• Radiation Oncology Journal
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• v.22 no.3
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• pp.192-199
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• 2004

Purpose: To determine the patterns on evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was peformed. Materials and Methods: A web-based database system for korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998$\~$1999 from 15 hospitals were reviewed. Results: The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9$\%$) followed by medullary carcinoma (4.2$\%$) and infiltrating lobular carcinoma (1.5$\%$). Pathologic T stage by AJCC was T1 in 59.7$\%$ of the casses, T2 in 29.5$\%$ of the cases, Tis in 8.8$\%$ of the cases. Axillary lymph node dissection was peformed I\in 91.2$\%$ of the cases and 69.7$\%$ were node negative. AJCC stage was 0 in 8.8$\%$ of the cases, stage I in 44.9$\%$ of the cases, stage IIa in 33.3$\%$ of the cases, and stage IIb in 8.4$\%$ of the cases. Estrogen and progesteron receptors were evaluated in 71.6$\%$, and 70.9$\%$ of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2$\%$, wide excision in 11.5$\%$, quadrantectomy in 23$\%$ and partial mastectomy in 27.5$\%$ of the cases. A pathologically confirmed negative margin was obtained in 90.8$\%$ of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90$\%$ of the planned radiotherapy dose. Radiotherapy volume was breast only In 88$\%$ of the cases, breast+supraclavicular fossa (SCL) in 5$\%$ of the cases, and breast+ SCL+ posterior axillary boost in 4.2%$\%$of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45$\~$59.4 Gy (median 50.4) and boost dose was 8$\~$20 Gy (median 10 Gy). The total radiation dose delivered was 50.4$\~$70.4 Gy (median 60.4 Gy). Conclusion: There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.

• Journal of the Korean earth science society
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• v.39 no.3
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• pp.250-259
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• 2018

We investigated the petrological features of the stone materials used in the Jeolla Usuyeong rampart and estimated their provenance through the geological survey. The Jeolla Usuyeong was designated as a historic site (No. 535) on 2016. Since the remaining rampart is less than 15%, it is necessary to make conservation on it. In this study, we discriminated the stone materials used for the rampart according to their petrographic characteristics and estimated the volume proportion of each stone by the rock type. Also, we measured the whole-rock magnetic susceptibility. The petrographic features of the stones in the rampart were compared with those in the vicinity by their mineral composition and texture. The stone materials of the rampart mainly consist of the tuff, lapilli tuff, and lapilli stone. Among these three kinds of rocks, lapilli tuff is quantitatively the most abundant (60.3%), the next is tuff (34.7%), and lapilli stone (2.5%) shows the least amount. The whole-rock magnetic susceptibility of the tuffaceous rocks can be divided by the value of $1.0{\times}10^{-3}$ SI unit. Also, the compressive strength of tuff exhibits about 156 MPa, which is adequate to reuse for the repairing work. Petrological comparisons between stone materials and outcrop rocks distributed around the Hwawon peninsula leads to a conclusion that the stone materials of the rampart are likely to have been delivered from the Dongoeri and Sindeok-ri. Judging from the results of the comparison on the frequency of use and physical properties among the tuffaceous rocks, tuff is considered to suitable for restoring the rampart.

• Clinical and Experimental Pediatrics
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• v.45 no.8
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• pp.1016-1023
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• 2002

Purpose : Brain tumors are the most common solid tumor in children. We retrospectively investigated the clinical characteristics of pediatric brain tumors, such as age, sex, tumor site and survival, as seen in a single institution over the last 15 years. We tried to evaluate the role of chemotherapy on the survival of some brain tumors. Methods : Three hundred fifty four children with primary brain tumor who were treated at Severance Hospital from Jan. 1985 to Sep. 2001 were enrolled. Results : Pediatric brain tumors were found most frequently in 10-15 years of age group(35.3%) and the ratio of male to female was 1.3 : 1. Supratentorial tumors(52%) were more frequent than infratentorial tumors(48%). Medulloblastoma/primitive neuroectodermal tumor(PNET) was the most common type(24.6%), followed by cerebellar astrocytoma(14.1%). Ten year survival rate of medulloblastoma, cerebellar astrocytoma and cerebral astrocytoma were 59.4%, 79.3% and 71%, respectively. The prognosis for brain stem glioma and glioblastoma multiforme were still grim with a 10 year survival rate of 12.7% and 13.3%, respectively. The addition of chemotherapy for high grade medulloblastoma led to an improved 10 year survival rate of 54.5%, compared with 40% without chemotherapy. Conclusion : The combined use of chemotherapy and radiation and surgery improved survival rate of pediatric brain tumors in our study. Chemotherapy for high grade medulloblastoma improved the 10 year survival rate. Further data analysis of the treatment modalities will lead to better comparisons.

