Purpose : To evaluate the outcome of early stage non-small cell lung cancer patients who were treated with radiation therapy alone and define the optimal radiotherapeutic regimen for these patients. Materials and Methods : A retrospective review was peformed on patients with sage I or II non-small cell carcinoma of the lung that were treated at our institution between June, 1987 and May, 2000. A total of 21 patients treated definitively with radiation therapy alone were included in this study. The age of the patients ranged from 53 to 81 years with a median of 66 years. All the patients were male. The medical reasons for inoperability were lack of pulmonary reserve, cardiovascular disease, poor performance status, old age, and patient refusal in the decreasing order. Pathological evidence was not adequate to characterize the non-small cell subtype in two patients. Of the remaining 19 patients, 16 had squamous cell carcinoma and 3 had adenocarcinoma. Treatment was given with conventional fractionation, once a day, five times a week. The doses to the primary site ranged from 56 Gy to 59 Gy. No patients were lost to follow-up. Results : The overall survival rates for the entire group at 2, 3 and 5 years were 41, 30 and $21\%$, respectively. The cause specific survivals at 2, 3 and 5 years were 55, 36 and $25\%$, respectively. An intercurrent disease was the cause of death in two patients. The cumulative local failure rate at 5 years was $43\%$. Nine of the 21 patients had treatment failures after the curative radiotherapy was attempted. Local recurrences as the first site of failure were documented in 7 patients. Therefore, local failure alone represented $78\%$ of the total failures. Those patients whose tumor sizes were less than 4 cm had a significantly better 5 year disease free survival than those with tumors greater than 4 cm $(0\%\;vs\;36\%)$. Those patients with a Karnofsky performance status less than 70 did not differ significantly with respect to actuarial survival when compared to those with a status greater than 70 $(25\%\;vs\;26\%,\;p>0.05)$. Conclusion : Radiation therapy 리one is an effective and safe treatment for early stage non-small ceil lung cancer patients who are medically inoperable or refuse surgery. Also we believe that a higher radiation dose to the primary site could improve the local control rate, and ultimately the overall survival rate.
Kim Yeon-Sil;Kim Sung-Whan;Yoon Sel-Chul;Lee Jung-Seok;Son Seok-Hyun;Choi Ihl-Bong
Radiation Oncology Journal
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v.22
no.3
/
pp.225-233
/
2004
Purpose: The Ideal breast irradiation method should provide an optimal dose distribution In the treated breast volume and a minimum scatter dose to the nearby normal tissue. Physical wedges have been used to Improve the dose distribution In the treated breast, but unfortunately Introduce an Increased scatter dose outside the treatment yield, pavllculariy to the contralateral breast. The typical physical wedge (FW) was compared with 4he virtual wedge (VW) to do)ermine the difference In the dose distribution affecting on the treated breast and the contralateral breast, lung, heart and surrounding perlpheral soft tissue. Methods and Materials: The data collected consisted of a measurement taken with solid water, a Humanoid Alderson Rando phantom and patients. The radiation doses at the ipsllateral breast and skin, contralateral breast and skin, surrounding peripheral soft tissue, and Ipsllateral lung and heart were compared using the physical wedge and virtual wedge and the radiation dose distribution and DVH of the treated breast were compared. The beam-on time of each treatment technique was also compared Furthermore, the doses at treated breast skin, contralateral breast skin and skin 1.5 cm away from 4he field margin were also measured using TLD in 7 patients of tangential breast Irradiation and compared the results with phantom measurements. Results: The virtual wedge showed a decreased peripheral dose than those of a typical physical wedge at 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$, and 60$^{\circ}$. According to the TLD measurements with 15$^{\circ}$ and 30$^{\circ}$ virtual wedge, the Irradiation dose decreased by 1.35$\%$ and 2.55$\%$ In the contralateral breast and by 0.87$\%$ and 1.9$\%$ In the skin of the contralateral breast respectively. Furthermore, the Irradiation dose decreased by 2.7$\%$ and 6.0$\%$ in the Ipsllateral lung and by 0.96$\%$ and 2.5$\%$ in the heart. The VW fields had lower peripheral doses than those of the PW fields by 1.8$\%$ and 2.33$\%$. However the skin dose Increased by 2.4$\%$ and 4.58$\%$ In the Ipsliateral breast. VW fields, In general, use less monitor units than PW fields and shoriened beam-on time about half of PW. The DVH analysis showed that each delivery technique results In comparable dose distribution in treated breast. Conclusion: A modest dose reduction to the surrounding normal tissue and uniform target homogeneity were observed using the VW technique compare to the PW beam in tangential breast Irradiation The VW field is dosmetrically superlor to the PW beam and can be an efficient method for minimizing acute, late radiation morbidity and reduce 4he linear accelerator loading bV decreasing the radiation delivery time.
