• Title/Summary/Keyword: Consolidation treatment

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Concurrent Chemoradiotherapy in Elderly Patients with Locally Advanced Esophageal Carcinoma (고령의 국소 진행된 식도암환자에서 동시 항암화학방사선치료)

  • Jung, Bae-Kwon;Kang, Ki-Mun;Lee, Gyeong-Won;Kang, Jung-Hoon;Kim, Hoon-Gu;Lee, Won-Seob;Chai, Gyu-Young
    • Radiation Oncology Journal
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    • v.27 no.2
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    • pp.84-90
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    • 2009
  • Purpose: The effect of concurrent chemoradiotherapy was analyzed in elderly patients when used in the treatment of locally advanced esophageal cancer. Materials and Methods: The retrospective analysis included 28 elderly patients aged 65 or older, with histopathologically confirmed squamous cell carcinoma of the esophagus, underwent concurrent chemoradiotherapy from January 2001 to July 2007. The squamous cell carcinoma disease stages included 8 patients (28.8%) in stage IIa, 10 patients (35.7%) in stage IIb, and 10 patients (35.7%) in stage III. Fractionated radiotherapy was performed with a 6 MV or 10 MV X-ray for 45~63 Gy (median: 59.4 Gy). Chemotherapy was applied concurrently with the initiation of radiotherapy. A 75 mg/$m^2$ dose of Cisplatin was intravenously administered on day 1. Further, 5-FU 1,000 mg/$m^2$ was continuously administered intravenously from days 1 to 4. This regimen was performed twice at 3-week intervals during radiotherapy. Two cycles of consolidation chemotherapy was performed after radiotherapy. Results: The follow-up period was 3~72 months (median: 19 months). The treatment responses after concurrent chemoradiotherapy included a complete response in 11 patients (39.3%), a partial response in 14 patients (50.0%), and no response in 3 patients (10.7%). The overall response rate was 89.3% (25 patients). The overall 1-, 2- and 3-year survival rates were 55.9%, 34.6% and 24.2%, respectively. The median survival time was 15 months. Two-year survival rates of patients with a complete response, partial response, and no response were 46.2%, 33.0%, and 0%, respectively. The stage and tumor response after concurrent chemoradiotherapy were statistically significant prognostic factors related with survival. No treatment-related deaths occurred in this study. Conclusion: Concurrent chemoradiotherapy is a relatively effective treatment without serious complications in elderly patients with locally-advanced esophageal cancer.

Combined Modality Therapy with Selective Bladder Preservation for Muscle Invading Bladder Cancer (침윤성 방광암 환자에서 방광 보존 치료)

