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Clinical review of acute seizures among children who visited the emergency room in Masan Samsung hospital from 2004 to 2006 (최근 3년간(2004-2006년) 응급실로 내원한 소아환자 중 급성 발작으로 인한 환자들에 대한 임상적 고찰)

  • Lee, Won Deok;Yoo, Jae Wook;Lee, Ju Suk;Lee, Jun Hwa;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.420-425
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    • 2008
  • Purpose : The purpose of this study was to evaluate acute childhood seizures, one of the most important causes of emergency room visits, to provide appropriate medical services. Methods : We reviewed the medical records of 433 (4.6%) pediatric patients with acute seizures that visited the emergency room at Masan Samsung hospital from 2004 to 2006. Results : The male to female ratio was 1.4:1 and the mean age was $40.9{\pm}34.9$ months range. The order of geographical distribution was Masan, Changwon, Haman, and others. Fever was present in 40.6% of patients; December (14.8%) was the most frequent month for visits and generalized tonic clonic seizures (62.7%) were the most common type of seizure. The average frequency and duration of the seizure was $1.5{\pm}1.0$ and $6.7{\pm}13.2$ minutes respectively. Febrile seizures were present in 69.7% of patients and afebrile seizures in 30.3%. The causes of the febrile seizures were acute pharyngotonsillitis (44.6%), acute bronchitis, gastroenteritis, pneumonia, urinary tract infection, and unknown origin, in order of frequency. The most common cause of an afebrile seizure was epilepsy (71.5%) followed by a benign convulsion with mild gastroenteritis (BCwMG), sequela of a perinatal brain injury or brain malformation, and acute CNS infection. Evaluation of the causes of an acute seizure according to age showed that febrile seizures, epilepsy, and the sequela of perinatal brain injuries were more common between 2 and 6 years of age and epilepsy, febrile seizures and acute CNS infection, in order of frequency, were common between 6 and 15 years of age. Many patients, 49.4%, were discharged without admission. Conclusion : The common characteristics of pediatric patients presenting to the emergency room were male gender, an age between 2-6 years, presenting during the month of December, with generalized tonic clonic seizures due to acute pharyngitis. The most common presentation for the group less than 6 years of age was a febrile seizure and in the group more than 6 years of age, it was epilepsy. In many cases, the seizures stopped by the time the family presented to the emergency room.

K-Ar and $^{40}$ Ar/$^{39}$ Ar Ages from Metasediments in the Okcheon Metamorphic Belt and their Tectonic Implication (옥천 변성대 변성퇴적암의 K-Ar및 $^{40}$ Ar/$^{39}$ Ar 연대와 그 의의)