Purpose : To analyze survival rate and late rectal and bladder complication for patients with stage I and II carcinoma of uterine cervix treated by radiation alone or combined with chemotherapy Materials and Methods : Between November 1984 and December 1993, 127 patients with stage I and II carcinoma of uterine cervix treated by radiation alone or combined therapy of radiation and chemotherapy. Retrospective analysis for survival rate was carried out on eligible 107 patients and review for complication was possible in 91 patients. The median follow-up was 47 months (range 3-118) and the median age of patiens was 56 years (range 31-76). 26 patients were stage IB by FIGO classification, 40 were stage IIA and 41 were stage IIB. 86 cases were treated by radiation alone and 21 were treated by radiation and chemotherapy. 101 patients were treated with intracavitary radiation therapy (ICRT), of these, 80 were received low dose rate (LDR) ICRT and 21 were received high dose rate (HDR) ICRT. Of the patients who received LDR ICRT, 63 were treated by 1 intracavitary insertion and 17 were underwent 2 insertions And we evaluated the external radiation dose and midline shield. Results : Actuarial survival rate at 5 years was $92{\%}$ for stage IB, $75{\%}$ for stage IIA, $53{\%}$ for stage IIB and $69{\%}$ in all patients Grade 1 rectal complications were developed in 20 cases ($22{\%}$), grade 2 were in 22 cases ($24{\%}$). 22 cases ($24{\%}$) of grade 1 urinary complications and 17 cases ($19{\%}$) of grade 2 urinary complications were observed But no patient had severe complications that needed surgical management or admission care. Maximum bladder dose for the group of patients with urinary complications was higher than that for the patients without urinary complications (7608 cGy v 6960cGy. p<0.01) Maximum rectal dose for the group of patients with rectal complications was higher than that for the patients without rectal complications (7041cGy v 6269cGy, p<0.01). While there was no significant difference for survival rate or bladder complication incidence as a function of dose to whole pelvis, Grade 2 rectal complication incidence was significantly lower for the patients receiving less than 4500cGy ($6.3{\%}$ v $25.5{\%}$, p<0.05). There was no significant differance between HDR ICRT group and LDR ICRT group for survival rate according to stage, on the other hand complication incidence was higher in the HDR group than LDR group, This was maybe due to different prescription doses between HDR group and LDR group. Midline shield neither improved survival rate nor decreased complication rate. The number of insertion in LDR ICRT group did not affect on survival and compication rate. Conclusion : In stage I and II carcinoma of uterine cervix there was no significant differance for 5 year survival rate by radiation therapy technique. Rectal complication incidence was as a function of dose to whole pelvis and there were positive correlations of maximum dose of rectum and bladder and each complication incidence. So we recommand whole pelvis dose less than 4500cGy and maximum dose of rectum and bladder as low as possible.
