Treatment Result of Ovarian Dysgerminoma (난소 미분화배세포종에 대한 방사선치료 결과)
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- Radiation Oncology Journal
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- v.15 no.4
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- pp.379-385
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- 1997
Purpose : Ovarian dysgerminoma is a highly radiosensitive malignant tumor occurring in young age group. The conventional treatment was total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by radiotherapy. We retrospectively analyzed the treatment results of Patients who had received radiotherapy in the era before chemotherapy was widely used. Material and Method : Twenty two patients with ovarian dysgerminoma were treated at the Department of Therapeutic Radiology, Seoul National University Hospital between August, 1980 and May, 1991. Four patients were excluded from this study, because three patients received incomplete treatment and one received combined chemotherapy. Sixteen patients received postoperative radiotherapy and two patients had radical radiotherapy as tumor was unresectable. Median follow-up period was 99 months (range, 51-178) Median age was 22 years (range, 11-42). Among the postoperatively treated patients, three Patients were in stage IA, eight in stage IC, two in stage II, and three in stage III. One patient had Turner's syndrome. Radiotherapy was performed with high energy photon (telecobalt unit or linear accelerator, either 6MV or 10MV), The radiation dose to the whole abdomen was 1950-2100cGy (median, 2000) and 1050-2520cGy was added to the whole pelvis, the total dose to the whole pelvis was 3000-4500cGy (median, 3500). Prophylactic Paraaortic area irradiation was done in six Patients (dose range, 900-1500cGy). One patient who had positive Paraaortic node, received radiation dose of 1620cGy, followed by additional 900cGy to the gross mass with shrinking field. Total dose to the paraaortic node was 4470cGy. Six patients, including one who had paraaortic node metastasis, received Prophylactic irradiation to mediastinum and supraclavicular area (2520cGy). Of the two patients with unresectable tumors who received radical radiotherapy, one was in stage III and the other was in stage IV with left supraclavicular lymph node metastasis. The stage III patient received radiation to the whole abdomen (2000cGy), followed by boost to whole pelvis (2070cGy) and paraaortic area (2450cGy). Stage IV patient received radiation to the whole abdomen (2000cGy), followed by radiation to the whole pelvis and paraaortic area (2400cGy), mediastinum (2520cGy) , and left supraclavicular area (3550cGy) .Results : The 5 year local control rate was
There is nothing more important than the form and function in design, because every design product can be done on the basis of them. Form and Function are already existed before the word of design has been appeared and all the natural and man-made things' basic organization is based on their organic relations. The organic relations is the source of vitality which identifies the subsistance of all the objects and the evolution of living creatures has been changed their appearances by the natural law and order. Design is no exception. Design is a man-made organic thing which is developed its own way according to the purposed aim and given situations. If so, what is the ultimate goal of design. It is without saying that the goal is to make every effort to contribute to the -human beings most desirable life by the designer who is devoting himself to their convenience and well-being. Therefore, the designer can be called the man of rich life practitioner. This word implies a lot of meanings since the essence of design is improving the guality of life by the man-made things which are created by the designer. Also, the things are existed through the relations between form and function, and the things can keep their value when they are answered to the right purpose. In design, thus, it is to be a main concern how to create valuable things and to use them in the right way, and the subject of study is focused on the designer's outlook of value and uk relations between form and function. Christopher Alexander mentioned the importance of form as follows. The ultimate object of design is form. Every design problem begins with an effort to achieve fittness between the form and its context. The form is the solution to the problem: the context defmes the problem. In other words, when we speak of design, the real object of discussion is not form alone, but the ensemble comprising the form and its context. Good fit is a desirable property of this ensemble which relates to some particular division of the ensemble into form and context. Max Bill mainatined how important form is in design. Form represents a self-contained concept, and its embodiment in an object results in that object becoming a work of art. Futhermore, this explains why we use form so freguently in a comparative sense for determining whether one thing is less or more beautiful than another, and why the ideal of absolute beauty is always the standard by which we appraise form, and through form, art itself. Hence form has became synonymous with beauty. On the other hand, Laszlo Moholy-Nagy stated the importance of function as follows. Function means the task an object is designed to fulfill the task instrument is shaping the form. Unfortunately, this principle was