• Title/Summary/Keyword: Concurrent

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A Relation of Urinary Aldosterone Concentration to K/Na Ratio Following Furosemide Administration in Normal Subjects with High Sodium or Low Sodium Intake (Furosemide 투여후의 뇨중 Aldosterone 농도대 K/Na 비사이의 관계)

  • Sung, Ho-Kyung
    • The Korean Journal of Physiology
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    • v.9 no.2
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    • pp.33-39
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    • 1975
  • Changes of urinary aldosterone excretion, concurrent sodium and potassium excretion following furosemide administration were studied in normotensive young Korean with high sodium intake, moderate sodium restriction and marked sodium depletion. After intravenous injection of furosemd 40mg, plasma and urine samples were collected at every thirty minutes for two hours. Plasma-and urinary aldosterone, electrolyte concentration and urine flow rate were measured by means of radioimmunoassay or flamephotometry. Relations of urinary aldosterone to concurrent sodium or potassium/sodium ratio, and of urinary aldosterone to concurrent plasma aldosterone activity were studied. Following were the results: 1. Furosemide administration resulted in a increased urinary aldosterone concentration and unchanged or somewhat decreased sodium concentration in course of time after the injection. 2. Urinary potassium concentration showed initial decrease and subsequent increase in course of time after furosemide administration and it resulted in a gradual increase in urinary potassium/sodium ratio. 3. Studying the relations between urinary aldosterone excretion and potassium/sodium excretion ratio, or sodium excretion were meaningless because of the urinary flow rate after the injection was decreased with time course. 4. Furosemide administration showed a good relationship of urinary aldosterone concentration to concurrent potassium/sodium ratio rather than concurrent sodium concentration in subjects with sodium restriction, but no meaningful relationship was detected in subjects with high sodium intake because increasing rate of the ratio was not so wide. 5. Furosemide also resulted a reasonable relation of plasma aldosterone concentration to concurrent urinary aldosterone concentration especially during low sodium intake. 6. Above results suggested that relation of urinary aldosterone concentration to K/Na ratio following furosemide administration during sodium restriction is significant and has a benefit to reduce the variation induced by kalemic change showing in the diragram for daily aldosterone to sodium excretion.

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Integrated CAD System for Ship and Offshore Projects

  • Suh, Heung-Won;Lee, Sung-Geun
    • International Journal of CAD/CAM
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    • v.6 no.1
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    • pp.41-48
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    • 2006
  • Nowadays major shipbuilding companies are trying to expand their business not only to shipbuilding but to offshore projects as well. DSME is one of them. DSME is trying to set up a flexible design and construction environment for shipbuilding and offshore construction in a single shipyard. The shipbuilding and offshore projects, however, have their unique technology but they need to be designed and constructed in one site. To support this new requirement, DSME has developed an integrated CAD system for ship and offshore projects. In this integrated design environment, the designers can design commercial ships and offshore projects in a flexible manner. Concurrent design is very important for ship and offshore design. As compared to the complexity of the product, the design period is quite short. In effect, the design system for the ship and offshore project has to support concurrent design. One essential point of concurrent design environment is a product model based design system. DSME has developed and implemented the 3D product model concurrent design environment based on Tribon M3. Tribon is a widely used CAD system in shipbuilding area that is developed by Tribon Solutions. DSME has both customized the Tribon system and developed in-house application systems to support its own design and production procedures. All the design objects are modeled in one common database to support concurrent design and accurate production. The major in-house development focused on the modeling automation and automatic drawing generation. During the drawing generation process many of the additional production information are also extracted from the 3D product model. In addition, several applications and functionalities have been developed to apply the shipbuilding based Tribon M3 system to offshore projects. The development of shape nesting, tubular connection, isometric drawing, grating nesting systems are the typical.