  • 김성원;오창환;이덕수;이정후
    • The Journal of the Petrological Society of Korea
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    • v.12 no.2
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    • pp.79-99
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    • 2003
  • Muscovite and biotite from 52 metasediments and 5 granites in the Hwasan area, the southwest of the Okcheon metamorphic belt and the Miwon-Jeungpyeong area, central Okcheon metamorphic belt were dated by the K-Ar and $^{40}$ Ar/$^{39}$ Ar methods. Muscovite and biotite ages from metapelitic and psammitic rocks (metasediments) of the Boeun and Pibanryeong units in the Hwasan area are concentrated in the mid-Jurassic (149-180 Ma). K-Ar and $^{40}$ Ar/$^{39}$ Ar ages for metapelitic and psammitic rocks of the Boeun and Pibanryeong units in the Miwon-Jeungpyeong area show complicated age distribution. Muscovite and biotite ages are classified by three groups, 142-194 Ma, 216-234 Ma, and 241-277 Ma. Younger (Cretaceous) ages occur only in metasediments close to Cretaceous granitic rocks in the southeastern region and the older ages of 216-277 Ma are restricted to the middle Part of the Jeungpyeong area. Most ages in the other area of the central Okcheon metamorphic belt fall between 142-194 Ma (Jurassic). K-Ar and $^{40}$ Ar/$^{39}$ Ar ages for granite from the northern part in the both the southwest and central Okcheon metamorphic belt also gave middle Jurassic ages (156-168 Ma). The similar ages from both metasediments and granites in the study areas indicate simultaneous cooling of both rocks to 300-350$^{\circ}C$ during the middle Jurassic. The state of graphitization of carbonaceous material of all metasediments in the study areas Indicates fully ordered graphite falling within a small range, from 3.353 to 3.359 ${\AA}$, which indicate amphibolite facies regional metamorphism. In the southern sector of the Boeun unit from the Hwasan area, metamorphic grade indicated by mineral paragenesis during regional intermediate-P/T metamorphism is greenschist facies. Whereas, the $d_{002}$ values for carbonaceous materials in the same sector show fully ordered graphite (ca. 500$^{\circ}C$) indicating amphibolite facies. This result with the concentration of mica ages of metasediments into the middle Jurassic, the presence of low-P/T thermal metamorphic zone (>500$^{\circ}C$) in the metasediments close to the Jurassic granite and the regional intrusion of Jurassic granites and their middle Jurassic intrusion and cooling ages may indicate the low-P/T regional thermal event during the early(\ulcorner)-middle Jurassic after main intermediate-P/T metamorphism which formed main mineral assemblage regionally in the study area. The regional thermal event failed, however, to reset the mineral assemblage of regional intermediate-P/T metamorphism except for narrow aureole (1-2 km) around Jurassic granite because e duration of thermal effect was relatively short by repid cooling of the Jurassic granite. In the middle part of the Jeungpyeong area, central Ogcheon metamorphic belt, muscovite and biotite K-Ar ages from 5 samples are 263-277 Ma and 241-249 Ma, respectively. An intermediate-P/T metamorphism is currently accepted to have occurred between 280 and 300 Ma. Therefore, the muscovite and biotite ages can be interpreted as cooling ages after Ml metamorphism indicating rapid cooling to ca 350$^{\circ}C$ between 280-300 Ma and 263-271 Ma, and biotite ages indicate slower cooling to ca. 300$^{\circ}C$ between 263-277 Ma and 241-249 Ma. However, more detail study is needed to confirm why the Permian to Triassic ages occur only in the middle Part of the Jeungpyeong area.a.

Surgery Alone or Postoperative Adjuvant Radiotherapy in Rectal Cancer - With Respect to Survival, Pelvic Control, Prognostic Factor - (직장암에서 수술단독 또는 수술후 방사선치료 -생존율, 골반종양제어율, 예후인자를 중심으로-)