• Tuberculosis and Respiratory Diseases
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• v.52 no.5
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• pp.441-452
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• 2002

Background : Anti-apoptotic proteins may be involved in tumor development, progression and the response to treatment, Bcl-2 is by far the most studied anti-apoptotic protein. A novel inhibitor of apoptosis, designated survivin, and the heat shock proteins (HSPs) have recently been found in many human cancers. Immunohistochemical methods were used to determine the expression level of survivin, HSP70 and bcl-2 in non-small cell lung cancer (NSCLC) to evaluate their clinical significance. Materials and Methods : Tissue array slides were obtained from 99 surgically resected NSCLCs. Immunohistochemical staining was performed by an immuno-peroxidase technique using an avidin-biotinylated horseradish peroxidase complex. Anti-survivin rabbit polyclonal antibodies, anti-HSP70 mouse monoclonal antibodies and anti-bcl-2 mouse monoclonal antibodies were used as the primary antibodies. Results : Positive staining of survivin was detected in 33.3% of the cases. Survivin positivity is associated with to females and recurrence. A nonstatistically significant trend toward increased survivin expression was observed in non-smokers, and its expression inversely correlated with the number of cigarettes smoked in smokers. HSP70 was detected in 84.8% but this did not correlated with the clinicopathologic characteristics. Bcl-2 was detected in 18.2% and its expression correlated to tumor recurrence. No significant difference in the median survival time was noted in a comparison of all cases with survivin expression and those without. There was no association between HSP70 or bcl-2 expression and survival. Conclusion : Survivin expression was significantly associated with females and tumor recurrence. In addition its expression was inversely associated with the number of cigarettes smoked. However, HSP70 and bcl-2 expression were not associated with the clinical parameters or survival. This suggests that measuring the survivin levels may be useful in identifying patients at high risk for disease recurrence. Therefore, survivin might be a new diagnostic/therapeutic target in cancer.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.144-150
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• 1997

Purpose : The kidney is one of the most common sites of cyst formation. Cystic diseases of the kidney are a diverse group of clinicopathologic entities and variable prognosis. They span a wide range of both age of presentation and severity of the renal disease. And many of them are systemic disorders, sharing similar process of cyst formation in other organs. Recently, development of imaging studies has been contributing widely to the diagnosis of the diseases. Treatment, however, is not established satisfactorily. We performed this study to evaluate the occurrence and treatment of cystic diseases of the kidney. Methods : We reviewed retrospectively the medical records of 44 patients with cystic diseases of the kidney in the Department of Pediatrics, during last 11 years. Results : In the 44 patients with cystic diseases of the kidney, 31 patients(71%) had multicystic dysplastic kidney and 11(35%) of them received nephrectomy due to differentiation from neoplasms or severe abdominal distension. Seven patients(16%) had polycystic kidney disease, and all of them were infantile type. Five patients(11%) were diagnosed as having a simple renal cysts. Progression to renal failure was noted in none of the cases. In 14(32%) out of total 44 patients, the diagnosis was made in neonatal or infantile pelted. Conclusion : The incidence of cystic diseases of the kidney appeared very low, but further investigation on their pathogenesis, classification, and indication of treatment is needed.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.615-620
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• 2001

