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Biodistribution and Scintigraphy of Iodine-131-Iododeoxyadenosine in Rats Bearing Breast Cancer (흰쥐에서 Iodine-131-Iododeoxyadenosine의 생체분포 및 유방암 영상화에 관한 연구)

  • Kim, Seon-Gu;Kim, Chang-Guhn;Lee, Kang-Mo;Kim, Hye-Won;Min Byung-Cheol;Choi, See-Sung;Lee, Jong-Deuk;Yang, David J.;Kim, E. Edmund;Lee, Hyun-Chul;Won Jong-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.374-381
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    • 1998
  • Purpose: I-131 labeled (2'-deoxy-2'-iodo-${\beta}$-D-arabinofuranosyl) adenine (IAD) may be involved in DNA synthesis during active proliferation of tumor cells. We conducted this study to find out the biodistribution of IAD and it's feasibility for scintigraphic tumor imaging. Materials and Methods: Tosyl acetyl-adenosine was dissolved in acetonitrile, and I-131-NaI was added and heated to synthesize IAD. Female Fisher 344 rats innoculated with breast tumor cells were injected with 0.27 MBq of IAD. Rats were sacrificed at 0.5, 1, 2, 4, 24h and the % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy, rats bearing breast cancer were administered with 1.11 MBq of IAD and imaging was performed after 2 and 24h. Then, rat body was fixed and microtomized slice was placed on radiographic film for autoradiography. Results: %ID/g of tumor was 0.74 (0.5h),0.73 (1h), 0.55 (2h), 0.38 (4h), and 0.05 (24h), respectively. At 1h after injection, %ID/g of tumor was higher than that of heart (0.34), liver (0.42), spleen (0.47), kidney (0.69), muscle (0.14), bone (0.33) and intestine (0.51). However, %ID/g of tumor was lower than blood (1.06), lung (0.77), and thyroid (177.71). At 4h, %ID/g of tumor in comparison with other tissue did not change. Tumor contrast expressed by tumor to blood ratio was 0.69 and tumor to muscle ratio was 5.11 at 1h. However, these ratios did not improve through 24h. On autoradiogram and scintigraphy at 2 and 24 hour, the tumor was well visualized. Conclusion: This results suggest that IAD may have a potential for tumor scintigraphy. However, further work is needed to improve localization in tumor tissue.

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Ultrastructure of Degenerating Axon Terminals in the Basal Forebrain Nuclei of the Rat following Prefrontal Decortication (이마앞겉질을 제거시킨 흰쥐 앞뇌의 바닥핵무리에서 변성축삭종말의 미세구조연구)

  • Ahn, Byung-June;Ko, Jeong-Sik;Ahn, E-Tay
    • Applied Microscopy
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    • v.35 no.3
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    • pp.135-152
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    • 2005
  • Prefrontal cortex is a psychological and metaphysical cortex, which deals with feeling, memory, planning, attention, personality, etc. And it also integrates above-mentioned events with motor control and locomotor activities. Prefrontal cortex works as a highest CNS center, since the above mentioned functions are very important for one's successful life, and further more they are upgraded every moments through memory and learning. Many of these highest functions are supposed to be generated via forebrain basal nuclei (caudate nucleus, fundus striati nucleus, accumbens septi nucleus, septal nucleus, etc.). In this experiment, prefrontal efferent terminals within basal forebrain nuclei were ultrastructurally studied. Spraque Dawley rats, weighing $250{\sim}300g$ each, were anesthetized and their heads were fixed on the stereotaxic apparatus (experimental model, David Kopf Co.). Rats were incised their scalp, perforated a 3mm-wide hole on the right side of skull at the 11mm anterior point from the frontal O point (Ref. 13, Fig. 1), suctioned out the prefrontal cortex including cortex of the frontal pole, with suction instrument. Two days following the operations, small tissue blocks of basal forebrain nuclei were punched out, fixed in 1% glutaraldehyde-1% paraformaldehyde solution followed by 2% osmium tetroxide solutions. Ultrathin sections were stained with 1% borax-toluidin blue solution, and the stained sections were obserbed with an electron microscope. Degenerating axon terminals were found within all the basal forbrain nuclei. Numbers of degenerated terminals were largest in the caudate nucleus, next in order, in the fundus striati nucleus, in the accumbens septi nucleus, and the least in the septal nucleus. Only axospinous terminals were degenerated within the caudate nucleus and the fundus striati nucleus, and they showed the characters of striatal motor control system. Axodendritic and axospinous terminals were degenerated within the accumbens septi nucleus and the lateral septal nucleus, and they showed the characters of visceral limbic system. Prefrontal role in integrating the limbic system with the striatal system, en route basal forebrain nuclei, was discussed.