  • Youn Seon Min;Yang Kwang Mo;Lee Hyung Sik;Hur Won Joo;Oh Sin Geun;Lee Jong Cheol;Yoon Jin Han;Kwon Heon Young;Jung Kyung Woo;Jung Se Il
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.237-244
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    • 2001
  • Purpose : To assess the tolerance, complete response rate, bladder preservation rate and survival rate in patients with muscle-invading bladder cancer treated with selective bladder preservation protocol. Method and Materials : From October 1990 to June 1998, twenty six patients with muscle-invading bladder cancer (clinical stage T2-4, N0-3, M0) were enrolled for the treatment protocol of bladder preservation. They were treated with maximal TURBT (transurethral resection of bladder tumor) and 2 cycles of MCV chemotherapy (methotrexate, crisplatin, and vinblastine) followed by $39.6\~45\;Gy$ pelvic irradiation with concomitant cisplatin. After complete urologic evaluation (biopsy or cytology), the patients who achieved complete response were planed for bladder preservation treatment and treated with consolidation cisplatin and radiotherapy (19.8 Gy). The patients who had incomplete response were planed to immediate radical cystectomy. If they refused radical cystectomy, they were treated either with TURBT followed by MCV or cisplatin chemotherapy and radiotherapy. The median follow-up duration is 49.5 months. Results : The Patients with stage T2-3a and T3b-4a underwent complete removal of tumor or gross tumor removal by TURBT, respectively. Twenty one out of 26 patients $(81\%)$ successfully completed the protocol of the planned chemo-radiotherapy. Seven patients had documented complete response. Six of them were treated with additional consolidation cisplatin and radiotherapy. One patient was treated with 2 cycles of MCV chemotherapy due to refusal of chemo-radiotherapy. Five of 7 complete responders had functioning tumor-free bladder. Fourteen patients of incomplete responders were further treated with one of the followings : radical cystectomy (1 patient), or TURBT and 2 cycles of MCV chemotherapy (3 patients), or cisplatin and radiotherapy (10 patients). Thirteen patients of them were not treated with planned radical cystectomy due to patients' refusal (9 patients) or underlying medical problems (4 patients). Among twenty one patients, 12 patients $(58\%)$ were alive with their preserved bladder, 8 patients died with the disease, 1 patient died of intercurrent disease. The 5 years actuarial survival rates according to CR and PR after MCV chemotherapy and cisplatin chemoradiotherapy were $80\%\;and\;14\%$, respectively (u=0.001). Conclusion : In selected patients with muscle-invading bladder cancer, the bladder preservation could be achieved by MCV chemotherapy and cisplatin chemo-radiotherapy. All patients tolerated well this bladder preservation protoco. The availability of complete TURBT and the responsibility of neoadjuvant chemotherapy and chemoradiotherapy were important predictors for bladder preservation and survival. The patients who had not achieved complete response after neoadjuvant chemotherapy and chemoradiotherapy should be immediate radical cystectomy. A randomized prospective trial might be essential to determine more accurate indications between cystectomy or bladder preservation.

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A Case of Idiopathic Interstitial Pneumonia in Childhood (소아 특발성 간질성 폐렴 1례)

  • Lee, Su-Jin;Shin, Eon-Woo;Park, Eun-Young;Oh, Phil-Soo;Lee, Kon-Hee;Kim, Kwang-Nam;Shin, Ho-Seung;Lee, Il-Seung
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.327-332
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    • 2005
  • Interstitial lung disease refers to a group of pulmonary disorders characterized by inflammation of the interstitium, derangements and loss of alveolar capillary units leading to disruption of alveolar gas exchange, which induces symptoms of restrictive lung disease. Cases of interstitial pneumonia in children are uncommon and mostly have unknown causes. We have experienced an 8-year old boy who had symptoms of cyanosis, dry cough, dyspnea and abrupt weight loss. He had not been exposed to organic dusts, allergens or any other systemic disease infections. Chest radiology showed diffuse ground glass opacity in both lung fields. High resolution computed tomography(HRCT) showed multiple small patchy areas of consolidation with an underlying ground glass appearance in both lungs. The pathologic findings of lung biopsy tissue showed patchy areas of interstitial fibrosis, alveolar obliteration and nodular fibrotic areas, strongly suggesting interstitial pneumonia. No specific finding of viral inclusion or any other evidence of infection was found under electromicroscopy. We used peak flow meters to compare functional improvement. Forced expiratory volume in one second ($FEV_1$) was decreased to 25 percent of predicted value. The boy was given treatment with prednisone and showed improvements in HRCT findings after two months. He was able to tolerate easy exercise in school and showed clinical improvements after one year of follow up.

EXPRESSION OF OSTEOGENESIS RELATED FACTORS ACCORDING TO DISTRACTION RATE IN THE DISTRACTION OSTEOGENESIS (신연 골형성술시 신연속도에 따른 골형성 관여 인자의 발현)