  • Nam, Taek-Keun;Ahn, Sung-Ja;Nah, Byung-Sik
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.327-334
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    • 2001
  • Purpose : To find out the role of postoperative adjuvant radiotherapy in the treatment of rectal cancer by comparing survival, pelvic control, complication rate, and any prognostic factor between surgery alone and postoperative radiotherapy group. Materials and methods : From Feb. 1982 to Dec. 1996 total 212 patients were treated by radical surgery with or without postoperative radiotherapy due to rectal carcinoma of modified Astler-Coiler stage $B2\~C3$. Of them, 18 patients had incomplete radiotherapy and so the remaining 194 patients were the database analyzed in this study. One hundred four patients received postoperative radiotherapy and the other 90 patients had surgery only. Radiotherapy was peformed in the range of $39.6\~55.8\;Gy$ (mean: 49.9 Gy) to the whole pelvis and if necessary, tumor bed was boosted by $5.4\~10\;Gy$. Both survival and pelvic control rates were calculated by Kaplan-Meier method and their statistical significance was tested by Log-rank test. Multivariate analysis was peformed by Cox proportional hazards model. Results : 5-year actuarial survival rate (5YSR) and 5-year disease-free survival rate (5YDFSR) of entire patients were $53\%\;and\;49\%$, respectively. 5YSRs of surgery alone group and adjuvant radiotherapy group were $63\%\;vs\;45\%$, respectively (p=0.03). This difference is thought to reflect uneven distribution of stages between two treatment groups (p<0.05 by $\chi^2-test$) with more advanced disease patients in adjuvant radiotherapy group. 5YSRs of surgery alone vs adjuvant radiotherapy group in MAC B2+3, C1, C2+3 were $68\%\;vs\;55\%$ (p=0.09), $100\%\;vs\;100\%$, $40\%\;vs\;33\%$ (p=0.71), respectively. 5YDFSRs of surgery alone vs adjuvant radiotherapy group in above three stages were $65\%\;vs\;49\%$ (p=0.14), $100\%\;vs\;100\%$, $33\%\;vs\;31\%$ (p=0.46), respectively. 5-year pelvic control rate (5YPCR) of entire patients was $72.5\%$. 5YPCRs of surgery alone and adjuvant radiotherapy group were $71\%\;vs\;74\%$, respectively (p=0.41). 5YPCRs of surgery alone vs adjuvant radiotherapy group in B2+3, C1, C2+3 were $79\%\;vs\;75\%$ (p=0.88), $100\%\;vs\;100\%$, $44\%\;vs\;68\%$ (p=0.01), respectively. Multivariate analysis showed that only stage was significant factor affecting overall and disease-free survival in entire patients and also in both treatment groups. In view of pelvic control, stage and operation type were significant in entire patients and only stage in surgery alone group but in adjuvant radiotherapy group, operation type instead of stage was the only significant factor in multivariate analysis as a negative prognostic factor in abdominoperineal resection cases. Conclusion : Our retrospective study showed that postoperative adjuvant radiotherapy could improve the pelvic control in MAC C2+3 group. To improve both pelvic control and survival in all patients with MAC B2 or more, other treatment modality such as concurrent continuous infusion of 5-FU, which is the most standard agent, with radiotherapy should be considered.

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Parotid Gland Sparing Radiotherapy Technique Using 3-D Conformal Radiotherapy for Nasopharyngeal CarcinomB (비인강암에서 방사선 구강 건조증 발생 감소를 위한 3차원 입체조형치료)

  • Lim Jihoon;Kim Gwi Eon;Keum Ki Chang;Suh Chang Ok;Lee Sang-wook;Park Hee Chul;Cho Jae Ho;Lee Sang Hoon;Chang Sei Kyung;Loh Juhn Kyu
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.1-10
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    • 2000
  • Purpose : Although using the high energy Photon beam with conventional Parallel-opposed beams radiotherapy for nasopharyngeal carcinoma, radiation-induced xerostomia is a troublesome problem for patients. We conducted this study to explore a new parotid gland sparing technique in 3-D conformal radiotherapy (3-D CRT) in an effort to prevent the radiation-induced xerostomia. Materials and Methods : We peformed three different planning for four clinically node-negative nasopharyngeal cancer patients with different location of tumor(intracranial extension, nasal cavity extension, oropharyngeal extension, parapharyngeal extension), and intercompared the plans. Total prescription dose was 70.2 Gy to the isocenter. For plan-A, 2-D parallel opposing fields, a conventional radiotherapy technique, were employed. For plan-B, 2-D parallel opposing fields were used up until 54 Gy and afterwards 3-D non-coplanar beams were used. For plan-C, the new technique, 54 Gy was delivered by 3-D conformal 3-port beams (AP and both lateral ports with wedge compensator; shielding both superficial lobes of parotid glands at the AP beam using BEV) from the beginning of the treatment and early spinal cord block (at 36 Gy) was peformed. And bilateral posterior necks were treated with electron after 36 Gy. After 54 Gy, non-coplanar beams were used for cone-down plan. We intercompared dose statistics (Dmax, Dmin, Dmean, D95, DO5, V95, VOS, Volume receiving 46 Gy) and dose volume histograms (DVH) of tumor and normal tissues and NTCP values of parotid glands for the above three plans. Results : For all patients, the new technique (plan-C) was comparable or superior to the other plans in target volume isodose distribution and dose statistics and it has more homogenous target volume coverage. The new technique was most superior to the other plans in parotid glands sparing (volume receiving 46 Gy: 100, 98, 69$\%$ for each plan-A, B and C). And it showed the lowest NTCP value of parotid glands in all patients (range of NTCP; 96$\~$100$\%$, 79$\~$99$\%$, 51$\~$72$\%$ for each plan-A, B and C). Conclusion : We conclude that the new technique employing 3-D conformal radiotherapy at the beginning of radiotherapy and cone down using non-coplanar beams with early spinal cord block is highly recommended to spare parotid glands for node-negative nasopharygeal cancer patients.