Comparison of Cholesterol Contents and Fatty Acid Composition in M. longissimus of Hanwoo, Angus and Wagyu Crossbred Steers (한우, 앵거스 및 화우 교잡종의 등심내 콜레스테롤 함량 및 지방산 조성 비교)

  • Choi, Chang-Bon;Shin, Hyeon-U;Lee, Sang-Oug;Kim, Sung-Il;Jung, Keun-Ki;Choi, Chang-Won;Baek, Kyung-Hoon;Lunt, David K.;Smith, Stephen B.
    • Journal of Animal Science and Technology
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    • v.50 no.4
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    • pp.519-526
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    • 2008
  • Although beef provides high quality proteins as well as vitamins and minerals, its concentrations of saturated fatty acids and cholesterol give negative impression to some consumers on the other hand. Excess fat, especially cholesterol contents in beef is related with metabolic diseases such as atherosclerosis and hypertension. Unfortunately, the data for the relationship of marbling degree and cholesterol contents in Hanwoo beef is very limited. The objectives of the current study were to provide basic data about cholesterol contents in Hanwoo beef and to compare those among beef cattle breeds using 61 Hanwoo and 15 each of Angus and Wagyu crossbred steers. Samples were collected from M. longissimus area and cholesterol concentrations and fatty acid compositions were analyzed using gas chromatography. Cholesterol concentrations in Hanwoo beef ranged from 32.36 mg/100g to 75.42mg/100g depending on individuals. In Angus, cholesterol contents in lowest marbling degree of “Practically devoid” was 56.84mg/100g, whereas it was 72.85mg/100g in the highest marbling degree of “Abundant” showing increase in cholesterol concentrations as the marbling degree increases. For Wagyu crossbred steers, it was 69.23mg/100g and 78.93 mg/100g for marbling degree of “Practically devoid” and “Abundant”, respectively, showing similar cholesterol concentrations to Angus steers but still much higher than Hanwoo steers. The ratio of unsaturated fatty acids:saturated fatty acids for Hanwoo, Angus and Wagyu Crossbred were 1,48, 1.08 and 1.17, respectively. And the ratio of monounsaturated fatty acids : saturated fatty acids were 1.41, 1.03, and 1.10, respectively showing significantly higher ratios in Hanwoo steers. In conclusion, cholesterol contents and saturated fatty acids in M. longissimus of Hanwoo steers were significantly lower while unsaturated fatty acids were higher comparing to those in Angus or Wagyu Crossbred steers. Further studies, however, considering genetic backgrounds, feeding conditions, slaughtering age, number of samples and location of sampling of experimental animals are necessary.

Computer Assisted EPID Analysis of Breast Intrafractional and Interfractional Positioning Error (유방암 방사선치료에 있어 치료도중 및 분할치료 간 위치오차에 대한 전자포탈영상의 컴퓨터를 이용한 자동 분석)

  • Sohn Jason W.;Mansur David B.;Monroe James I.;Drzymala Robert E.;Jin Ho-Sang;Suh Tae-Suk;Dempsey James F.;Klein Eric E.
    • Progress in Medical Physics
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    • v.17 no.1
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    • pp.24-31
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    • 2006
  • Automated analysis software was developed to measure the magnitude of the intrafractional and interfractional errors during breast radiation treatments. Error analysis results are important for determining suitable planning target volumes (PTV) prior to Implementing breast-conserving 3-D conformal radiation treatment (CRT). The electrical portal imaging device (EPID) used for this study was a Portal Vision LC250 liquid-filled ionization detector (fast frame-averaging mode, 1.4 frames per second, 256X256 pixels). Twelve patients were imaged for a minimum of 7 treatment days. During each treatment day, an average of 8 to 9 images per field were acquired (dose rate of 400 MU/minute). We developed automated image analysis software to quantitatively analyze 2,931 images (encompassing 720 measurements). Standard deviations ($\sigma$) of intrafractional (breathing motion) and intefractional (setup uncertainty) errors were calculated. The PTV margin to include the clinical target volume (CTV) with 95% confidence level was calculated as $2\;(1.96\;{\sigma})$. To compensate for intra-fractional error (mainly due to breathing motion) the required PTV margin ranged from 2 mm to 4 mm. However, PTV margins compensating for intefractional error ranged from 7 mm to 31 mm. The total average error observed for 12 patients was 17 mm. The intefractional setup error ranged from 2 to 15 times larger than intrafractional errors associated with breathing motion. Prior to 3-D conformal radiation treatment or IMRT breast treatment, the magnitude of setup errors must be measured and properly incorporated into the PTV. To reduce large PTVs for breast IMRT or 3-D CRT, an image-guided system would be extremely valuable, if not required. EPID systems should incorporate automated analysis software as described in this report to process and take advantage of the large numbers of EPID images available for error analysis which will help Individual clinics arrive at an appropriate PTV for their practice. Such systems can also provide valuable patient monitoring information with minimal effort.

