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Clinical outcomes of adjuvant radiation therapy and prognostic factors in early stage uterine cervical cancer

  • Kim, Hyun Ju;Rhee, Woo Joong;Choi, Seo Hee;Nam, Eun Ji;Kim, Sang Wun;Kim, Sunghoon;Kim, Young Tae;Kim, Gwi Eon;Kim, Yong Bae
    • Radiation Oncology Journal
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    • v.33 no.2
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    • pp.126-133
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    • 2015
  • Purpose: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. Results: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Conclusion: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.

Synthesis and Application of Bluish-Green BaSi2O2N2:Eu2+ Phosphor for White LEDs (백색 LED용 청록색 BaSi2O2N2:Eu2+ 형광체의 합성 및 응용)

  • Jee, Soon-Duk;Choi, Kang-Sik;Choi, Kyoung-Jae;Kim, Chang-Hae
    • Korean Journal of Materials Research
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    • v.21 no.5
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    • pp.250-254
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    • 2011
  • We have synthesized bluish-green, highly-efficient $BaSi_2O_2N_2:Eu^{2+}$ and $(Ba,Sr)Si_2O_2N_2:Eu^{2+}$ phosphors through a conventional solid state reaction method using metal carbonate, $Si_3N_4$, and $Eu_2O_3$ as raw materials. The X-ray diffraction (XRD) pattern of these phosphors revealed that a $BaSi_2O_2N_2$ single phase was obtained. The excitation and emission spectra showed typical broadband excitation and emission resulting from the 5d to 4f transition of $Eu^{2+}$. These phosphors absorb blue light at around 450 nm and emit bluish-green luminescence, with a peak wavelength at around 495 nm. From the results of an experiment involving Eu concentration quenching, the relative PL intensity was reduced dramatically for Eu = 0.033. A small substitution of Sr in place of Ba increased the relative emission intensity of the phosphor. We prepared several white LEDs through a combination of $BaSi_2O_2N_2:Eu^{2+}$, YAG:$Ce^{3+}$, and silicone resin with a blue InGaN-based LED. In the case of only the YAG:$Ce^{3+}$-converted LED, the color rendering index was 73.4 and the efficiency was 127 lm/W. In contrast, in the YAG:$Ce^{3+}$ and $BaSi_2O_2N_2:Eu^{2+}$-converted LED, two distinct emission bands from InGaN (450 nm) and the two phosphors (475-750 nm) are observed, and combine to give a spectrum that appears white to the naked eye. The range of the color rendering index and the efficiency were 79.7-81.2 and 117-128 lm/W, respectively. The increased values of the color rendering index indicate that the two phosphor-converted LEDs have improved bluish-green emission compared to the YAG:Ce-converted LED. As such, the $BaSi_2O_2N_2:Eu^{2+}$ phosphor is applicable to white high-rendered LEDs for solid state lighting.

Antibody response to pneumococcal vaccination in children with chronic or recurrent rhinosinusitis

  • Baek, Ji Hyeon;Seo, Hyun Kyong;Jee, Hye Mi;Shin, Youn Ho;Han, Man Yong;Oh, Eun Sang;Lee, Hyun Ju;Kim, Kyung Hyo
    • Clinical and Experimental Pediatrics
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    • v.56 no.7
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    • pp.286-290
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    • 2013
  • Purpose: Although chronic and recurrent rhinosinusitis is prevalent in children, little is known about its causes. Here, we investigated the humoral immunity in children with chronic or recurrent rhinosinusitis. Methods: We examined 16 children attending the outpatient clinic at the CHA Bundang Medical Center including 11 boys and 5 girls, aged 3-11 years (mean age, 5.6 years), who had rhinosinusitis for >3 months or >3 times per year. The complete blood count with differential and total serum concentrations of Immunoglobulin (Ig) E, IgA, IgD, IgM, IgG, and IgG subclasses ($IgG_1$, $IgG_2$, $IgG_3$, and $IgG_4$) of all children were measured. All subjects received 23-polysaccharide pneumococcal vaccination (PPV), and the levels of antibodies to 5 serologic types (4, 6B, 14, 18C, and 23F) of pneumococcal capsular polysaccharide antigens were measured before and after vaccination. Post-PPV antibody titers ${\geq}0.35{\mu}g/mL$ or with a ${\geq}4$-fold increase were considered as positive responses. Results: The titers of IgG, IgA, IgD, and IgM were within normal range in all 16 children, whereas the total IgE concentration was higher than normal in 2 children. $IgG_1$ deficiency was observed in 1 patient and $IgG_3$ deficiency in 3. After PPV, 1 patient failed to respond to all 5 serologic types, 2 failed to respond to 4 serologic types, and 2 failed to respond to 3 serologic types. Conclusion: Clinicians should consider the evaluation of humoral immune functions in children with chronic or recurrent rhinosinusitis who do not respond to prolonged antibiotic treatment.

