• Journal of Gastric Cancer
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• v.3 no.3
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• pp.122-127
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• 2003

Purpose: The incidence rate and the mortality rate of gastric cancer have decreased in developed countries over the last several decades. On the other hand, they remain high in far eastern countries such as Korea, Japan, China and in many developing countries. The cure of patients with gastric carcinomas can be achieved mostly through complete surgical resection, but most gastric cancer patients are in advanced stages when diagnosed and have poor prognoses. therefore, the development of an effective systemic therapy is essential for far advanced gastric cancer patients. Until recently, the most commonly used combination chemotherapy was based on 5-flurouracil or cisplatin, but the results were not satisfactory, so recently etoposide, adriamycin and cisplatin (EAP-II) combination chemotherapy was introduced in patients with advanced gastric cancer. Early studies showed a high response rate and the ability to convert unresectable cases to resectable ones, but later studies couldn't duplicate the result. the purpose of this study was to evaluate the relative efficacy & toxicity of EAP-II chemotherapy and ELF chemotherapy which is based on 5-flurouracil. Materials and Methods: Between July 1992 and July 2002, sixty-five patients with inoperable advanced gastric cancer were enrolled for this study. Thirty-seven patient received EAP-II chemotherapy:etoposide (20 mg/$m^{2}$ IV for $1\∼5 days$), adriamycin (20 mg/$m^{2}$ IV for $1\∼5 days$) and cisplatin (20 mg/$m^{2}$ IV for $1\∼5 days$) and Twenty-eight patients receieved ELF chemotherapy : etoposide (100 mg/$m^{2}$ IV for $1\∼3 days$), leucovorin (20 mg/$m^{2}$ IV for $1\∼5 days$) and 5-FU (500 mg/$m^{2}$ IV for $1\∼5 days$). Each treatment schedule for each group was repeated every four weeks: EAP-II means 3.4 cycles per patient..ELF means 4.1 cycles per patient Results: Total respones rates were $5.4\%$ in the ELF group and $3.6\%$ in the EAP group (P-value>0.05). The median times to progression were 144 days in the ELF group and 92 days in the EAP-II group (P-value<0.05), and themedian overall survival times were 189 days in the ELF group and 139 days in the EAP-II group (P-value>0.05). The difference in the survival curves for the two regimens was not statistically significant. Non-hematologic toxicitis & hematologic toxicitis were more frequently observed for the EAP-II regimen. Anemia: $27.6\%$ in ELF vs $54\%$ in EAP-II; Leukopenia: $8.5\%$ in ELF vs $19\%$ in EAP-II; nausea & vomiting: $45.9\%$ in ELF vs $67.8\%$ in EAP-II. Conclusion: EAP-II regimen is not superior to ELF regimen in the tratment of inoperable advanced gastric cancer (J Korean Gastric Cancer Assoc 2003;3:122-127)

• Tuberculosis and Respiratory Diseases
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• v.55 no.1
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• pp.88-97
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• 2003

Background : Although smoking is a major cause of chronic obstructive pulmonary disease (COPD), only 10-20% of cigarette smokers develop symptomatic COPD, which suggests the presence of genetic susceptibility. This genetic susceptibility to COPD might depend on variations in the activities of the enzyme that detoxify hazardous chemical products, such as microsomal epoxide hydrolase (mEPHX) and glutathione-S transferase M1 subunit (GSTM1) genes. Methods : The genotypes of 58 patients with COPD, and 79 age matched control subjects, were determined by a polymerase chain reaction, followed by restriction fragment length polymorphism (PCR-RFLP) for the mEPHX, and multiplex PCR for the GSTM1. Results : GSTM1 was deleted in 53.3% of the subjects. There was no difference in GSTM1 deletion rates between the COPD patients (32/58, 55.2%) and the control subjects (41/79, 51.9%). The combination patterns of two polymorphisms of mEPHX showed slow enzyme activity in 29(21.2%), normal in 73(53.3%) and fast in 32(23.4%). The COPD group (7/57, 12.3%) showed a significantly lower incidence of slow enzyme activity compared to the control subjects (22/77, 28.6%, p<0.05). However, when the COPD and control groups were compared with smokers only, there were no significant differences in the genotypes of GSTM1 and mEPHX. Conclusion : The genotypes of GSTM1 and mEPHX were not significant risk factors of COPD in this cohort of study.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.330-338
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• 2009