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Analysis of Relationship between Spatial Distribution of Land Use and Water Quality in Agricultural Reservoirs (토지이용의 공간적 분포와 농업용저수지 수질 간의 상관분석)

  • Lee, Sae-Bom;Yoon, Chun-Gyeong;Jung, Kwang-Wook;Jang, Jae-Ho;Jeon, Ji-Hong
    • Korean Journal of Ecology and Environment
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    • v.40 no.3
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    • pp.481-488
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    • 2007
  • This study covers the relationship between land use and water quality items. The kinds of land used in this study were almost agricultural areas with paddy fields and mountains. We set up zones at intervals of 200 m along 48 watersheds all over the country. The analysis showed high relationship between the water quality and the land use specially on the areas in the 400 m radius from the stream so that the areas needed to have strict managements. In the cases of residential area and upland, the positive correlation had a tendency to be lower when they were farther away from the stream. It depended on the increase of rainfall during July and August which affected on the water quality of reservoirs. The correlation analysis of paddy fields resulted in negative relationship, which indicated that paddy fields did not have negative effect on the quality of the stream. Through adequate irrigation and Management, paddy fields may be led to have positive effect on the quality of the reservoirs. In the case of forest, it also resulted in negative correlation so it was concerned as a positive factor which helped to improve water quality. Furthermore more than 00% of the land used in this study is comprised of forest so that it would have a positive effect on the reservoir management.

Earthquake impacts on hydrology: a case study from the Canterbury, New Zealand earthquakes of 2010 and 2011

  • Davie, Tim;Smith, Jeff;Scott, David;Ezzy, Tim;Cox, Simon;Rutter, Helen
    • Proceedings of the Korea Water Resources Association Conference
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    • 2011.05a
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    • pp.8-9
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    • 2011
  • On 4 September 2010 an earthquake of magnitude 7.1 on the Richter scale occurred on the Canterbury Plains in the South Island of New Zealand. The Canterbury Plains are an area of extensive groundwater and spring fed surface water systems. Since the September earthquake there have been several thousand aftershocks (Fig. 1), the largest being a 6.3 magnitude quake which occurred close to the centre of Christchurch on 22February 2011. This second quake caused extensive damage to the city of Christchurch including the deaths of 189 people. Both of these quakes had marked hydrological impacts. Water is a vital natural resource for Canterburywith groundwater being extracted for potable supply and both ground and surface water being used extensively for agricultural and horticultural irrigation.The groundwater is of very high quality so that the city of Christchurch (population approx. 400,000) supplies untreated artesian water to the majority of households and businesses. Both earthquakes caused immediate hydrological effects, the most dramatic of which was the liquefaction of sediments and the release of shallow groundwater containing a fine grey silt-sand material. The liquefaction that occurred fitted within the empirical relationship between distance from epicentre and magnitude of quake described by Montgomery et al. (2003). . It appears that liquefaction resulted in development of discontinuities in confining layers. In some cases these appear to have been maintained by artesian pressure and continuing flow, and the springs are continuing to flow even now. In spring-fed streams there was an increase in flow that lasted for several days and in some cases flows remained high for several months afterwards although this could be linked to a very wet winter prior to the September earthquake. Analysis of the slope of baseflow recession for a spring-fed stream before and after the September earthquake shows no change, indicating no substantial change in the aquifer structure that feeds this stream.A complicating factor for consideration of river flows was that in some places the liquefaction of shallow sediments led to lateral spreading of river banks. The lateral spread lessened the channel cross section so water levels rose although the flow might not have risen accordingly. Groundwater level peaks moved both up and down, depending on the location of wells. Groundwater level changes for the two earthquakes were strongly related to the proximity to the epicentre. The February 2011 earthquake resulted in significantly larger groundwater level changes in eastern Christchurch than occurred in September 2010. In a well of similar distance from both epicentres the two events resulted in a similar sized increase in water level but the slightly slower rate of increase and the markedly slower recession recorded in the February event suggests that the well may have been partially blocked by sediment flowing into the well at depth. The effects of the February earthquake were more localised and in the area to the west of Christchurch it was the earlier earthquake that had greater impact. Many of the recorded responses have been compromised, or complicated, by damage or clogging and further inspections will need to be carried out to allow a more definitive interpretation. Nevertheless, it is reasonable to provisionally conclude that there is no clear evidence of significant change in aquifer pressures or properties. The different response of groundwater to earthquakes across the Canterbury Plains is the subject of a new research project about to start that uses the information to improve groundwater characterisation for the region. Montgomery D.R., Greenberg H.M., Smith D.T. (2003) Stream flow response to the Nisqually earthquake. Earth & Planetary Science Letters 209 19-28.