Purpose: On-line image guided radiation therapy(on-line IGRT) and(kV X-ray images or cone beam CT images) were obtained by an on-board imager(OBI) and cone beam CT(CBCT), respectively. The images were then compared with simulated images to evaluate the patient's setup and correct for deviations. The setup deviations between the simulated images(kV or CBCT images), were computed from 2D/2D match or 3D/3D match programs, respectively. We then investigated the correctness of the calculated deviations. Materials and Methods: After the simulation and treatment planning for the RANDO phantom, the phantom was positioned on the treatment table. The phantom setup process was performed with side wall lasers which standardized treatment setup of the phantom with the simulated images, after the establishment of tolerance limits for laser line thickness. After a known translation or rotation angle was applied to the phantom, the kV X-ray images and CBCT images were obtained. Next, 2D/2D match and 3D/3D match with simulation CT images were taken. Lastly, the results were analyzed for accuracy of positional correction. Results: In the case of the 2D/2D match using kV X-ray and simulation images, a setup correction within $0.06^{\circ}$ for rotation only, 1.8 mm for translation only, and 2.1 mm and $0.3^{\circ}$ for both rotation and translation, respectively, was possible. As for the 3D/3D match using CBCT images, a correction within $0.03^{\circ}$ for rotation only, 0.16 mm for translation only, and 1.5 mm for translation and $0.0^{\circ}$ for rotation, respectively, was possible. Conclusion: The use of OBI or CBCT for the on-line IGRT provides the ability to exactly reproduce the simulated images in the setup of a patient in the treatment room. The fast detection and correction of a patient's positional error is possible in two dimensions via kV X-ray images from OBI and in three dimensions via CBCT with a higher accuracy. Consequently, the on-line IGRT represents a promising and reliable treatment procedure.
We evaluated the diagnostic accuracy of $^{99m}Tc$-DISIDA scintigrauhy as a mean of differentiating biliary atresia from neonatal hepatitis. $^{99m}Tc$-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepatic retention Index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake Index was graded visually with 5 minute images using the following scoring scheme : grade 0(normal hepatic uptake), grade 1(decreased hepatic uptake), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent intestinal radioactivity. The results were as follows ; 1) None of the 30 biliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity. The sensitivity, specificity, and accuracy of the presence of intestinal radioactivity ?or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patients with absent intestinal radioactivity the mean hepatic retention index was $1.5{\pm}0.6$ in the 16 biliary atresia patients, and $1.1{\pm}0.2$ in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary atresia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake Index between biliary atresia and neonatal hepatitis patients. However there were differences in age, total bilirubin, and hepatic uptake index between neonatal hepatitis patients with and without intestinal radioactivity. The hepatic uptake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioactivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake Index and the hepatic retention index. Thus, we conclude that $^{99m}Tc$-DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patient's age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.
Present studies were carried out to investigate the distribution and formation of organic tiers contained paddy soils in Honam area characteristics to give basic informations on the effective utilization, management and improvement of the soils. The results obtained were summarized as follows; 1. The extent of organic tiers contained paddy soils in Honam area were 6.538㏊ and the amount of peat deposits were presumed about 2.41 million M/T. 2. Out of the total extent of the organic tiers contained paddy soils, about 97.6% was distributed in Honam plains (water-sheds of Mangyeong-Dongjin river), while about 1.5% in the Naju plains (water-sheds of Yeongsan river), and 0.9% in the Wando and Yeocheon areas. 3. The period of peat formation was presumed to be about the early of Seung Moon period (B.C. 4,250), and the Gongdeog series and the Bongnam series were formed in the bog conditions close to the valley mouth of near rolling and hill with small steram channels, and the Gimje series was formed in the out-skirts plains of the Gongdeog and Bongnam soils. 4. In the casue of peat formation, it was presumed to be the Gimje series that accumulated the fibrous peat out of the autochthonous peat such as reeds and grasses etc, to be the Gongdeog and Bongnam series that accumulated the autochtonous peat and the xylem and fibrous peat out of first allochthonous peat. 5. In the Organic horizons of these soils, the range of muck and peat horizons were in 62-68cm and 68-137cm of soil profile in the Gongdeog series, 52-84cm and 84-113cm in the Bongnam series respectively, one of muck horizon was in 46-71cm in the Gimje series. 6. The marks of soil horizons of the soils were expressed that the lower soils than the horizon of muck and peat were formed Cg, Aag for the muck horizon, 0 for the peat horizon, 0 of peat horizon were distingushed with Oag and Oig according to Organic forms. 7. The depthe occurred the muck and peat horizons were positively correlated with the width of local in the Gongdeog series ($r=0.881^{**}$, $r=0.827^{**}$), but not in the Bongnam series and Gimje series.
