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Impact of Postoperative Chemoradiotherapy and Chemoradiotherapy Alone for Esophageal Cancer in North-West Iran

  • Mirinezhad, Seyed Kazem;Somi, Mohammad Hossein;Shirmohamadi, Masoud;Seyednejad, Farshad;Jangjoo, Amir Ghasemi;Ghojazadeh, Morteza;Mohammadzadeh, Mohammad;Naseri, Ali Reza;Nasiri, Behnam
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3921-3924
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    • 2013
  • Background: To investigate the role of surgical treatment for locally advanced esophageal cancer, we compared the outcomes of chemoradiotheroy alone (CRT) to postoperative chemoradiotherapy (S/CRT), using, Regional Radiotherapy Center, database. Materials and Methods: This retrospective study was conducted in North-West of Iran, included of 255 consecutive patients with esophageal cancer. Eligible operable and non-operable, were treated with S/CRT and CRT respectively. Radiotherapy (RT) was delivered at 1.8-2 Gy/day for five consecutive days in a given week. Chemotherapy (CT) consisted of cisplatin and 5-fluorouracil. Results: From March 2006 to March 2011 255 patients: male/female 129/96, median age 68 (35-90), squamous/adeno 213/12, received CRT/S+CRT 166/59, median radiation dose $45{\pm}13.6Gy$, Median survival 13.5 (11-15), overall survival (OS) One/Two/Three 57/21/16%, Died/alive 158/97, Univariate analysis prognostic factors: age/stag/differentiation/dose of RT/fraction/treatment, Multivariate analysis predictor factor: dose of RT/fraction. Conclusions: Although this treatment offers some possibility for improvement of patients with esophageal cancer, there remains a significant need for development of new drug and new therapeutic approaches that can substantially impact survival.

Latency in the Architectural Space of Mies van der Rohe (미스 반 데어 로에 건축공간의 잠복성)

  • Chung, Mann-Young;Choe, Eun-Guk
    • Journal of architectural history
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    • v.15 no.3
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    • pp.119-135
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    • 2006
  • This study based on the hypothesis which the spatial qualities in the Mies's early works are not extinct but potentially immanent in his latter works. In Mies's early works, destruction of outline, centrifugal extension of fluid space, and asymmetry are distinctly showed. These qualities probably revert to the indefiniteness of space. In Mies's latter works, however, these dynamic qualities are disappeared. Geometrically precise outline and exact grid structure represent universal space derived from zero-degree pure box. These qualities probably revert to tile definiteness of space, characterized by the unmovable emptiness. Although Mies works vary in external form, his expression technique of space reveals continually both the qualify of definitive and indefinitive space. For example, in the Museum for a Small City(1942) unbuilt project. elements defined by the perspective are fixed and static, but elements defined by the collages are floated and dynamic. The former reigns over the realized buildings of Mies, while the latter seems to be latent in terms of Schein which transcends reality. If we can penetrate this point, it's possible to read the other side of Mies' architectural works, distinct from both the canonized interpretation and the excessive criticism. Point is that later works of Mies must be understood as interplay of universal space appeared as phenomenon and flowing elements latent in. Architectural space of Mies keeps a distance with actual space through latent manner of being while preserves the empirical actuality It provides us with an occasion which appears only in an instant, in which even the ordinary things reveal its poetics.

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Early hypopharyngeal cancer treated with different therapeutic approaches: a single-institution cohort analysis

  • Kim, Nalee;Lee, Jeongshim;Kim, Kyung Hwan;Park, Jong Won;Lee, Chang Geol;Keum, Ki Chang
    • Radiation Oncology Journal
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    • v.34 no.4
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    • pp.280-289
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    • 2016
  • Purpose: Early hypopharyngeal squamous cell carcinoma (HPSCC) is a rarely diagnosed disease, for which the optimal treatment has not been defined yet. We assessed patterns of failure and outcomes in early HPSCC treated with various therapeutic approaches to identify its optimal treatment. Materials and Methods: Thirty-six patients with stage I (n = 10) and II (n = 26) treated between January 1992 and March 2014 were reviewed. Patients received definitive radiotherapy (RT) (R group, n = 10), surgery only (S group, n = 19), or postoperative RT (PORT group, n = 7). All patients in both the R and PORT groups received elective bilateral neck irradiation. In the S group, 7 patients had ipsilateral and 8 had bilateral dissection, while 4 patients had no elective dissection. Results: At a median follow-up of 48 months, the 5-year locoregional control (LRC) rate was 65%. Six patients had local failure, 1 regional failure (RF), 3 combined locoregional failures, and 2 distant failures. There was no difference in 5-year LRC among the R, S, and PORT groups (p = 0.17). The presence with a pyriform sinus apex extension was a prognosticator related to LRC (p = 0.01) in the multivariate analysis. Patients with a bilaterally treated neck showed a trend toward a lower RF rate (p = 0.08). Conclusion: This study shows that patients with early stage HPSCC involving the pyriform sinus apex might need a tailored approach to improve LRC. Additionally, our study confirms elective neck treatment might have an efficacious role in regional control.