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Une étude sur les textes théâtrals de Young-Sun Yun: L'écriture théâtrale sur la mort et le deuil (윤영선 희곡 연구: 죽음과 애도의 글쓰기)

  • Ahn, chiwoon
    • Journal of Korean Theatre Studies Association
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    • no.52
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    • pp.117-157
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    • 2014
  • Cette ${\acute{e}}tude$ est pour l'objectif de rechercher sur $l^{\prime}{\acute{e}}criture$ $th{\acute{e}}{\hat{a}}trale$ de la mort et le deuil dans les $th{\acute{e}}{\hat{a}}tres$ chez Young-sun Yun(1954-2007) ${\grave{a}}$ travers des textes dramatiques ${\acute{e}}crits$ par $lui-m{\hat{e}}me$, qui ${\acute{e}}tait$ aussi le metteur en $sc{\grave{e}}ne$ depuis 1994 dans le $th{\acute{e}}{\hat{a}}tre$ contemporain en $Cor{\acute{e}}e$. Cette $th{\grave{e}}se$ est $commenc{\acute{e}}$ ${\grave{a}}$ ${\acute{e}}crire$ pas pour apprendre ses textes mais pour comprendre la ralation entre les textes et les ${\exp}{\acute{e}}riences$ de l'auteur. Ici, pour cela, j''ai $analys{\acute{e}}$ ses 4 $pi{\grave{e}}ces$ $th{\acute{e}}{\hat{a}}trales$ produites ${\grave{a}}$ cette ${\grave{e}}poque$, dont (1994), (2000), $d{\acute{e}}biteur$, mon $p{\grave{e}}re$ est $progress{\acute{e}}$ de cancer>(1996), (2005), en referrant les rapports entre $l^{\prime}{\acute{e}}criture$ dramatique et de la mort et le deuil de $p{\grave{e}}re$. Cette ${\acute{e}}tude$ $pr{\acute{e}}suppose$ un certain situation psychologue de l'auteur sur la mort et le deuil de personnage '$p{\grave{e}}re$'. L'auteur dramatique et le metteur en $sc{\grave{e}}ne$ du $th{\acute{e}}{\hat{a}}tre$ Young-sun Yun propose certaines orientations de la mort de son $p{\grave{e}}re$ dans ses texts dramatiques: le sentiment de victime sous le pouvoir absolu de son $p{\grave{e}}re$. Chez lui, ${\acute{e}}crire$ le texte dramatique, c'est transmettre les amertumes d'esprit et une forme de $r{\acute{e}}flextion$ vis-${\grave{a}}$-vis de la relation avec son $p{\grave{e}}re$ surtout le $probl{\grave{e}}me$ $inachev{\acute{e}}$ de deuil. c'est-${\grave{a}}$-dire fournir des sentiments coupables et des $anxi{\acute{e}}t{\acute{e}}s$ qui $r{\acute{e}}sident$ au fond de son coeur, tout au long de sa vie. Pour cette objecif, il est ${\acute{e}}vident$ qu'il faudra toujours partir du texte et y revenir. J'ai $essay{\acute{e}}$ de ne pas $r{\acute{e}}duiser$ $l^{\prime}{\acute{e}}tude$ des textes au respect myope des paroles des personnage et rester la $r{\acute{e}}flextion$ pshchologique sur la mort et le processu de deuil. J'ai $essay{\acute{e}}$ d'appuyer mes remarques sur les sources $autoris{\acute{e}}es$: psychanalytiques en la $mati{\grave{e}}re$. C'est pourquoi j'ai cru devoir $pr{\acute{e}}senter$ cette recherche de l'analyse sous la forme d'une $synth{\grave{e}}se$ des principaux concepts de la $th{\acute{e}}orie$ de la pshchologie moderne qui permettent l'analyse des textes dramatiques.(Dany Nobus, David K. Switzer, Fritz Riemann, Giles Deleuze, Sigmund Freud, Julia Kristeva) Et auiss j'ai $essay{\acute{e}}$ de explorer l'imaginaire des paroles dans les textes en ses rapports avec l'auteur et les personnages et entre les personnages. Ainsi conçu, j'ai $analys{\acute{e}}$ les formes de paroles en ce qui concerne la mort de $p{\grave{e}}re$ et le deuil. Cette $mani{\grave{e}}re$ s'est $r{\acute{e}}v{\acute{e}}l{\acute{e}}e$ efficace pour montrer comment des traces de sentiment se transforment dans des textes. Dans les pluparts des personnages chez les textes de Young-sun Yun, on peut voir si $d{\acute{e}}finitivement$ leur cicatrices personnelles, $sensibilit{\acute{e}}s$ $m{\hat{e}}l{\acute{e}}s$, ce 'je-ne-pourrai-rien-contre-mon-$p{\grave{e}}re$' ou 'je-ne-sais-quoi-et-presque-$apr{\grave{e}}s$-la mort-de-mon pere'. Pour $d{\acute{e}}pouiller$ cet aspect, j'ai $montr{\acute{e}}$ qu'il n'y avait pas de $v{\acute{e}}rit{\acute{e}}s$ objectives, mais que la $subjectivit{\acute{e}}$ doit trouver le jeu triangulaire entre l'inconscient de l'auteur par les paroles des textes et par les rapports entre le symbolisant et le $symbolis{\acute{e}}$ dans les $repr{\acute{e}}sentation$ socio-culturelle en $Cor{\acute{e}}e$ d'aujourd'hui.