Purpose : The causes of acute lower respiratory tract infection (ALRTI) are mostly attributable to viral infection, including respiratory syncytial virus (RSV), parainfluenza virus (PIV), influenza virus A/B (IFV A/B), or adenovirus (ADV). Several Korean studies reported human metapneumovirus (hMPV) as a common pathogen of ALRTI. However, studies on seasonal distribution and clinical differences relative to other viruses are insufficient, prompting us to perform this study. Methods : From November 2006 to October 2007, we tested nasopharyngeal aspiration specimens in children hospitalized with ALRTI with the multiplex reverse transcriptase-polymerase chain reaction to identify 6 kinds of common pathogen (hMPV, RSV, PIV, IFV A/B, and ADV). We analyzed positive rates and clinical features by respiratory chart review. Results : We detected 38 (8.4%) hMPV-positive cases out of 193 (41.8%) virus-positive specimens among 462 patients. HMPV infection prevailed from March to June with incidence peaking in April. HMPV-positive patients were aged 15 years (76.3%), and the ratio of boys to girls was 1.2:1. The median age was 27 months. HMPV primarily caused pneumonia (76.3 %) (P=0.018). Average hospitalization of HMPV-associated ALRTI patients was 5.8 days. In addition, they showed parahilar peribronchial infiltration (100%) on chest X-ray, normal white blood cell count (73.7%), and negative C-reactive protein (86.8 %) (P>0.05). All hMPV-positive patients recovered without complication. Conclusion : HMPV is a common pathogen of ALRTI in Korean children, especially in 1-5 year olds, from March to May. Immunocompetent children diagnosed with hMPV-associated ALRTI may have a good prognosis.

• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1411-1416
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• 2002

Purpose : Although the use of intravenous gamma-globulin(IVGG) in Kawasaki disease(KD) is effective in reducing clinical symptoms and coronary artery complications, 20-30% of patients have persistent or recrudescent fever and ongoing clinical symptoms. In these patients, the additional infusion of IVGG is considered. The authors studied the characteristics of patients who received IVGG retreatment, and compared them with the patients who did not need IVGG retreatment, for determination of IVGG retreatment. Methods : We reviewed the medical records of 117 KD patients who could be followed up at least six months. We studied the conventional laboratory findings, electrocardiogram(EKG), signal averaged ECG(SAECG) and echocardiogram. Results : Twenty three patients had early cardiac complications during the six months of follow-up. Four patients had late cardiac complications after six months. The early cardiac complication rate was higher in the IVGG retreatment group than the single infusion group(P<0.0001). The late complication rate was also higher in the retreatment group(P<0.0001). The patients who received methyl-prednisolone(m-PD) pulse therapy had much higher rates of early and late cardiac complications than those who received a single IVGG infusion. Among the clinical data and laboratory findings, only CRP increased significantly in patients who have had the cardiac complications. The IVGG retreatment group had increased CRP than the single infusion group. Conclusion : The patients with increased initial CRP may have an increased incidence of complications and an increased possibility of IVGG retreatment. We thought that retreated KD patients might have inflammations severe enough to need high dose IVGG as shown by high CRP levels, and IVGG retreatment could not prevent coronary artery lesions sufficiently.

• Korean Journal of Animal Reproduction
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• v.24 no.1
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• pp.19-33
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• 2000