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Results of Radiation Therapy for Carcinoma of the Uterine Cervix (자궁경부암의 방사선치료 성적)

  • Lee Kyung-Ja
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.359-368
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    • 1995
  • Purpose : This is a retrospective analysis for pattern of failure, survival rate and prognostic factors of 114 patients with histologically proven invasive cancer of the uterine cervix treated with definitive irradiation. Materials and Methods : One hundred fourteen patients with invasive carcinoma of the cervix were treated with a combination of intracavitary irradiation using Fletcher-Suit applicator and external beam irradiation by 6MV X-ray at the Ewha Womans University Hospital between March 1982 and Mar 1990. The median age was 53 years(range:30-77 years). FIGO stage distribution was 19 for IB, 23 for IIA, 42 for IIB, 12 for IIIA and 18 for IIIB. Summation dose of external beam and intracavitary irradiation to point A was 80-90 Gy(median:8580 cGy) in early stage(IB-IIA) and 85-100 Gy(median:8850 cGy) in advanced stage(IIB-IIIB). Kaplan-Meier method was used to estimate the survival rate and multivariate analysis for progrostic factors was performed using the Log likelihood for Weibull Results : The pelvic failure rates by stage were $10.5{\%}$ for IB. $8.7{\%}$ for IIA, $23.8{\%}$ for IIB, $50.0{\%}$ for IIIA and $38.9{\%}$ for IIIB. The rate of distant metastasis by stage were $0{\%}$ for IB, $8.7{\%}$ for IIA, $4.8{\%}$ for IIB. $0{\%}$ for IIIA and $11.1{\%}$ for IIIB. The time of failure was from 3 to 50 months and with median of 15 months after completion of radiation therapy. There was no significant coorelation between dose to point A($\leq$90 Gy vs >90 Gy) and pelvic tumor control(P>0.05). Incidence rates of grade 2 rectal and bladder complications were $3.5{\%}$(4/114) and $7{\%}$(8/114), respectively and 1 patient had sigmoid colon obstruction and 1 patient had severe cystitis. Overall 5-year survival rate was $70.5{\%}$ and disease-free survival rate was $53.6{\%}$. Overall 5-year survival rate by stage was $100{\%}$ for IB, $76.9{\%}$ for IIA, $77.6{\%}$ for IIB $87.5{\%}$ for IIIA and $69.1{\%}$ for IIIB. Five-rear disease-free survival rate by stage was $81.3{\%}$ for IB, $67.9{\%}$ for IIA, $46.8{\%}$ for IIB, $45.4{\%}$ for IIIA and $34.4{\%}$ for IIIB. The prognostic factors for disease-free survival rate by multivariate analysis was performance status(p= 0.0063) and response rate after completion of radiation therapy(p= 0.0026) but stage, age and radiation dose to point A were not siginificant. Conclusion : The result of radiation therapy for early stage of the uterine cervix cancer was relatively good but local control rate and survival rate in advanced stage were poor inspite of high dose irradiation to point A above 90 Gy. Prospective randomized studies are recommended to establish optimal tumor doses for various stages and volume of carcinoma of uterine cervix, And ajuvant chemotherapy or radiation-sensitizing agents must be considered to increase the pelvic control and survival rate in advanced cancer of uterine cervix.