not appreciated at the same time but through the endeavors of Frank Lloyd Wright and of the Bauhaus group and its many collegues in Europe, the idea of functionalism became the keynote of the twenites. Functionalism soon became a cheap slogan, however, and its original meaning blurred. It is neccessary to reexamine it in the light of present circumstances. Charles William Eliot expressed his idea on the relations between function and beauty. Beauty often results chiefly from fittness: indeed it is easy to manitain that nothing is fair except what is fit its uses or functions. If the function of the product of a machine be useful and valuable, an the machine be eminently fit for its function, it conspicuously has the beauty of fittness. A locomotive or a steamship has the same sort of beauty, derived from the supreme fittness for its function. As functions vary, so will those beauty..vary. However, it is impossible to study form and function in separate beings. Function can't be existed without form, and without function, form is nothing. In other words, form is a function's container, and function is content in form. It can be said that, therefore, the form and function are indispensable and commensal individuals which have coetemal relations. From the different point of view, sometimes, one is more emphasized than the other, but in this case, the logic is only accepted on the assumption of recognizing the importance of the other's entity. The fact can be proved what Frank Hoyd wright said that form and function are one. In spite of that, the form and function should be considered as independent indivisuals, because they are too important to be treated just as the simple single one. Form and function have flexible properties to the context. In other words, the context plays a role as the barometer to define the form and function, also which implies every meaning of surroun'||'&'||'not;dings. Thus, design is formed under the influence of situations. Situations are dynamic, like the design process itself, in which fixed focus can be cripping. Moreover, situations control over making the good design. Judging from the respect, I defined the good design in my thesis An Analytic Research on Desigh Ethic, "good design is to solve the problem by the most proper way in the situations." Situations are changeable, and so is design. There is no progress without change, but change is not neccessarily progress. It is highly desirable that there changes be beneficial to mankind. Our main problem is to be able to discriminate between that which should be discarded and that which should be kept, built upon, and improved. Form and Function are no exception. The practical function gives birth to the inevitable form and the
Purpose: To evaluate the treatment outcomes after postmastectomy radiotherapy (PMRT) and chemotherapy in patients with breast cancer. Materials and Methods: The PMRT were retrospectively analyzed in 83 patients with stage II-III female breast cancer treated between 1989 and 1995. The median age was 46 years (range, 23-77): Seventy-seven patients had modified radical mastectomies, 5 radical mastectomies and 1 simple mastectomy. Three patients (
Purpose: To analyze the treatment outcomes, complications, prognostic factors after a long-term follow-up of patients with nasopharyngeal carcinoma treated with radiation therapy (RT) alone or concurrent chemoradiation therapy (CCRT). Materials and Methods: Between December 1981 and December 2006, 190 eligible patients with non-metastatic nasopharyngeal carcinoma were treated at our department with a curative intent. Of these patients, 103 were treated with RT alone and 87 patients received CCRT. The median age was 49 years (range, 8~78 years). The distributions of clinical stage according to the AJCC 6th edition included I: 7 (3.6%), IIA: 8 (4.2%), IIB: 33 (17.4%), III: 82 (43.2%), IVA: 31 (16.3%), IVB: 29 (15.3%). The accumulated radiation doses to the primary tumor ranged from 66.6~87.0 Gy (median, 72 Gy). Treatment outcomes and prognostic factors were retrospectively analyzed. Acute and late toxicities were assessed using the RTOG criteria. Results: A total of 96.8% (184/190) of patients completed the planned treatment. With a mean follow-up of 73 months (range, 2~278 months; median, 52 months), 93 (48.9%) patients had relapses that were local 44 (23.2%), nodal 13 (6.8%), or distant 49 (25.8%). The 5- and 10-year overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) rates were 55.6% and 44.5%, 54.8% and 51.3%, in addition to 65.3% and 57.4%, respectively. Multivariate analyses revealed that CCRT, age, gender, and stage were significant prognostic factors for OS. The CCRT and gender were independent prognostic factors for both DFS and DSS. There was no grade 4 or 5 acute toxicity, but grade 3 mucositis and hematologic toxicity were present in 42 patients (22.1%) and 18 patients (9.5%), respectively. During follow-up, grade 3 hearing loss in 9 patients and trismus in 6 patients were reported. Conclusion: The results of our study were in accordance with findings of previous studies and we confirmed that CCRT, low stage, female gender, and young age were related to improvement in OS. However, there are limitations in the locoregional control that can be achieved by CCRT with 20 conventional radiation therapy. This observation has led to further studies on clarifying the efficacy of concurrent chemotherapy by intensity modulated radiation therapy.
Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.
With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study.
Researchers in welfare services of local government in Korea have rather been on isolated issues as disables, childcare, aging phenomenon, etc. (Kang, 2004; Jung et al., 2009). Lately, local officials, yet, realize that they need more comprehensive welfare services for all residents, not just for above-mentioned focused groups. Still cases dealt with focused group approach have been a main research stream due to various reason(Jung et al., 2009; Lee, 2009; Jang, 2011). Social Security Information System is an information system that comprehensively manages 292 welfare benefits provided by 17 ministries and 40 thousand welfare services provided by 230 local authorities in Korea. The purpose of the system is to improve efficiency of social welfare delivery process. The study of local government expenditure has been on the rise over the last few decades after the restarting the local autonomy, but these studies have limitations on data collection. Measurement of a local government's welfare efforts(spending) has been primarily on expenditures or budget for an individual, set aside for welfare. This practice of using monetary value for an individual as a "proxy value" for welfare effort(spending) is based on the assumption that expenditure is directly linked to welfare efforts(Lee et al., 2007). This expenditure/budget approach commonly uses total welfare amount or percentage figure as dependent variables (Wildavsky, 1985; Lee et al., 2007; Kang, 2000). However, current practice of using actual amount being used or percentage figure as a dependent variable may have some limitation; since budget or expenditure is greatly influenced by the total budget of a local government, relying on such monetary value may create inflate or deflate the true "welfare effort" (Jang, 2012). In addition, government budget usually contain a large amount of administrative cost, i.e., salary, for local officials, which is highly unrelated to the actual welfare expenditure (Jang, 2011). This paper used local government welfare service data from the detailed data sets linked to the Social Security Information System. The purpose of this paper is to analyze the factors that affect social welfare spending of 230 local authorities in 2012. The paper applied multiple regression based model to analyze the pooled financial data from the system. Based on the regression analysis, the following factors affecting self-funded welfare spending were identified. In our research model, we use the welfare budget/total budget(%) of a local government as a true measurement for a local government's welfare effort(spending). Doing so, we exclude central government subsidies or support being used for local welfare service. It is because central government welfare support does not truly reflect the welfare efforts(spending) of a local. The dependent variable of this paper is the volume of the welfare spending and the independent variables of the model are comprised of three categories, in terms of socio-demographic perspectives, the local economy and the financial capacity of local government. This paper categorized local authorities into 3 groups, districts, and cities and suburb areas. The model used a dummy variable as the control variable (local political factor). This paper demonstrated that the volume of the welfare spending for the welfare services is commonly influenced by the ratio of welfare budget to total local budget, the population of infants, self-reliance ratio and the level of unemployment factor. Interestingly, the influential factors are different by the size of local government. Analysis of determinants of local government self-welfare spending, we found a significant effect of local Gov. Finance characteristic in degree of the local government's financial independence, financial independence rate, rate of social welfare budget, and regional economic in opening-to-application ratio, and sociology of population in rate of infants. The result means that local authorities should have differentiated welfare strategies according to their conditions and circumstances. There is a meaning that this paper has successfully proven the significant factors influencing welfare spending of local government in Korea.