Physicochemical properties of deposited particles on surface of pine leaves as biomarker for air pollution (솔잎가지 표면에 침착된 입자상 물질의 물리화학적 특성 및 대기오염 지표로서의 가능성 고찰)

  • Chung, David;Choi, Jeong-Heui;Lee, Jang-Ho;Lee, Soo-Yong;Lee, Ha-Eun;Park, Ki-Wan;Shim, Kyu-Young;Lee, Jong-Chun
    • Analytical Science and Technology
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    • v.31 no.6
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    • pp.247-258
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    • 2018
  • The purpose of the present study was to investigate whether the degree of air pollution can be evaluated via examination of local plants. Selected sites included two parks in an industrial area, as well as two parks in an urban area. Selected plant samples comprised one-year-old pine shoot leaves. Leaves growing over 2 m from the ground were collected from over 10 pine trees. Leaf surface was analyzed for deposition of 14 trace elements and 16 polycyclic aromatic hydrocarbons (PAHs), including particle size and mass, surface imaging, precipitation-mediated particle removal rate, and concentration. Particle size ranged from 0.4 to $200{\mu}m$, and the volume percentage of particles ${\leq}10$ was 20 %. Deposited particle mass ranged from 0.450-0.825 mg, and precipitation-mediated removal rate ranged from 10.0-27.6 %. Trace element concentration, as measured by ICP/MS after microwave acid digestion, was 18.8-26.3 mg/kg As, 0.08-0.13 mg/kg Be, 0.06-0.08 mg/kg Cd, 4.91-17.8 mg/kg Cr, 5.26-405 mg/kg Cu, 1,930-2,670 mg/kg Fe, 3.03-28.1 mg/kg Pb, 26.9-42.8 mg/kg Mn, 2.66-10.4 mg/kg Ni, 4,560-8,730 mg/kg Al, 2,500-6,120 mg/kg Ba, 5.27-17.8 mg/kg Rb, 40.9-95.3 mg/kg Sr, and 4,030-8,260 mg/kg Zn. Concentration of PAHs, as analyzed by GC/MS/MS after liquid-liquid extraction and purification of deposited particles, ranged from 1.17 to 12.378 mg/kg for ${\Sigma}PAH_{16}$ and from 1.17 to 12.378 mg/kg for ${\Sigma}PAH_7$.