  • Jee, Yu-Jin;Kim, Yeo-Gab
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.250-265
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    • 2008
  • Distraction osteogenesis is a well-established clinical treatment for limb length discrepancy and skeletal deformities. Appropriate mechanical tension-stress is believed not to break the callus but rather to stimulate osteogenesis. In contrast to fracture healing, the mode of bone formation in distraction osteogenesis is primarily intramembranous ossification. Although the biomechanical, histological, and ultrastructural changes associated with distraction osteogenesis have been widely described, the basic biology of the process is still not well known. Moreover, the molecular mechanisms in distraction osteogenesis remain largely unclear. Recent studies have implicated the growth factor cascade is likely to play an important role in distraction. And current reserch suggested that mechanical tension-stress modulates cell shape and phenotype, and stimulates the expression of the mRNA for bone matrix proteins. The purpose of this study is to examine the pattern of expression of growth factors($TGF-{\beta}1$, IGF-I, bFGF) and extracellular matrix proteins(osteoclacin, osteonectin) related to osteogenesis by osteodistraction of the mandible in rabbits. 24 rabbits is used for this experiment. Experimental group are gradual distraction(0.7mm, twice/day), acute distraction(1.4mm, twice/day) and control group is only osteotomized. After 5 days latency, osteotomic site is distracted for each 7 days and 3.5 days. Consolidation period is 28 days. The animal is sacrificed at the 3th, 7th, 14th, 28th. The distracted bone is examined by immunohistochemical analysis and RT-PCR analysis. The results obtained from this study were as follow : No significant difference was found on clinical examination according to distraction rate, but gradual distraction was shown to improve regenerate bone formation on radiographic and histologic examination. Growth factors and extracelluar matrix proteins expression increased in distraction group than control group. From these results, it could be stated that graudal distraction is shown to improve and accelerate bone formation and mechanical stress like distraction has considerable effects on osteogenesis related factors. And rabbit is the most appropriate animal model for further reseach on the molecular mechanisms that mediate osteodistraction. It is believed that understanding the biomolecular mechanisms that mediate distraction osteogenesis may guide the development of targeted strategies designed to improve distraction osteogenesis and accelerate bone healing.

A Case of Bronchus-Associated Lymphoid Tissue(BALT) Lymphoma Treated with Lobectomy (폐엽절제를 통한 BALT 림프종 치료 1 예)

  • Choi, Won Sub;Cho, Jae Hyun;Hwang, Young Il;Jang, Seung Hun;Kim, Dong-Gyu;Jun, Sun-Young;Min, Kwangseon;Lee, In Jae;Lee, Jae Woong;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.427-431
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    • 2007
  • The bronchus-asociated lymphoid tissue(BALT) lymphoma is a low-grade primary malignant lymphoma that originates from bronchus associated lymphoid tissue. A 67-year-old woman was admitted for evaluation of cough, sputum, rhinorrhea which had persisted for one month. Physical examination showed decreased breathing sound on the left upper lung field. High resolution chest computed tomography demonstrated consolidation which showed air-bronchogram and surrounding ground glass opacity in left upper lobe. These findings implicated inactive tuberculosis, organizing pneumonia, or bronchiolo-alveolar carcinoma. The histologic findings from percutaneous needle aspiration biopsy revealed aggregated atypical small lymphoid cells with lymphoepithelial lesions. With immunohistochemical staining, the atypical lymphoid cells reacted positively with CD 20 antibody and negatively with CD 3 antibody. Thus, we could diagnosed her as a patient with BALT lymphoma. After left upper lobectomy, she has been well without recurrence of the disease for 14 months. In this country of Republic of Korea, it was the 1st case of BALT lymphoma surgically treated when histological diagnosis had been done. Based on this case, we wanted to demonstrate the importance of early histological diagnosis and treatment of BALT lymphoma.

Characterization of Surface Deterioration for Stone Property around the Hyeonleung (Royal Tomb of Joseon Dynasty) in Guri, Korea (구리 현릉 능상석물의 표면 손상특성 평가)