Definitive Concurrent Chemoradiotherapy in Cervical Cancer - a University of Malaya Medical Centre Experience

  • Zamaniah, W.I. Wan;Mastura, M.Y.;Phua, C.E.;Adlinda, A.;Marniza, S.;Rozita, A.M.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8987-8992
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    • 2014
  • Background: The efficacy of concurrent chemoradiotherapy in the treatment of locally advanced cervical cancer is well established. We aimed to investigate the long-term efficacy of definitive concurrent chemoradiotherapy for cervical cancer in the University of Malaya Medical Centre. Materials and Methods: A cohort of 60 patients with FIGO stage IB2-IVA cervical cancer who were treated with definitive concurrent chemoradiotherapy with cisplatin followed by intracavitary brachytherapy or external beam radiotherapy (EBRT) boost between November 2001 and May 2008 were analysed. Patients were initially treated with weekly intravenous cisplatin ($40mg/m^2$) concurrent with daily EBRT to pelvis of 45-50Gy followed by low dose rate brachytherapy or EBRT boost to tumour. Local control rate, progression free survival, overall survival and treatment related toxicities graded by the RTOG criteria were evaluated. Results: The mean age was 56. At the median follow-up of 72 months, the estimated 5-year progression-free survival (PFS) (median PFS 39 months) and the 5-year overall survival (OS) (median OS 51 months) were 48% and 50% respectively. The 5-year local control rate was 67.3%. Grade 3-4 late gastrointestinal and genitourinary toxicity occurred in 9.3% of patients. Conclusions: The 5-year PFS and the 5-year OS in this cohort were lower than in other institutions. More advanced stage at presentation, longer overall treatment time (OTT) of more than fifty-six days and lower total dose to point A were the potential factors contributing to a lower survival.

Gemcitabine-based Concurrent Chemoradiotherapy Versus Chemotherapy Alone in Patients with Locally Advanced Pancreatic Cancer

  • Wang, Bu-Hai;Cao, Wen-Miao;Yu, Jie;Wang, Xiao-Lei
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2129-2132
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    • 2012
  • Objective: To explore improved treatment by retrospectively comparing survival time of gemcitabine-based concurrent chemoradiotherapy (GemRT) versus chemotherapy (Gem) alone in patients with locally advanced pancreatic cancer (LAPC). Methods: From January 2005 to June 2010, 56 patients with LAPC from Subei People's Hospital were treated either with Gem (n=21) or GemRT (n=35). Gem consisted of 4-6 cycles gemcitabine alone (1000 mg/m2 on Days 1, 8, 15, 28-day a cycle). GemRT consisted of 50.4Gy/28F radiotherapy with concurrent 2 cycles of gemcitabine (1000 $mg/m^2$ on days of radiation 1, 8, 15, 21-day a cycle). Radiation was delivered to the gross tumor volume plus 1-1.5 cm by use of a three-dimensional conformal technique. The follow-up time was calculated from the time of diagnosis to the date of death or last contact. Kaplan-Meier methodology wes used to evaluate survival. Results: Patient characteristics were not significantly different between treatment groups. The disease control rate and the objective response rate of GemRT versus Gem was 97.1% vs 71.4%, 74.3% vs 38.1%. The overall survival (OS) was significantly better for GemRT compared to Gem (median 13 months versus 8 months; 51.4% versus 14.3% at 1 year, respectively). Conclusion: Radiation therapy at 50.4Gy with 2 concurrent cycles of gemcitabine results in favorable rates of OS. Concurrent chemoradiotherapy should be the first choice for patients with LAPC.

Concurrent Chemoradiotherapy in Nasopharyngeal Carcinoma (비인강암의 동시 항암화학방사선치료)