A Study on the Gwanbang forest of Ganghwa in the Joseon Dynasty Period (조선시대 강화지역 관방림(關防林)의 특성 연구)

  • Shim, Sun-Hui;Lee Jae-Yong;Kim, Choong-Sik
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.41 no.1
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    • pp.35-46
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    • 2023
  • This study investigated and analyzed ancient records on the type, planting background, and construction process of Gwanbang forest(關防林) planned for military defense during the Joseon Dynasty to find out the purpose, location, and planting species of Gwanbang forest. The research results were as follows. During the Joseon Dynasty, Gwanbang forests were created around various government facilities(關防施設), such as Eupseong(邑城), major government offices, camps, and fortifications, for the purpose of defending against enemies. Gwanbang forest includes Yeongaeglim(嶺阨林), which was created on the crest of a strategically important hill, and Military Forest created for military purposes. Most of the spirit forest was designated as Geumsan(禁山) and protected and managed, and the Gwanbang forest was created for various purposes such as shielding, flood damage and river bank erosion prevention as well as external defense. In addition, in order to continuously and efficiently produce wood, which is a material for ships, buildings, and agricultural tools, in most cases, large areas were created as mixed forests. As for the species constituting the Gwanbang forest, there are records of tangerine tree, which is effective for defense because it has thorns, and deciduous broad-leaved trees such as zelkova, elm, willow, david hemiptelea, and oak appear. In the case of Ganghwa island, which served as the defense of the capital and the royal family during the Joseon Dynasty, several records have confirmed that a forest densely planted with trifoliate orange was created for the purpose of Gwanbang forest to reinforce the defense of the outer fortress. Based on historical research in the literature, assuming that the natural monument 'Gapgotri tangerine tree in Ganghwa Island' was planted in the 30th year of King Sukjong(1704), the first record of planting trifoliate orange in Ganghwa Island, the maximum age is estimated to be more than 319 years.

Survival Value of Myocutaneous Flaps in the Management of Epidermoid Carcioma of the Oral Cavity (구강내 상피암의 치료에서 근피부판이 생존율에 미치는 영향)

  • Seel David John;Park Chul-Young;Yoo Chung-Joon;Lee Samuel;Park Yoon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.6 no.2
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    • pp.79-84
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    • 1990
  • This paper is a review of our experience with radical resection for cancer of the oral cavity with particular emphasis upon the value of myocutaneous(i.e., musculocutanous) flaps employed in the surgical reconstruction in patient survival. During the past 15 years, 98 patients underwent resection of cancer arising in the oral cavity and oropharynx. Of these, 14 had composite resections in which the mandible was not sectioned, and 4 underwent en bloc resections without neck dissections in the face of post-radiation recurrence. When these excluded, 84 patients who underwent COMMANDO procedures with or without myocutaneous flaps were suitable for analysis of recurrence and survival according to the various surgical technics employed. 1) According to the surgical technic, there were 24 standard COMMANDO procedures in whom no regional or myocutanous flap was used; 12 patients who underwent reconstruction employing a forehead flap; 19 patients in whom a posterior cervical 'nape' flap was employed; 27 patients who underwent myocutaneous or osteo-myocutaneous flap repair; and two patients who had double flap repair. 2) The uncorrected two-year disease free survival was 41% for standard COMMANDOs, 17% for forehead flap COMMANDOs; 35% for nape flap COMMANDOs; and 35% for myocutaneous flap COMMANDO procedures. 3) The two-year disease-free survival by Stage was 100% in Stage I, 45% in Stage II, 41% in Stage III, and 18% in Stage IV. 4) When myocutanous flaps cases were compared with Group I, comprised of matched historical controls including both Standard COMMANDOs and those who had undergone regional flap repairs(that is, forehead and nape flap COMMANDOs)there was no difference, both groups showing a 40% 2-year disease-free survival. 5) When musculocutanous flap cases were compared with Goup II, which was composed of matched historical controis limited to patients who had undergone regional flap repairs(that is, forehead and nape flap cases only)there was no difference, both groups showing a 27% 2-year desease-free survival. 6) When musculocutanous flap cases were compared with Group III, composed of patients who had undergone classic COMMANDO procedures without any sort of flap repair, there was a striking difference; the patients undergoing MC flap repair showed 50% 2-year disease-free survival, whereas the classic COMMANDO cases showed a 25% survival free of disease. 7) Locoregional recurrence was also evaluated in the four categories; for standard COMMANDO cases it was 25%, for nape flap cases 26% ; for forehead flap cases, 33%, and for the musculocutaneous flap cases, the lowest recurrence rate, 22%. These results are of particular significance in view of the fact that the proportion of advanced cases(Stage III and IV)in each category was 67% of standard cases, 79% of nape flap patients, 100% of forehead flap cases, and 96% of musculocutaneous flap cases.

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