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Studies on the Organic Tiers Contained Paddy Soils in Honam Area -I. The Characteristcs and Formation of Organic Tiers Contained Paddy Soils (유기질토시(有機質土尸)을 함유(含有)한 호남지역(湖南地域) 답토양(畓土壤)에 관(關)한 연구(硏究) -I. 유기질토시함유(有機質土尸含有) 답토양(畓土壤)의 특성(特性) 및 생성(生成))

  • Yoo, Chul-Hyun;Kim, Eung-Bog;Cho, Guk-Hyun;Kim, Han-Myoung;Yoo, Sug-Jong;Park, Keon-Ho;Bae, Sung-Ho;Um, Ki-Tae
    • Korean Journal of Soil Science and Fertilizer
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    • v.18 no.3
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    • pp.265-275
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    • 1985
  • 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.

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Clinical Outcome after Breast Conserving Surgery and Radiation Therapy for Early Breast Cancer (초기 유방암의 유방 보존수술 후 방사선 치료 결과)

  • Cho, Heung-Lae;Kim, Cheol-Jin;Park, Sung-Kwang;Oh, Min-Kyung;Lee, Jin-Yong;Ahn, Ki-Jung
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.204-212
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    • 2008
  • Purpose: This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range $43.8{\sim}129.4$ months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for T is and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had $1{\sim}3$ lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close (${\leq}2\;mm$) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy ($41.4{\sim}60.4\;Gy$) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0.0001) and higher relapse rates (p=0.0507). However, patients with close margins were at equal risk of relapse and disease-free survival as with negative margins (p=1.000). Patients younger than 40 years of age had higher relapse rates (9.3% vs. 0%) and lower disease-free survival periods, but the difference was not statistically significant (p=0.1255). The relapse rates for patients with tumors was 14% for tumor stage T2, compared to 0% for tumor stage T1 tumors (p=0.0284). A univariate analysis found that disease-free survival and relapse rates, T stage, positive resection margin and mutation of p53 were significant factors for clinical outcome. Conclusion: The results of this study have shown that breast conservation surgery and radiation therapy in early breast cancer patients has proven to be a safe treatment modality with a low relapse rate and high disease-free survival rate. The patients with a positive margin, T2 stage, and mutation of p53 are associated with statistically higher relapse rates and lower disease-free survival.

The Role of Primary Radiotherapy for Squamous Cell Carcinoma of the Suprag1ottic Larynx (성문상부 상피세포암에서의 근치적 방사선치료의 역할)