  • Chung, Eun-Ji;Kim, Yong-Tai;Hong, Hyun-Jun;Hong, Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.2
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    • pp.169-173
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    • 2008
  • Purpose:This is a retrospective study to evaluate the results of concurrent chemoradiotherapy in nasopharyngeal carcinoma. Material and Methods:From Mar 2000 to June 2005, 18 patients with nasopharyngeal carcinoma completed planned concurrent chemoradiotherapy. Stages were I in 1 patients, II in 2 patients, III in 7 patients and IV in 8 patients. Pathologic type was squamous cell carcinoma(WHO type 1) in 2 patients, non-keratinizing type(WHO type 2) in 8 patients and undifferetiated carcinoma(WHO type 3) in 8 patients. The follow up period ranged from 30 months to 95 months with a median of 56 months. Follow up was possible in all patients. Results:Response to concurrent chemoradiation therapy was a complete response in all patients. Patterns of failure were as follows:local recurrence in only one patient(5.6%) and distant metastases in three patients with N3 diseases(16.7%). The overall 5 year survival rates were 88.5%, the 5 year disease free survival rate was 77% and these were very good results. There were no significant differences in the local control and survival rates between the clinical stages and pathologic types. Conclusion:The outcome of the nasopharyngeal carcinoma treated with concurrent chemoradiotherapy was very good, even though most of the patients(15/18=83.3%) were in stage III and IV diseases. We concluded that concurrrent chemoradiotherapy in nasopharyngeal carcinoma showed the good local control and survival rates without significant complications. In the patients with N3 disease, we have to consider the more effective and strong chemotherapeutic regimens to prevent distant metastases.

Treatment outcome of radiation therapy and concurrent targeted molecular therapy in spinal metastasis from renal cell carcinoma

  • Park, Sangjoon;Kim, Kyung Hwan;Rhee, Woo Joong;Lee, Jeongshim;Cho, Yeona;Koom, Woong Sub
    • Radiation Oncology Journal
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    • v.34 no.2
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    • pp.128-134
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    • 2016
  • Purpose: To evaluate the clinical outcomes of patients who underwent radiation therapy with or without targeted molecular therapy for the treatment of spinal metastasis from renal cell carcinoma (RCC). Materials and Methods: A total of 28 spinal metastatic lesions from RCC patients treated with radiotherapy between June 2009 and June 2015 were retrospectively reviewed. Thirteen lesions were treated concurrently with targeted molecular therapy (concurrent group) and 15 lesions were not (nonconcurrent group). Local control was defined as lack of radiographically evident local progression and neurological deterioration. Results: At a median follow-up of 11 months (range, 2 to 58 months), the 1-year local progression-free rate (LPFR) was 67.0%. The patients with concurrent targeted molecular therapy showed significantly higher LPFR than those without (p = 0.019). After multivariate analysis, use of concurrent targeted molecular therapy showed a tendency towards improved LPFR (hazard ratio, 0.13; 95% confidence interval, 0.01 to 1.16). There was no difference in the incidence of systemic progression between concurrent and nonconcurrent groups. No grade ${\geq}2$ toxicities were observed during or after radiotherapy. Conclusion: Our study suggests the possibility that concurrent use of targeted molecular therapy during radiotherapy may improve LPFR. Further study with a large population is required to confirm these results.

Early Result of Surgical Resection after Pre-Operative Concurrent chemoradiotherapy for N2-Positive Stage IIIA NSCLC (N2 종격동 림프절 전이가 있는 제 III A 병기 비소세포폐암에 있어 수술전 동시화학방사선요법 후 폐적출술의 조기 성적)