The new stage of metastatic lung cancer based upon resectability, disease-free interval, and the number of pulmonary metastases was proposed in 1998 by Ginsberg, et al. We evaluated the validity of the new staging proposal for pulmonary metastases through the analysis of experiences at Severance Hospital. Material and Method: The cases of 111 patients who underwent resection of metastatic lung cancer during the eleven-year period (1990-2000) were reviewed. Of these patients, 103(92.8%) underwent compete surgical resection. The primary tumor was carcinoma in 60 cases, sarcoma in 46, and others in 5. The disease-free interval(DFI) was 0 to 35 months in 79 cases adn more than 36 months in 32 cases. Single metastasis accounted for 53 cases and multiple lesions for 58 cases. Mean follow-up was 49 months. Result: The actuarial survival after complete metastasectomy was 48.2% at 3 years and 32.6% at 5 years; the corresponding values for incomplete resection were 21.9% at 3 years. The 3-year survival rate(3-YSR) for complete resction was 40.5% and 5-year survival rate(5-YSR) was 30.4% for patients with a DFI less than 36 months, the 3-YSR, 75.8% and 5-YSR, 39.0% for those with a DFI equal or more than 36 moths; 45.8% and 30.5% for single lesions, 50.0% and 34.4% for multiple lesions. The 3-YSR and 5-YSR were 58.5% and 43.8% for stage I patients, 54.0% and 37.4% for stage II, 38.2% and 27.9% for stage III and 21.9% for stage IV. Conclusion: The result of the analysis of new stage of pulmonary metastases showed that the survival rate was different according to stage and there was no statistical significance. We need more experiences and long-term follow up to determine the prognostic factor of metastatic lung cancer surgery.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.725-731
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• 2009

Background: Lobectomy and more extended anatomic resection are regarded as standard treatment for stage Ia non-small cell lung cancer, but approximately 15~40% of patients suffer from treatment failures such as cancer recurrence or death. The authors analyzed types and causes of treatment failures in surgically treated cases of stage Ia non small cell lung cancer. Material and Method: We retrospectively reviewed the medical records of 156 patients who had undergone complete resection for stage Ia NSCLC between Jan 1992 and Aug 2005. Patients were divided into two different treatment failure groups: cancer-related deaths and non-cancer-related deaths. Risk factors were analyzed in each group by the Kaplan-Meyer survival method and the Cox proportional hazard model. Result: Among the 156 patients, 93 were males; the mean age was 61. The median follow-up period was 33.8 months. The 5 year survival rate was 87.6%. Microscopic lympho-vascular permeation was reported in 10 patients. Recurrence was reported in 19 patients and 12 patients died due to recurrent lung cancer. Noncancer related deaths occurred in 16 patients. Risk factors for cancer recurrence and cancer related death were microscopic lympho-vascular permeation (HR=6.81, p=0.007, HR=7.81, p<0.001); for non-cancer related death, risk factors were pneumonectomy (HR=25.92, p=0.001) and postoperative cardiopulmonary complications (HR=29.67, p=0.002). Conclusion: After complete resection of stage Ia non small cell lung cancer patients, mortality includes not only cancer related deaths but also cancer unrelated deaths. Adjuvant chemotherapy is advised for patients who show microscopic lympho-vascular permeation, which is a risk factor for recurrence and for cancer related death. Patients who had pneumonectomy or who suffered from cardiac or respiratory complications need meticulous care in order to reduce comorbidity-induced death.

• The Journal of the Petrological Society of Korea
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• v.15 no.3 s.45
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• pp.139-153
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• 2006

For the characteristics of rock material and standardization, flagstones of the trifurcated path in Jongmyo Royal Shrine, registered as World Cultural Heritage, were studied on the basis of petrographic, petrochemical and magnetic properties. The flagstones are composed mainly of pale gray fine to medium grained hornblende biotite granite, pale gray fine to medium grained biotite granite, pale pink medium to coarse grained biotite granite, pink medium to coarse grained biotite granite and minor pegmatite and schist. Flagstone represents the average size of $65cm{\times}4cm$ (standard deviation $12cm{\times}7cm$) and suitable (34.7%), common (41.4%) and unsuitable (23%) in roughness. It is interpreted that pale pink and pink granite, pegmatite, schist and other flagstones with unsuitable state are not original rock materials and were exchanged during restoration, in the past. The number of these non-original rock materials is about 560 flagstones. We suggests that the standard flagstone of the trifurcated path is pale gray fine to medium grained biotite granite (${\pm}$hornblende in trace), 70wt.% in $SiO_2$, content, and ${\pm}0.1{\times}10^{-3}\;SI$ in magnetic susceptibility.