  • Kim, Won-Taek;Kim, Dong-Won;Kwon, Byung-Hyun;Nam, Ji-Ho;Hur, Won-Joo
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.233-243
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    • 2000
  • Purpose : First of all, this study was performed to assess the result of curative radiotherapy and to evaluate different possible prognostic factors for squamous cell carcinoma of the supraglottic larynx treated at the Pusan National University Hospital. The second goal of this study was by comparing our data with those of other study groups, to determine the better treatment policy of supraglottic cancer in future. Methods and Material : Thirty-two patients with squamous cell carcinoma of the supraglottic larynx were treated with radiotherapy at Pusan National University Hospital, from August 1985 to December 1996. Minimum follow-up period was 29 months, Twenty-seven patients (84.4$\%$) were followed up over 5 years. Radiotherapy was delivered with 6 MV photons to the primary laryngeal tumor and regional iymphatics with shrinking field technique. Ail patients received radiotherapy under conventional fractionated schedule (once a day). Median total tumor dose was 70.2 Gy (range, 55.8 to 75.6 Gy) on primary or gross tumor lesion. Thirteen patients had Induction chemotherapy with cisplatln and 5-fluorouracil (1-3 cycles). Patient distribution, according to the different stages, were as follows: stage I, 5/32 (15.6$\%$): stage II, 10/32 (31.3$\%$); stage III, 8/32 (25$\%$): stage IV, 9/32 (28.1$\%$). Results :The 5-year overall survival rate of the whole series (32 patients) was 51.7$\%$. The overall survival rate at 5-years was 80$\%$ in stage I, 66.7$\%$ in stage II, 42.9$\%$ in stage III, 25$\%$ in stage IV (p=0.0958). The S-year local control rates after radiotherapy were as fellows: stage I, 100$\%$; stage II, 60$\%$ stage III, 62.5$\%$; stage IV, 44.4$\%$ (p=0.233). Overall vocal preservation rates was 65.6$\%$, 100% In stage I, 70% in stage II, 62.5$\%$ In stage III, 44.4$\%$ in stage IV (p=0.210). There was no statistical significance in survival and local control rate between neoadjuvant chemotherapy followed by radiotherapy group and radiotherapy alone group. Severe laryngeal edema was found in 2 cases after radiotllerapy, emergent tracheostomy was done. Four patients were died from distant metastsis, . three in lung, one in brain. Double primary tumor was found in 2 cases, one in lung (metachronous), another in thyroid (synchronous). Ulcerative lesions were revealed as unfavorable prognostic factor ( p=0.0215), and radiation dose (more or less than 70.2 Gy) was an important factor on survival (p=0.002). Conclusion : The role of radiotherapy treatment of supraglottic carcinoma is to important factor on survival and to preserve the laryngeal function. Based on our data and other studies, early and moderately advanced supragiottic carcinomas could be successfully treated with either consewative surgery or radiotherapy alone. Both modalities showed similar results in survival and vocal preservation. For the advanced cases, radiotherapy alone is Inadequate for curative aim and surgery combined with radiotherapy should be done in operable patients. When patients refuse operation or want to preserve vocal function, or for the patients with inoperable medical conditions, combined chemoradiotherapy (concurrent) or altered fractionated radiotherapy with or without radiosensitizer should be taken into consideration in future.

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Concurrent Chemoradiotherapy in Locally Advanced Carcinoma of The Uterine Cervix : A Phase I/II Prospective Study (국소적으로 진행된 자궁경부암의 방사선치료와 복합 항암화학요법의 동시치료 결과)

  • Kang One Chul;Choi Eun Kyung;Chung Weon Kuu;Kim Jong Hoon;Chang Hyesook;Kim Yong Man;Kim Young Tak;Nam Joo Hyun;Mok Jung-Eun;Lee Moo-Song
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.311-323
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    • 1998
  • Purpose : Prospective, single arm, Phase I/II clinical trial was performed to assess the efficacy and toxicity of the concurrent chemotherapy and definitive radiotherapy (RT) in patients with previously untreated locally advanced carcinoma of the uterine cervix. Methods and Materials : From Mar 1992 to January 1997, a total of 73 patients with advanced cervical carcinoma were entered on the protocol but 5 patients were excluded in analysis because of patients' refusal of treatment. Their ages ranged from 31 to 77 years, median 58 years. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution was as follows: IIB 46, IIIA 2, IIIB 15 and IVA 5. RT consisted of external beam irradiation to 4,140-5,040 cGy/23-28 fractions plus high dose rate intracavitary treatments to deliver a dose of 30-35 Gy to point A in 6-7 fractions. During the intracavitary treatments parametrial boost was delivered for point B dose of 60 Gy in stage IIB and 65 Gy in stage IIIB. Two cycles of concurrent 5-fluorouracil and cisplatin (FP) chemotherapy (5-fluorouracil 1,000 mg/$m^2$/day continuous infusion for 4 days, day 1-4, 29-32 and cisplatin 20 mg/$m^2$/day intravenous bolus for 3 days day 1-3, 29-31) administered starting on day 1 of RT. Results : The median follow-up was 24 months (range 4-68+). Sixty-four patients were evaluable for survival rate in this protocol: The 5-year actuarial and disease-free survival rate were 52$\%$ and 64$\%$, respectively. The 5-rear actuarial survival for stage IIB and III+IVA patients were 58$\%$ and 36$\%$, respectively The 5-year disease-free survival rate for stage IIB and III+IVA patients were 71$\%$ and 40$\%$, respectively. Of the 68 patients evaluated for patterns of failure, overall recurrence rate was 27.9$\%$ (19/68) : local failure in 5.9$\%$ (4/68), distant metastasis in 10.3$\%$ (7/68) and both in 11.8$\%$ (8/68). Of the 64 patients evaluated for response at one month after the completion of treatment the complete response rate was 78$\%$ (50/64). Concurrent chemoradiation appear to be a well-tolerated regimen but there were two treatment-related deaths. Conclusion : Concurrent chemotherapy of FP with high-dose definitive RT in locally advanced carcinoma of the uterine cervix is feasible and effective with acceptable toxicities. This chemoradiation regimen may offer a modest survival benefit for advanced stage. Further follow-up of these patients will evaluate the impact of this regimen on the long-term local control and their survival.