  • 차대원;김진국;심영목;김관민;박근칠;안용찬
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.662-668
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    • 2000
  • Background: Many recent results of clinical trials show that pre-operative concurrent chemoradiotherapy and surgical resection could increase the survival of N2 positive stage IIIA non-small cell lung cancer. This study was performed to assess the feasibility, toxicity, and affect rates of concurrent chemoradiotherapy and surgical resection in N2 positive stage IIIA non-small cell lung cancer. Material and Method: Thirty-one patients who underwent preoperative concurrent chemoradiotherapy for N2 positive stage IIIA non-small-cell lung cancer from May 1997 to April 1999 were entered into the study. Mean age was 61 yrs(43∼70 yrs), There were 24 men and 7 women. The confirmation of N2 disease were achieved through mediastinoscopic biopsy(24) and CT scans(7). Induction was achieved by two cycles of cisplatin and etoposide(EP) plus concurrent chest radiotherapy to 45 Gy. Resections were done at 3 weeks after the complection of preoperative concurrent chemoradiotherapy. Resections were performed in 23 patients, excluding 5 refusals and 3 distant metastasis. Result: All patients were compled the thoracic radiotherapy except one who had distant metastasis. Twenty three patients were completed the planned 2 cycles of EP chemotherapy, and 8 patients were received only 1 cycle for severe side effects(6), refusal(1), and distant metastasis(1). There was one postoperative mortality, and the cause of death was ARDS. Three patients who had neutropenic fever and one patient who had radiation pneumonitis were required admission and treatment. Esophagitis was the most common acute side effect, but relatively well-tolerated in most patients. The complection rate of concurrent chemoradiotherapy was 74%, resection rate was 71%, pathologic complete remission rate was 13.6%, and pathologic down-staging rate was 68%. Conclusion: Morbidity related to each treatment was acceptable and many of the patients have benefited down staging of its disease. Further prospective, preferably randomized, clinical trials of larger scale may be warranted to confirm the actual benefit of preoperative concurrent chemoradiotherapy and surgical resection in N2-positive stage IIIA non-small cell lung cancer.

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Combined Modality Treatment in Nasopharyngeal Carcinoma (비인강암의 병합요법)

  • Yun, Sang-Mo;Kim, Jae-Cheol;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.100-106
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    • 2001
  • Purpose : We performed a retrospective analysis to compare short term results of induction chemotherapy-radiotherapy versus concurrent chemo-radiotherapy in patients with locally advanced nasopharyngeal carcinoma. Materials and Methods : From Oct. 1989 to May 1998, 62 patients with locally advanced nasopharyngeal carcinoma were treated with induction chemotherapy followed by radiotherapy (induction group) or concurrent chemo-radiotherapy (concurrent group). Induction chemotherapy was done for 50 patients, and concurrent chemotherapy for 12 patients. Age, sex, performance status, and pathologic types were evenly distributed between two groups. Stage distribution showed $32\%$ with IIB, $32\%$ with III, and $38\%$ with IV in induction group, and $50\%,\;33.3\%,\;and\;16.7\%$ in concurrent group, respectively. Chemotherapy regimen was CF (cisplatin and 5-FU) in both groups, and drug delivery method also same. Cisplatin $100\;mg/m^2$ was intravenously infused on day 1, and 5-FU $1,000\;mg/m^2$ on day $2\~6$. This was repeated at 3 weeks interval. At the end of radiotherapy, total cycles of chemotherapy were $1\~3$ (median 2) in both groups. Conventionally fractionated radiotherapy with daily fraction size $1.8\~2.0\;Gy$ and 5 fractions/week was done. Total dose was $69.4\~86\;Gy$(median 73.4 Gy) for induction group, and $69.4\~75.4\;Gy$ (median 70.8 Gy) for concurrent group. Follow-up time was $9\~116$ months (median 40.5 months) for induction group, $14\~29$ months (median 21 months) for concurrent group, respectively. Results : Overall 2 year survival rate (2YSR) for all patients was $78.7\%$. According to treatment modality, 2YSR were $77\%$ for induction group, $87\%$ for concurrent group (p>0.05). 2 year disease-free survival rate were $56\%$ and $81\%\;(p>0.05)$, respectively. Complete response to treatment were $75.5\%$ for induction group and $91.7\%$ for concurrent group, but there was no statistical difference. The incidence of grade $3\~4$ hematologic toxicity during radiotherapy was not differ between two groups, but grade 2 leukopenia was more frequent in concurrent group $(18\%\;vs\;66.7\%)$Grade $3\~4$ mucositis was more frequent in concurrent group $(4.0\%\;vs\;33.3\%)$. Overall incidence of grade $3\~4$ acute toxicity during radiotherapy was more frequent in concurrent group $(6.0\%\;vs\;41.7\%,\;p=0.005)$. Conclusion : Concurrent chemo-radiotherapy showed a trend of improvement in short-term survival and in treatment response when compared with induction chemotherapy-radiotherapy in locally advanced nasopharyngeal carcinoma. More controlled randomized trial are needed.

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