Eighty dairy farms (38 farms responded) in Palmerston North area of New Zealand were questioned by mail questionnaire on: 1) general characteristics, 2) milk yield and feed supplementary, 3) reproductive efficiencies (12 questions) and 4) reproductive disorders (12 questions) from February to July, 1998. Among those 4 items, the reproductive efficiencies (3) and disorders (4), various diseases and culling rates were surveyed and analyzed for Korean dairy farmers (especially in Cheju island) and compared with New Zealand. The results are as follows: 1. Fifteen farms in 38 dairy farms relied entirely on artificial insemination, the rest of 23 dairy farms (60.5%) raised 5∼6 bulls to increase conception rate. The dairy farmers in Palmerston North used artificial insemination from Oct 4th to Dec 10th for 42.8 days, and then used bulls from that point to coming Jan 10th for 41.4 days. The submission rate within 3, 6 and 10 weeks following the initiation of AI season was 84.7, 93.9 and 97.9% respectively. 2. The average age of heifers at the first estrus, pregnancy and calving was 11.0, 18.0 and 24.7 months respectively, and an average 1.4 estrus cycles were required for conception. The intervals of estrus recurrence and the following conception after calving were 38 and 68 days respectively. 3. Among inseminated cows, calving, abortion and empty cow was 90.9, 1.6 and 7.4% respectively. Calving rate decreased according to increasing farm size, while the number of empty cows decreased. 4. Stillbirth, retained placenta and delivery abnormalities were 5.3, 3.7 and 5.5% respectively, not different depend on herd size. 5. The incidence of milk fever, grass tetany, and ketosis was 3.6, 3.0 and 1.0%, respectively. The delivery abnormality and mastitis treated with medicine were 3.1 and 6.7%, but decreased according to farm size. Lameness was 8.6% on average, but over 10% in farms which has more than 400 milking cows. 6. Among the culled cows (15.5% of the total), those culled due to an old age, lameness and other diseases were 2.9, 1.8 and 4.3% respectively and those culled due to low milk production, reproductive abnormality reduced with farm size. 7. Compared with the data collected in Korea, the reproductive efficiency was better, and lameness, metabolic problem and culling rate were higher in New Zealand

• Korean journal of applied entomology
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• v.54 no.3
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• pp.191-197
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• 2015

Fruit drop due to Eurytoma maslovskii infestations of Japanese apricot (Prunus mume) is a serious economic issue in most parts of Jeonnam Province, with the exception of the coastal areas such as Wando, Shinan, Yeosu, and Muan. The average incidence of fruit drop was 67% in 2013 and 33.3% in 2014. E. maslovskii larvae overwinter inside the pits of Japanese apricots. Larval survival rates decrease to less than 30% after a rainy summer season. The eggs are long oval of 0.68 mm, 0.29 mm and ivory white. Mature larva is of 6.56 mm, 3.18 mm. Free pupa are black, adult females and males of 6.97 mm, 4.90 mm lengths, respectively, while the ovipositor is 0.64 mm in length. Adult emergence occurs from early April to early May, when Japanese apricot fruits are from 4 mm to 17 mm in diameter. Adults persist for 13.5 d after emergence, and the sex ratio of females to males was found th be 45.9:54.1. Although up to four eggs may be oviposited per fruit, only one larva will ultimately survive, ans the larvae are cannibalistic. The period during which E. maslovskii is able to oviposit on Japanese apricots only lasts from mid- to late April (fruit diameter: 12~16 mm). When the diameter of the fruit is >16 mm, the pit of the Japanese apricot hardens and larvae have difficultly penetrating the stone. Therefore, the most effective method of controlling this pest is to spray orchards with a control agent 2~3 times, at 5 d intervals, beginning in mid- April.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.474-480
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• 1995

Background: In spite of initial intensive and long-term chemotherapy for pulmonary tuberculosis, many problems remain in the treatment of the residual lesion. The role of surgical intervention for pulmonary tuberculosis is getting rid of such residual lesion of pulmonary tuberculosis to support the healing process and to induce bacteriologically negative conversion in the end. Method: We experienced 30 cases of pulmonary resection for pulmonary tuberculosis from Aug. 1994 through Apr. 1995 in National Masan Tuberculosis Hospital. We conducted retrospective study to analyze several variables for the cases. Results: 1) The ratio between male and female was 4:1(male 24, female 6) and the age of peak incidence was in 3rd and 4th decades. 2) Indications for pulmonary resection in the radiographic findings were cavitary lesions of 19 cases(63.3%), destroyed one side of 8 cases(26.7%) and destroyed one lobe of 3 cases(10%). 3) 16 of 20 cases with unilateral lesions and all of 10 cases with bilateral lesions on chest X-ray films showed AFB positive on preoperative sputum smears. 14 cases(87.5%) of unilateral lesions and 9 cases(90%) of bilateral ones were converted into AFB negative postoperatively. Negative conversion rates of pneumonectomy and lobectomy cases were 100% and 85.7%, respectively. 4) Preoperative combined disease was 3 cases(10%) of DM and postoperative complications were 2 cases(6.7%) of dead space and no death. Conclusion: Chemotherapy only has some limitation in treatment of all tuberculosis. So, surgical intervention for pulmonary tuberculosis is an effective method as partner of chemotherapy.

• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.504-511
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• 2021

Purpose: This study examined the difference between the drainage volume, blood loss, transfusion rate, volume, and complications with or without an intra-articular (IA) tranexamic acid (TXA) injection among patients who underwent simultaneous bilateral total knee arthroplasty (SBTKA) with bilateral knee joint osteoarthritis, including patients who have contraindications of intravenous administration. Materials and Methods: Among patients who underwent SBTKA from April 2016 to December 2018, 139 patients injected with 3 g of TXA in each side through a drainage tube after joint capsule repair (group T), and 57 patients (group A) who underwent the procedure without TXA between October 2007 and August 2010 were tested. No significant difference in age and sex was observed between the two groups (p=0.572, 0.474). TXA was injected in patients with contraindications of intravenous administrations. Patients who underwent SBTKA with inflammatory arthritis were excluded from this study. The average amount of drainage, blood loss, transfusion rate, volume and daily average transfusion rate, and hemoglobin (Hb) change by the postoperative day were compared. Complications, such as deep vein thrombosis, pulmonary thromboembolism, myocardial infarction, cerebral infarction, and infection, were investigated. Results: The average total blood losses in groups A and T were 2195.32±1175.63 ml and 1145.09±382.95 ml, respectively, and the average total drain volume was 1,178.30±48.59 ml and 774.19±310.06 ml, respectively; both were significantly lower in group T (p=0.002, <0.001). The transfusion rates were 77.2% (44/57) and 0.7% (1/139), which were significantly lower in group T (p<0.001). The total average transfusion volume in groups A and T were 735.44±550.83 ml and 4.60±54.28 ml, respectively, which were significantly lower in group T (p<0.001). Hb tended to increase for three or four days after surgery in group A and group T. Regarding complications, deep vein thrombosis was encountered in two cases (1.4%), and pulmonary thromboembolism was noted in three cases (2.2%) in group T, but there were no cases in group A. No infections, cerebral infarction, or myocardial infarction occurred. Conclusion: In SBTKA, IA injections of TXA reduced the average drain volume, blood loss, transfusion rate, and volume significantly and did not increase the incidence of complications, even in patients with contraindications of intravenous administration.

• Radiation Oncology Journal
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• v.22 no.2
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• pp.115-123
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• 2004

Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.237-246
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• 2008

Purpose: Three-dimensional conformal radiation therapy (3DCRT) and intensity-modulated radiation therapy (IMRT) were found to reduce the incidence of acute and late rectal toxicity compared with conventional radiation therapy (RT), although acute and late urinary toxicities were not reduced significantly. Acute urinary toxicity, even at a low-grade, not only has an impact on a patient's quality of life, but also can be used as a predictor for chronic urinary toxicity. With bladder filling, part of the bladder moves away from the radiation field, resulting in a small irradiated bladder volume; hence, urinary toxicity can be decreased. The purpose of this study is to evaluate the impact of bladder volume on acute urinary toxicity during RT in patients with prostate cancer. Materials and Methods: Forty two patients diagnosed with prostate cancer were treated by 3DCRT and of these, 21 patients made up a control group treated without any instruction to control the bladder volume. The remaining 21 patients in the experimental group were treated with a full bladder after drinking 450 mL of water an hour before treatment. We measured the bladder volume by CT and ultrasound at simulation to validate the accuracy of ultrasound. During the treatment period, we measured bladder volume weekly by ultrasound, for the experimental group, to evaluate the variation of the bladder volume. Results: A significant correlation between the bladder volume measured by CT and ultrasound was observed. The bladder volume in the experimental group varied with each patient despite drinking the same amount of water. Although weekly variations of the bladder volume were very high, larger initial CT volumes were associated with larger mean weekly bladder volumes. The mean bladder volume was $299{\pm}155\;mL$ in the experimental group, as opposed to $187{\pm}155\;mL$ in the control group. Patients in experimental group experienced less acute urinary toxicities than in control group, but the difference was not statistically significant. A trend of reduced toxicity was observed with the increase of CT bladder volume. In patients with bladder volumes greater than 150 mL at simulation, toxicity rates of all grades were significantly lower than in patients with bladder volume less than 150 mL. Also, patients with a mean bladder volume larger than 100 mL during treatment showed a slightly reduced Grade 1 urinary toxicity rate compared to patients with a mean bladder volume smaller than 100 mL. Conclusion: Despite the large variability in bladder volume during the treatment period, treating patients with a full bladder reduced acute urinary toxicities in patients with prostate cancer. We recommend that patients with prostate cancer undergo treatment with a full bladder.