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Breeding and Development of the Tscherskia triton in Jeju Island (제주도 서식 비단털쥐(Tscherskia triton)의 번식과 발달)

  • Park, Jun-Ho;Oh, Hong-Shik
    • Korean Journal of Environment and Ecology
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    • v.31 no.2
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    • pp.152-165
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    • 2017
  • The greater long-tail hamster, Tscherskia triton, is widely distributed in Northern China, Korea and adjacent areas of Russia. Except for its distribution, biological characteristics related to life history, behavior, and ecological influences for this species are rarely studied in Korea. This study was conducted to obtain biological information on breeding, growth and development that are basic to species-specific studies. The study adopted laboratory management of a breeding programme for T. triton collected in Jeju Island from March, 2015 to December, 2016. According to the study results, the conception rate was 31.67% and the mice in the large cages had a higher rate of conception than those in the small cages (56.7 vs. 6.7%). The gestation period was $22{\pm}1.6days$ (ranges from 21 to27 days), and litter size ranged from 2 to 7, with a mean of $4.26{\pm}1.37$ in the species. The minimum age for weaning was between $19.2{\pm}1.4days$ (range of 18-21 days). There were no significant differences by sex between mean body weight and external body measurements at birth. However, a significant sexual difference was found from the period of weaning (21 days old) in head and body length, as well as tail length (HBL-weaning, $106.50{\pm}6.02$ vs. $113.34{\pm}4.72mm$, p<0.05; HBL-4 months, $163.93{\pm}5.42$ vs. $182.83{\pm}4.32mm$, p<0.05; TL-4 months, $107.23{\pm}3.25$ vs. $93.95{\pm}2.15mm$, p<0.05). Gompertz and Logistic growth curves were fitted to data for body weight and lengths of head and body, tail, ear, and hind foot. In two types of growth curves, males exhibited greater asymptotic values ($164.840{\pm}7.453$ vs. $182.830{\pm}4.319mm$, p<0.0001; $163.936{\pm}5.415$ vs. $182.840{\pm}4.333mm$, p<0.0001), faster maximum growth rates ($1.351{\pm}0.065$ vs. $1.435{\pm}0.085$, p<0.05; $2.870{\pm}0.253$ vs. $3.211{\pm}0.635$, p<0.05), and a later age of maximum growth than females in head and body length ($5.121{\pm}0.318$ vs. $5.520{\pm}0.333$, p<0.05; $6.884{\pm}0.336$ vs. $7.503{\pm}0.453$, p<0.05). However, females exhibited greater asymptotic values ($105.695{\pm}5.938$ vs. $94.150{\pm}2.507mm$, p<0.001; $111.609{\pm}14.881$ vs. $93.960{\pm}2.150mm$, p<0.05) and longer length of inflection ($60.306{\pm}1.992$ vs. $67.859{\pm}1.330mm$, p<0.0001; $55.714{\pm}7.458$ vs. $46.975{\pm}1.074mm$, p<0.05) than males in tail length. These growth rate constants, viz. the morphological characters and weights of the males and females, were similar to each other in two types of growth curves. These results will be used as necessary data to study species specificity of T. triton with biological foundations.