Quantification of the tug-back by measuring the pulling force and micro computed tomographic evaluation

  • Jeon, Su-Jin;Moon, Young-Mi;Seo, Min-Seock
    • Restorative Dentistry and Endodontics
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    • v.42 no.4
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    • pp.273-281
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    • 2017
  • Objectives: The aims of this study were to quantify tug-back by measuring the pulling force and investigate the correlation of clinical tug-back pulling force with in vitro gutta-percha (GP) cone adaptation score using micro-computed tomography (${\mu}CT$). Materials and Methods: Twenty-eight roots from human single-rooted teeth were divided into 2 groups. In the ProTaper Next (PTN) group, root canals were prepared with PTN, and in the ProFile (PF) group, root canals were prepared using PF (n = 14). The degree of tug-back was scored after selecting taper-matched GP cones. A novel method using a spring balance was designed to quantify the tug-back by measuring the pulling force. The correlation between tug-back scores, pulling force, and percentage of the gutta-percha occupied area (pGPOA) within apical 3 mm was investigated using ${\mu}CT$. The data were analyzed using Pearson's correlation analysis, one-way analysis of variance (ANOVA) and Tukey's test. Results: Specimens with a strong tug-back had a mean pulling force of 1.24 N (range, 0.15-1.70 N). This study showed a positive correlation between tug-back score, pulling force, and pGPOA. However, there was no significant difference in these factors between the PTN and PF groups. Regardless of the groups, pGPOA and pulling force were significantly higher in the specimens with a higher tug-back score (p < 0.05). Conclusions: The degree of subjective tug-back was a definitive determinant for master cone adaptation in the root canal. The use of the tug-back scoring system and pulling force allows the interpretation of subjective tug-back in a more objective and quantitative manner.

Fabrication of immediate complete denture using Campagna tray technique (전악 발치 환자에서 캠퍼그나 트레이를 적용한 즉시의치 수복 증례)

  • Kim, Nam-Hoon;Kim, Jong-Eun;Oh, Kyung Chul;Chung, Moon-Kyu;Moon, Hong-Seok
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.3
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    • pp.331-335
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    • 2017
  • An immediate complete denture is considered as restoration for lost natural teeth, which is fabricated following the extraction of the remaining teeth. Current esthetics and function can be retained by using immediate denture without edentulous period. However, the major disadvantages of immediate denture relate to the difficulties associated with taking accurate definitive impression and predicting the results of immediate denture. In this case report, the Campagna tray technique was used to take the final impression in a 49-year-old male patient presented with all remaining teeth diagnosed as hopeless teeth. Surgical templates were used for alveoloplasty after extraction. The immediate complete dentures were then delivered. The clinical assessments of immediate dentures showed good esthetic and functional outcomes. The patient showed high level of satisfaction.

Impact of Healthcare Accreditation Using a Systematic Review: Balanced Score Card Perspective (의료기관인증의 효과에 대한 체계적 문헌고찰: Balanced Score Card 관점으로)

  • Park, Il-Tae;Jung, Yoen-Yi;Park, Seong-Hi;Hwang, Jeong-Hae;Suk, Seung-Han
    • Quality Improvement in Health Care
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    • v.23 no.1
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    • pp.69-90
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    • 2017
  • Purpose: The purpose of this study was to analyze the impact of healthcare accreditation and to provide empirical evidence to validate positive effectiveness. Methods:Six electronic databases (KERIS, KoreaMed, NDSL, Ovid-medline, Embase, Cochrane library) were accessed in May 2016. Keywords used were 'accreditation' and 'Joint Commission on Accreditation of Healthcare Organization (JCAHO)'. Of the initially identified 3,008 articles, 60 studies on healthcare accreditation were selected based on inclusion criteria that are hospital accreditation, accreditation by disease and clinical center accreditation. These were retrieved and analyzed. Result: The 60 study results were on the impact of healthcare accreditation. Results were classified into four perspectives of Balanced Score Card (Financial, Customer, Internal Process, Learning & Growth). In internal process perspective, results revealed that healthcare accreditation has made a positive impact on "care process and procedure". In learning & growth perspective, healthcare accreditation has made a positive influence on "leadership", "organizational cultures" and "change mechanisms". However, it revealed that healthcare accreditation does not directly affect financial performance. It is also difficult to reach a definitive conclusion that healthcare accreditation programs affect patient satisfaction of customer and clinical outcome of the internal process. Conclusion: Healthcare accreditation programs provide positive impact on change of care process and building communication-oriented hospital culture. However, more rigorous and diverse research is needed on financial effects and clinical outcomes of healthcare accreditation.

The Analysis on the Results of Mathematics Field Trips for Pre-service Mathematics Teacher (예비교사를 위한 수학답사활동 수행 결과 분석)

  • Suh, Bo Euk
    • Communications of Mathematical Education
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    • v.30 no.2
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    • pp.139-159
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    • 2016
  • This study is the field of mathematics education on the assumption that they can extend outside the classroom. Recent mathematics education is increasing the importance of field experience and various activities based on real-life math education. Thus, it is necessary to consider this situation in pre-service teacher's education. The purpose of this study is to apply the 'Mathematics Field Trips Activities' in the pre-mathematics teacher education. So the specific case of 'Mathematics Field Trips Activities' was analyzed. Mathematics teachers conducted preliminary exploration activities on the historical cultural property which were effective in the following four aspects. First, cognitive effects and second, definitive effect. Third, cultural-mathematical effect. Fourth, the effect on improving math class. Finally they were summarized and divided into classes target content knowledge and teaching knowledge both sides. As a result, the 'Mathematics Field Trips Activities' were found to have significant effects on pre-service math teacher. Finally, ongoing research is needed to settle into a new teaching and learning methods.