  • Oh, Jeong Hyun;Kim, Sa Dug;Lee, Chan Hee;Lee, Tae Jong
    • Journal of Conservation Science
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    • v.32 no.3
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    • pp.353-364
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    • 2016
  • The materials of sculptured stone property around the Hyeonleung Royal Tomb in Guri consist mainly of high weathered of granitic rocks with magnetite-series. Deterioration characteristics occurred highly with microorganism, soil inflow and black contaminants at the burial mound zone. As a result of deterioration evaluation, stone surface around the burial mound zone show serious comprehensive damage of soil inflow (50.5%) and lichen coverage (47.6%) which are the major damaging factors, and there are about 8.6% of biological growth noticeably in the north side. Surface contaminants and the discoloration had the complex causes. Gypsum occurred between joints of stones and the major contaminant type, darkening which was analyzed organic bodies caused discoloration. From result of ultrasonic velocity measurements, there are mean value of 2,195 m/s with highly weathered (HW) grade. Most of the stone properties showed 4 to 5 weathered grade. Therefore, it turned out that sculpture stone properties require conservation treatments. To remove soil accelerating damage factors and lichen occupying high percents, the cleaning process is necessary and consolidation, rejoining and filling are needed as well. Also, consideration on removing conservation materials containing Ca and e fflorescence is required and retreatments need to be considered.

The Role of H2O as PCA and the Precipitation Behavior in Mechanically Alloyed Ni-20Cr-20Fe-5Nb Alloy (기계적합금화로 제조된 Ni-20Cr-20Fe-5Nb 합금에서 PCA로서 H2O의 역할과 시효석출거동)

  • Kim Il-Ho;Kwun S.I.;Lee Won-Sik;Chae S.W.;Hwang S.K.;Kim M.H.
    • Journal of Powder Materials
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    • v.13 no.3 s.56
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    • pp.178-186
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    • 2006
  • The effect of use of $H_2O$ as PCA(process control agent) to prevent the carbon contamination during mechanical alloying process and the precipitation behavior in Ni-20Cr-20Fe-5Nb bulk alloy after aging were investigated. NbC and $Cr_2O_3$ were formed during mechanical alloying and consolidation processes in the Ni-20Cr-20Fe-5Nb alloy in which methanol($CH_3OH$) was added as PCA. Formation of NbC in this alloy decreased the amount of Nb dissolved in the Ni matrix. The use of $H_2O$ as PCA in Ni-20Cr-20Fe-5Nb alloy prevented the formation of NbC and increased the hardness. The increase of hardness in this alloy was attributed to the increased amount of Nb dissolved in the Ni matrix. After aging treatment for 20 hours at $600^{\circ}C\;and\;720^{\circ}C$ of Ni-20Cr-20Fe-5Nb bulk alloy in which $H_2O$ added as PCA, ${\gamma}"$$(Ni_3Nb,\;tetragonal)\;and\;{\delta}\;(Ni_3Nb,\;orthorhombic)$ precipitates were formed, respectively. The precipitation temperatures of ${\gamma}"$ and ${\delta}$ in this bulk alloy were lower than those in commercial IN 718 alloy. It seemed that the lower precipitation temperatures for ${\gamma}"$ and ${\delta}$ in this bulk alloy than in commercial IN 718 alloy were due to severe plastic deformation during mechanical alloying.

Effect of early chemoradiotherapy in patients with limited stage small cell lung cancer

  • Ha, In-Bong;Jeong, Bae-Kwon;Jeong, Hojin;Choi, Hoon-Sik;Chai, Gyu-Young;Kang, Myoung-Hee;Kim, Hoon Gu;Lee, Gyeong-Won;Na, Jae-Beom;Kang, Ki-Mun
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.185-190
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    • 2013
  • Purpose: We evaluated the effect of early chemoradiotherapy on the treatment of patients with limited stage small cell lung cancer (LS-SCLC). Materials and Methods: Between January 2006 and December 2011, thirty-one patients with histologically proven LS-SCLC who were treated with two cycles of chemotherapy followed by concurrent chemoradiotherapy and consolidation chemotherapy were retrospectively analyzed. The chemotherapy regimen was composed of etoposide and cisplatin. Thoracic radiotherapy consisted of 50 to 60 Gy (median, 54 Gy) given in 5 to 6.5 weeks. Results: The follow-up period ranged from 5 to 53 months (median, 22 months). After chemoradiotherapy, 35.5% of the patients (11 patients) showed complete response, 61.3% (19 patients) showed partial response, 3.2% (one patient) showed progressive disease, resulting in an overall response rate of 96.8% (30 patients). The 1-, 2-, and 3-year overall survival (OS) rates were 66.5%, 41.0%, and 28.1%, respectively, with a median OS of 21.3 months. The 1-, 2-, and 3-year progression free survival (PFS) rates were 49.8%, 22.8%, and 13.7%, respectively, with median PFS of 12 months. The patterns of failure were: locoregional recurrences in 29.0% (nine patients), distant metastasis in 9.7% (three patients), and both locoregional and distant metastasis in 9.7% (three patients). Grade 3 or 4 toxicities of leukopenia, anemia, and thrombocytopenia were observed in 32.2%, 29.0%, and 25.8%, respectively. Grade 3 radiation esophagitis and radiation pneumonitis were shown in 12.9% and 6.4%, respectively. Conclusion: We conclude that early chemoradiotherapy for LS-SCLC provides feasible and acceptable local control and safety.

