Principles Governing the Activities of States in the Exp1oration and Use of Outer Space" adopted by UNGA Resolution 1962(XVIII), December 13 1963, the 9 principles proclaimed in that Declaration, although all of them incorporated in the Space Treaties, could be regarded as customary international law binding all states considering the time and opinio juris by the responses of the world. Although the soft law such as resolutions, guidelines are not binding law, there are some provisions which have a fundamentally norm-creating character and customary international law. In November 12 1974 UN General Assembly recalled through a Resolution 3232(XXIX) "Review of the role of International Court of Justice" that the development of international law may be reflected, inter alia, by the declarations and resolutions of the General Assembly which may to that extend be taken into consideration by the judgements of the International Court of Justice. We are expecting COPUOS which gave birth 5 Space Treaties that it could give us binding space debris mitigation measures to be implemented based on space debris mitigation soft law in the near future.

Role of Invasive Procedures in the Diagnosis and Management of Pulmonary Infiltrates in Patients with Leukemia (백혈병 환자에서 발생한 폐침윤의 진단 및 치료에 있어 침습적 검사의 역할)

  • Kang, Soo-Jung;Park, Sang-Joon;An, Chang-Hyeok;Ahn, Jong-Woon;Kim, Ho-Cheol;Lim, Si-Young;Suh, Gee-Young;Kim, Ho-Joong;Kwon, O-Jung;Lee, Hong-Ghi;Rhee, Chong-H.;Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.448-463
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    • 2000
  • Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.

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Phase II Study of Gemcitabine and Vinorelbine as a Combination Chemotherapy for the Second-Line Treatment of Nonsmall Cell Lung Carcinoma (비소세포 폐암 환자의 2차 치료로서 Gemcitabine과 Vinorelbine의 병합 요법의 효과)

  • Lee, EunJoo;Ha, EunSil;Park, SangHoon;Hur, GyuYoung;Jung, KiHwan;Jeong, HyeCheol;Lee, SungYong;Kim, JeHyeong;Lee, SangYeub;Sin, Chol;Shim, JaeJeong;In, KwangHo;Kang, KyungHo;Yoo, SeHwa
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.510-516
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    • 2005
  • Backgroud : Lung cancer is the leading cause of cancer deaths in Korea and the number of lung cancer deaths is increasing. The higher response rates, decreased toxicity and improved performance status of the first-line treatments have resulted in an increased number of patients becoming candidates for second-line therapy. Several new antineoplastic agents, including gemcitabine, docetaxel and paclitaxel, have recently demonstrated second-line activity. This phase II study evaluated the efficacy and toxicity of gemcitabine and vinorelbine as combination chemotherapy for Korean patients with NSCLC as a second-line treatment. Methods : Sixty response-evaluable patients were enrolled from December 2000 to July 2003. We conducted a phase II study of a combination gemcitabine and vinorelbine chemotherapy for patients with histologically confirmed NSCLC that was stage IIIB and IV disease at the time of diagnosis, and the disease had progressed onward or the patients had relapsed after first-line platinum-based chemotherapy. They were treated with intravenous gemcitabine $1000mg/m^2$ and intravenous vinorelbine $25mg/m^2$ on days 1 and 8. This chemotherapy regimen was repeated every 3 weeks. Results : A total of 215 cycles of treatment were given and the mean number of cycles was 3.6 cycles. All the patients were evaluable for the toxicity profile. The response rate was 10% according to the WHO criteria. The median progression free survival was 3.8 months and the median survival time was 10.1 months. The 1-year survival rate was 32.9%. Grade III and IV neutropenia were seen in 20 (33.3%) and 7 (11.7%) patients, respectively. Conclusion : The combination of gemcitabine and vinorelbine is active and well tolerated as a second-line therapy for patients with advanced nonsmall cell lung carcinoma.

Research Trend Analysis Using Bibliographic Information and Citations of Cloud Computing Articles: Application of Social Network Analysis (클라우드 컴퓨팅 관련 논문의 서지정보 및 인용정보를 활용한 연구 동향 분석: 사회 네트워크 분석의 활용)

  • Kim, Dongsung;Kim, Jongwoo
    • Journal of Intelligence and Information Systems
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    • v.20 no.1
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    • pp.195-211
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    • 2014
  • Cloud computing services provide IT resources as services on demand. This is considered a key concept, which will lead a shift from an ownership-based paradigm to a new pay-for-use paradigm, which can reduce the fixed cost for IT resources, and improve flexibility and scalability. As IT services, cloud services have evolved from early similar computing concepts such as network computing, utility computing, server-based computing, and grid computing. So research into cloud computing is highly related to and combined with various relevant computing research areas. To seek promising research issues and topics in cloud computing, it is necessary to understand the research trends in cloud computing more comprehensively. In this study, we collect bibliographic information and citation information for cloud computing related research papers published in major international journals from 1994 to 2012, and analyzes macroscopic trends and network changes to citation relationships among papers and the co-occurrence relationships of key words by utilizing social network analysis measures. Through the analysis, we can identify the relationships and connections among research topics in cloud computing related areas, and highlight new potential research topics. In addition, we visualize dynamic changes of research topics relating to cloud computing using a proposed cloud computing "research trend map." A research trend map visualizes positions of research topics in two-dimensional space. Frequencies of key words (X-axis) and the rates of increase in the degree centrality of key words (Y-axis) are used as the two dimensions of the research trend map. Based on the values of the two dimensions, the two dimensional space of a research map is divided into four areas: maturation, growth, promising, and decline. An area with high keyword frequency, but low rates of increase of degree centrality is defined as a mature technology area; the area where both keyword frequency and the increase rate of degree centrality are high is defined as a growth technology area; the area where the keyword frequency is low, but the rate of increase in the degree centrality is high is defined as a promising technology area; and the area where both keyword frequency and the rate of degree centrality are low is defined as a declining technology area. Based on this method, cloud computing research trend maps make it possible to easily grasp the main research trends in cloud computing, and to explain the evolution of research topics. According to the results of an analysis of citation relationships, research papers on security, distributed processing, and optical networking for cloud computing are on the top based on the page-rank measure. From the analysis of key words in research papers, cloud computing and grid computing showed high centrality in 2009, and key words dealing with main elemental technologies such as data outsourcing, error detection methods, and infrastructure construction showed high centrality in 2010~2011. In 2012, security, virtualization, and resource management showed high centrality. Moreover, it was found that the interest in the technical issues of cloud computing increases gradually. From annual cloud computing research trend maps, it was verified that security is located in the promising area, virtualization has moved from the promising area to the growth area, and grid computing and distributed system has moved to the declining area. The study results indicate that distributed systems and grid computing received a lot of attention as similar computing paradigms in the early stage of cloud computing research. The early stage of cloud computing was a period focused on understanding and investigating cloud computing as an emergent technology, linking to relevant established computing concepts. After the early stage, security and virtualization technologies became main issues in cloud computing, which is reflected in the movement of security and virtualization technologies from the promising area to the growth area in the cloud computing research trend maps. Moreover, this study revealed that current research in cloud computing has rapidly transferred from a focus on technical issues to for a focus on application issues, such as SLAs (Service Level Agreements).