Detection Rate of Intravascular Injections during Cervical Medial Branch Blocks: A Comparison of Digital Subtraction Angiography and Static Images from Conventional Fluoroscopy

  • Jeon, Young Hoon;Kim, Sae Young
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.105-108
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    • 2015
  • Background: The most definitive diagnosis of neck pain caused by facet joints can be obtained through cervical medial branch blocks (CMBBs). However, intravascular injections need to be carefully monitored, as they can increase the risk of false-negative blocks when diagnosing cervical facet joint syndrome. In addition, intravascular injections can cause neurologic deficits such as spinal infarction or cerebral infarction. Digital subtraction angiography (DSA) is a radiological technique that can be used to clearly visualize the blood vessels from surrounding bones or dense soft tissues. The purpose of this study was to compare the rate of detection of intravascular injections during CMBBs using DSA and static images obtained through conventional fluoroscopy. Methods: Seventy-two patients were included, and a total of 178 CMBBs were performed. The respective incidences of intravascular injections during CMBBs using DSA and static images from conventional fluoroscopy were measured. Results: A total of 178 CMBBs were performed on 72 patients. All cases of intravascular injections evidenced by the static images were detected by the DSAs. The detection rate of intravascular injections was higher from DSA images than from static images (10.7% vs. 1.7%, P < 0.001). Conclusions: According to these findings, the use of DSA can improve the detection rate of intravascular injections during CMBBs. The use of DSA may therefore lead to an increase in the diagnostic and therapeutic value of CMBBs. In addition, it can decrease the incidence of potential side effects during CMBBs.

A Studies on the Effect of the Mediating Variable Affecting the Business Performance in the TPM Activity (TPM활동에 있어서 기업성과에 영향을 미치는 매개변수의 효과에 관한 연구)

  • Yeon, Keyong-Hwa
    • Journal of the Korea Convergence Society
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    • v.7 no.1
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    • pp.197-203
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    • 2016
  • This study is to constructs the model by the relationship between the most important ones of TPM's step activities which are derived from the result of AHP analysis and the management performance. And it is to analyze whether step activities have impact on corporate performance through the mediating variable from a convergence point. Also it is to choose four step activities - irrational field and loss improvement, preparation and system establishment for the basic conditions of 5S, initial cleaning, loss analysis of facility efficiency - as independent variables, and to analyze the effect of TPM activity level as mediating variable on management performance as dependent variable. According to the analysis, four step activities don't have direct effect on corporate performance but TPM activity level as mediating variable has a full-mediated effect on corporate performance. That is, TPM activity level has been shown to play a role as mediating variable. Therefore, higher recognition of confidence in facility, awareness of self-development and definitive management of individual work shows TPM activity can contribute to corporate performance successfully.

Comparison of Cellular Features Diagnostic of Papillary Thyroid Carcinoma in Liquid-Based (Cell Scan 1500TM) Preparations and Conventional Smears

  • Lee, Jung Dal;Park, Yong Wook;Back, OunCheol;Jung, Pa Jong;Kim, Jong Yull
    • Korean Journal of Clinical Laboratory Science
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    • v.45 no.3
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    • pp.108-113
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    • 2013
  • The study compared the cytological features of papillary thyroid carcinoma (PTC) in liquid-based preparations (LBPs) and conventional Pap (CP) smears from fine needle aspiration (FNA), and assessed the feasibility of LBP using the Cell Scan $1500^{TM}$ processor on thyroid FNA samples. Thyroid FNA samples were obtained from 883 consecutive patients. Each sample was divided into two and used for LBPs and CP smears. All were screened independently in a double-blind manner. From the 883 cases, 95 cases were diagnosed as PTC in one or both types of preparation (10.8%). PTC was diagnosed via CP smears in 83 cases (87.4%) and via LBPs in 70 cases (73.7%). However, there were differences in categorization between the paired preparations: Twelve (12) PTCs were misinterpreted in CP smears and 25 PTCs in LBPs. There was a significant discrepancy in the rate of detection of the diagnostic features, with LBPs having a lower detection rate. One (1) case (1.2%) of CP smears and 16 cases (22.9%) of LBPs were categorized as unsatisfactory/nondiagnostic in a total of the 95 PTCs. To conclude, the detection rate of the diagnostic features of PTC is lower in Cell Scan 1500TM samples than in CP smears. However, there are some cases in which a diagnosis of PTC is made in LBPs, but not in CP smears. Therefore, definitive cancer diagnosis in thyroid FNA preparations is likely to result from agreement between direct smears and Cell Scan 1500TM preparations.

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