Severe Endobronchial Inflammation Induced by Aspiration of a Ferrous Sulfate Tablet

  • Lim, Sang Youn;Sohn, Sung Birm;Lee, Jung Min;Lee, Ji Ae;Chung, Sangmi;Kim, Junga;Choi, Juwhan;Kim, Sehwa;Yoo, Ah Young;Roh, Jong Ah;Park, Haein;Kim, Won Shik;Sim, Jae Kyeom;Shim, Jae Jeong;Min, Kyung Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.1
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    • pp.37-41
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    • 2016
  • Iron supplements such as ferrous sulfate tablets are usually used to treat iron-deficiency anemia in some elderly patients with primary neurologic disorders or decreased gag reflexes due to stroke, senile dementia, or parkinsonism. While the aspiration of ferrous sulfate is rarely reported, it is a potentially life-threatening condition that can lead to airway necrosis and bronchial stenosis. A detailed history and high suspicion of aspiration are required to avoid delays in diagnosis and treatment. The diagnosis can be confirmed by bronchoscopic examination and a tissue biopsy. Early removal of the aspirated tablet prevents acute complications, such as bronchial necrosis, hemoptysis, and lobar consolidation. Tablet removal is also necessary to prevent late bronchial stenosis. We presented the first case in Korea of a ferrous sulfate tablet aspiration that induced severe endobronchial inflammation.

Application Experiments of Consolidation Treatment for Pelitic Sedimentary Rocks: Bird Track Fossils in Haman Formation (점토질 퇴적암의 강화처리 적용실험 연구: 함안층 새발자국 화석지)

  • Lee, Gyu Hye;Lee, Chan Hee;Yang, Hye Ri
    • Economic and Environmental Geology
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    • v.53 no.1
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    • pp.87-98
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    • 2020
  • The bird track fossil site in Haman Formation is divided into seven sedimental layers by the sedimentary structures, lithofacies and sequences. The bird tracks top on the highest layer, which includes ripple marks and suncracks. The layer has lithofacies with reddish grey siltstone and dark grey mudstone, alternately. As an analysis for the same rocks of the fossil site, physical properties show on mean values for 0.62% of absorption rate, 1.64% of porosity and 2.63 of specific gravity. Rock-forming minerals composed mainly of plagioclase, quartz, calcite, chlorite and mica. Meanwhile, we executed an experiments based on the petrography and weatherings to find a proper consolidants. In the experiments, the OH 100 reagent proved stable aspect and the lowest transition rate in terms of weight and chromaticity. Also, it showed the highest increase in ultrasonic velocity, improving the physical properties of the rocks. In the case of applying the OH 100 with antihygro, an swelling inhibitors on the sedimentary rocks, the chromaticity indicated an stable transition aspect. When it comes to the physical properties, the antihygro also decreases the porosity effectively. Thus, the most proper method for the fossil site of Haman Formation is to apply antihygro and OH 100 reagents since the rocks includes clay minerals that show swelling characteristics. However, this result is deduced from an indoor application experiments, leaving the necessity of verification how these reagents would affect the bird tracks site under the field condition.