Kim, Hyeong Hwan;Kim, Dong Hwan;Yang, Chang Yeol;Kwon, Sun Jung;Jeon, Sung Wook;Song, Jin Sun;Cho, Myoung Rae;Lee, Chan Jung;Cheong, Jong Chun
Journal of Mushroom
/
v.11
no.4
/
pp.230-239
/
2013
The major species of fungus gnats which caused the severe damage in shiitake farm were identified as a Bradysia difformis, B. alpicola, and Camtomyia cortocalis on oak log beds cultivation. The B. difformis occurred early in the middle of March while B. alpicola and C. cortocalis appeared since the beginning of May. The occurrence rate for adults of B. difformis showed highly at the end of July (11.9~1,774.2 in dong-myeon and 0.4~2,583.3 in pungse-myeon) in 2012 and mid-June (10.7~4,650 in dong-myeon and 36.8~4740 in pungse-myeon) in 2013. The counting numbers on the traps for B. alpicola reached highest peak in the middle of June (2.1~63.2 in dong-myeon and 1.0~21.7 in pungse-myeon) and the end of May (0.8~163.7 in dong-myeon and 0.5~280.5 in pungse-myeon) in 2012 and 2013, respectively. The number of C. cortocalis showed high record in the middle of May in 2012 (0.6~4.7) and in the middle of June (2.1~17.3) in 2013 in dong-myeon whereas showed the peaks in the middle of May (0.6~4.7) in 2012 and in the late of May (1.3~17.6) in 2013 in pungse-myeon. The fruiting bodies of shiitake mushroom by fungus gnats were severely damaged from mid-June to late-July and the damage rate were 0.625.5% (2012) and 0.7~30.5% (2013) in dong-myeon and 1.5%~21.6% (2012) and 1.9~36.8%(2012) in pungse-myeon. To investigate the control effect for fungus gnats by Hypoaspis aculeifer, H. aculeifer (30 mixutre of nymph and adult per $m^2$) were treated to oak log beds shiitake cultivation for six times (May 2 and 28, June 25, July 10 and 25 and August 28). The occurrence rate of adults and damage rate of fruiting bodies of 3 major species reduced 79.3% (adult numbers) and 74.8% (fruiting bodies) in dong-myeon and 64.1% (adult numbers) and 65.5% (fruiting bodies) in pungse-myeon, respectively, compared to non-treatment. Accordingly, H. aculeifer effectively controlled the fungus gnats on shiitake mushroom and can be used as good control agent.
Purpose: The aim of this study was to evaluate the relationship between H. pylori infection and recurrent abdominal pain (RAP) in children and to evaluate the effects of eradication therapy on RAP. Methods: From January 1998 to January 2005, 166 children with RAP (61 male, 105 female) aged $10.0{\pm}3.3$ years were included. Upper gastrointestinal endoscopies were performed for all the patients. All H. pylori infected children (n=70) received the eradication therapy and were divided into two groups: Group Ia (n=52); eradicated, Group Ib (n=18); non-eradicated. H. pylori-negative children (n=96) were divided into three groups according to the medication: Group IIa (n=67); no medication, Group IIb (n=13); acid-suppressant, Group IIc (n=16); both acid-suppressant and antibiotics. Questionnaire for symptoms were asked at the first, 6th, 12th, 24th, and 36th months following the treatment (grade 0; completely resolved, grade 1; definitely improved, but there are occasional episodes of mild abdominal pain, grade 2; no change in the frequency and intensity of abdominal pain). Results: In about 90% of H. pylori positive children, RAP improved in the both H. pylori-eradicated and non-eradicated children in a follow-up survey. In about 75% of H. pylori-negative children, RAP also improved among in the three groups of patients regardless of medication. Conclusion: These results suggest that there was no correlations between improvement of RAP and eradication of H. pylori, and between improvement of RAP and medication. Consequently the reassurance that the children with RAP have no serious organic cause was important to improvement of RAP.