Purpose : Xerostomia is a complication met by almost all patients who have radiotherapy for cancers of head and neck. Many studies for prevention of xerostomia will be necessary. Radiation-induced acute response of salivary glands has been defined as interphase death or apoptosis. Increased intracellular calcium level have an important role in radiation-induced apoptosis. Calcium channel blocker may prevent radiation-induced apoptosis of salivary glands. This study was designed to evaluate the effectiveness of diltiazem known as calcium channel blocker and pentoxifylline with inhibition of inflammatory response on the apoptosis as an acute response of radiation in rat salivary glands. Materials and Methods : Sprague-Dawley rats with about body weight 200-250 g were divided into 5 study groups : control, radiation alone, diltiazem with radiation, pentoxifylline with radiation, and diltiazem and pentoxifylline with radiation. The diltiazen and pentoxifylline were injected intraperitoneally 20 mg/kg and 50 mg/kg, 30 and 20 mimute before irradiation. respectively. Irradiation was given with a 4 MV linear accelerator. The 1600 cGy of radiation was delivered in a single fraction through a single anterior portal encompassing the entire neck. After 24 h of irradiation, rats were sacrificed and parotid and submandibular glands were removed and stained with hematoxylin and eosin. The quantification of apoptosis was performed by microscopic examination of stained tissue sections at a magnification of 200X and the percentage of apoptotic cell was calculated. Results : On parotid glands, the percentage of apoptosis by radiation alone, diltiazem with radiation, pentoxifylline with radiation, and diltiazem and pentoxifylline with radiation were 1.72
An epidemiological study and mass treatments of Enterobius vermicularis infection among children near Wonju area of Kangwon province were carried out. The children were divided into 4 groups according to their residing localities; children in the mountainous area, rural area, urban area and in orphanage. They were examined by adhesive cellotape anal swab technique, and egg positive rates were obtained. The rates of egg reduction and re-infection rates after repeated mass treatments were also observed. The results obtained were as follows: 1. The overall egg Positive rate of E. vermicularis in the first screening was 19.9% (251 out of 1, 262 examinees; 19.7% in males and 20.1% in females). The positive rates were 13.0% in the mountainous area, 11 9% in the rural area, 15.1% in the urban (medium-sized) area and 61.9% in orphanages. 2. The highest positive rates were observed in the kindergarten children, and 1st and 2nd grade children of primary schools (26.2~32.2%), and the lowest rate (13.6%) in 6-year grade children of primary schools. 3. Cumulative detection rates from 3 repeated anal swabs at 4~5 days interval were higher (70.8%) than those from single anal swabs (50.0~59.2%). 4. Out of the examinees who showed the highest cumulative positive rate (70.8%), about 39.2% were consecutively positive in 3 anal swabs. Among different groups of children, the higher the total egg detection rates (87.5%), the higher the consecutive positive rates (71.9%) . 5. A total of 2, 609 (male : female=1 : 12.4) worms were collected from 17 egg-positive cases treated with anthelinintics. The mean number of worms per child was 153 (range: 4-824) . 6. The egg-positive cases in several studied groups (180 children) were treated with anthelmintics 6 times at 3-week intervals. In this case, the overall positive rate was decreased from 54.8% to 2.2% at 15 weeks after the treatments, but no complete negative conversion was experienced. However, in a group of children (154 children) including egg Positive and negative cases who were both treated with anthelmintics at 3-week interval, a complete egg-negative conversion was observed in the 9th week after treatments. 7. The egg-detection rate in the brothers or sisters of egg Positive children was 70.0% (28 out of 40 examined), and the egg-positive rate according to the family unit was 69.7%. In summarizing the above results, it is concluded that Enterobius vermicularis infection is still highly prevalent among children in Korea, and that repeated mass treatments of more than 3 times will be effective for control of this infection.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70