The aim of this study was to compare one-year graft patency after coronary artery bypass grafting without cardiopulmonary bypass(OPCAB) with that of conventional CABG and that of on-pump beating CABG, and to demonstrate any differences in patency of various conduits among the three groups. Material and Method: We analyzed the results of OPCAB cases(group I; n=122) compared with those of conventional CABG cases(group II; n=65) and those of on-pump beating CABG cases(group III; n=19). In group I, coronary angiography(CAG) was performed immediately postoperatively and 1 year after surgery. In group II and III, CAG was performed 1 year after surgery. Graft patency was graded as grade A(excellent), grade B(fair), or grade O(occluded). Result: The average number of distal anastomoses in groups I, II, and II were 3.1$\pm$1.1, 3.7$\pm$0.9, and 3.6$\pm$0.9, respectively. In group I, postoperative CAG was performed in 92%(112/122) of patients before discharge. The patency rate(grade A+B) was 96.4$(162/168) for arterial grafts, and 85.6%(160/187) for saphenous vein grafts(SVG). One-year follow-up CAG was performed in 74%(90/122) of patients. The patency rate was 97.8%(132/135) for arterial grafts, and 67.9%(106/156) for SVG. In group II, one-year follow-up CAG was performed in 65%(42/65) of patients. The patency rate(grade A+B) was 93.5%(43/46) for arterial grafts, and 86.8%(33/38) for SVG. Conclusion: Our results demonstrated that the patency rate of SVG after OPCAB was significantly lower than that of arterial grafts in the early postoperative CAG(p<0.001), and was also significantly lower than those of SVG of group II(p<0.001) and group III(p<0.01) in the postoperative one-year CAG, although there was no significant difference is one-year patency of arterial grafts among the three groups. Our data suggest that a specific perioperative anticoagulant therapy may be advisable in patients undergoing OPCAB with SVG.
Although high nutritional values and continuous identification of important functional substances of soybean [Glycine max (L.) Merrill.] promote consumption of soybean products worldwide, informations on quality of brand soybean is not enough for consumers. Total of 100 brand soybeans [32 for soypaste and source, 45 black testa (lage), and 17 black testa (small) or medicinal soybean and beansprout soybean] were collected at supermarkets and several external quality factors were analyzed. Brand soybeans were marked with the environmental friendly and intimating words along with soybean (white or yellow), black soybean (black-, frost-, late frost-, green or inner-green-), medicinal soybean and beansprout soybean. Among 100 brand soybeans 30% was 1 kg package and 59% was 500 g package, difference between printed and actual weights of 70% brand soybeans was ${\pm}1%$ and weights of 2/3 of brand soybeans were higher than printed weight. Range of 100 seed weights of soypaste and source, black testa (large) and black testa (small) and beansprout soybeans were $23.7{\sim}47.8g$, $21.9{\sim}44.5g$ and $9.5{\sim}15.0g$, respectively. Although ranges of 100 seed weights of soypaste and source and black testa (large) soybeans were similar, 63% of soypaste and source were less than 29 g, while 78% of black testa (large) soybeans were higher than 30 g. Although average and highest percentages of seeds separated with 6.7 mm sieve were similar with 87.4% and 99.9% for soypaste and source soybean and 86.5% and 99.5% for black testa (large) soybean, respectively, the lowest percentages were 70.7% for soypaste and source soybean and 14.4% for black testa (large) soybean. When 100 seed weight was greater than 35 g, 90% of seeds were remained on 6.7 mm sieve. On the other hand 100 g weight and percentage of seeds remained on 6.7 mm sieve showed significantly positive correlations [r=0.7488** for soypaste and source soybean and r=0.7874** for black testa (large) soybean when 100 seed weight was $20{\sim}30g$. Based on hilum color and/or appearance, 76% of brand soybeans collected (more than 90% in yellow testa soybeans) were found to be mixed more than 10% with other cultivars or landraces. Foreign materials such as sand, piece of clothe, wood piece, dead insects, other soybeans were found in 20% of brand soybeans. Average test weight of brand soybeans was 762g $L^{-1}$ with a range of $645{\sim}820g\;L^{-1}$. Soybeans from local markets were as good as brand soybeans in 100 seed weight, uniformity of seeds, weight of foreign materials and test weight.
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