Studies on Viruses Isolated from Lilium spp. In Korea I. Broad Bean Wilt Virus and Cucumber Mosaic Virus (한국산 나리류에서 분리한 바이러스에 관한 연구 I. Broad Bean Wilt Virus 및 Cucumber Mosaic Virus)

  • Chang Moo Ung;Chung Jae Dong
    • Korean Journal Plant Pathology
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    • v.3 no.3
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    • pp.223-235
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    • 1987
  • Samples showing yellow mosaic symptom of Lilium spp. with necrotic fleck, stunting, malformation, and colour breaking were collected from lily-growing areas in the southern part of Korea. Two viruses were distinguished under a electron microscope and their host range, serological reaction, stability in sap, type of aphid transmission, and relations with cells and tissues were examined. Broad bean wilt virus (BBWV) was transmitted by sap-inoculation to 23 plant species in 8 families and by the aphid, Myzus persicae. This virus was inactivated after 10 min at 70C, at dilution of $10^{-3}$, and after 6 days at about 20C. Electron microscopic examination of purified preparation showed that the virus is spherical particle of 28nm in diameter. The virus reacted positively with BBWV-antiserum in agar gel diffusion test. In ultrathin sections of BBWV infected tissues, large aggregates or crystalline array of virus particles and vesicular body were found in the cytoplasm, vacuole, and nucleus of mesophyll cells. Cucumber mosaic virus (CMV) was transmitted by sap-inoculation. Electron microscopic examination of its purified preparation showed spherical particles of 30nm in diameter. The virus reacted positively with CMV-Y strain-antiserum in agar gel diffusion test. In ultrathin sections of CMV infected tissues, crystalline array of virus particles were found in the vacuole and a large number 0f virus particles were found in the cytoplasm and the plasmodesmata of mesophyll cells. When each of these viruses was retransmitted to Lilium tigrinum. L. concolor, and L. auratum, BBWV induced slight symtoms and colour breaking, but CMV induced yellowing mosaic or necrotic fleck.

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Risperidone Monotherapy in Children and Adolescents with Autism Spectrum Disorders : A Naturalistic Study

  • Won, Eun-Kyung;Park, Jin-Park;Lee, Young-Ryul;Nam, Yoon-Young;Min, He-Ji;Kim, Yeni
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.4
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    • pp.273-278
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    • 2015
  • Objectives : We retrospectively investigated the efficacy and tolerability of risperidone monotherapy in subjects with autism spectrum disorder (ASD). In addition, we did mixed effect model analysis of the effects of risperidone in patients with ASDs naturalistically treated in a routine clinical setting to determine whether the clinical effects were maintained and the side effects were tolerable. Methods : This retrospective study assessed children and adolescents with ASD, who were on risperidone monotherapy from July 2010 to July 2011 at the Child and Adolescent ASD Clinic at Seoul National Hospital. Outcome measures included the Clinical Global Impression-Severity of Illness (CGI-S) and the CGI-Improvement (CGI-I) scales along with other clinical indices: dosage, target symptoms, and side effects. Results : The mean dose of risperidone in 47 children and adolescents with ASD (40 males, 7 females; age range 5-19 years) who were on risperidone monotherapy was $1.6{\pm}0.8mg/day$, and the mean duration of the treatment period was $20.2{\pm}17.3months$. Aggressive behavior, stereotypic behavior, irritability, and self-injurious behavior were the most frequent target symptoms of risperidone. The most common side effects were weight gain followed by somnolence and extrapyramidal symptoms. In a mixed effects model analysis of CGI-I scores, the mean CGI-I score at the 1 month follow-up was significantly different from the mean CGI-I score of the 3-month follow-up (p=.046), and the CGI-I scores were equally maintained over 3 to 48 months [F(6, 28.9)=4.393, p=.003]. Of the 47 patients, 33 patients (70.2%) were identified as the response group, showing an end point CGI-I rating of 3 or under and having continued risperidone treatment for at least 6 months. The baseline CGI-S score showed significant association with clinical response to risperidone (p=.005), the mean baseline CGI-S was higher in the response group compared to the non-response group. Conclusion : In this study, clinical improvement of risperidone stabilized around 3 months and was equally maintained up to 48 months with tolerable side effects, supporting maintenance of risperidone treatment in children and adolescents with ASDs.

Aerobic Degradation of Tetrachloroethylene(PCE) by Pseudomonas stutzeri OX1

  • Ryoo, Doohyun;Shim, Hojae;Barbieri, Paola;Wood, Thomas K.
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2000.11a
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    • pp.207-208
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    • 2000
  • Since trichloroethylene (TCE), dichloroethylene (DCE), and vinyl chloride (VC) arise from anaerobic degradation of tetrachloroethylene (PCE) and TCE, there is interest in creating aerobic remediation systems that avoid the highly toxic VC and cis-DCE which predonominate in anaerobic degradation. However, it seemed TCE could not be degraded aerobically without an inducing compound (which also competitively inhibits TCE degradation). It has been shown that TCE induces expression of both the toluene dioxygenase of p. putida F1 as well as toluene-p-monooxygenase of P.mendocina KRI. We investigated here the ability of PCE, TCE, and chlorinated phenols to induce toluene-o-xylene monooxygenase (ToMO) from P.stutzeri OX1. ToMO has a relaxed regio-specificity since it hydroxylates toluene in the ortho, meta, and para positions; it also has a broad substrate range as it oxidizes o-xylene, m-xylene, p-xylene, toluene, benzene, ethylbenzene, styrene, and naphthalene; chlorinated compounds including TCE, 1, 1-DCE, cis-DCE, trans-DCE, VC, and chloroform : as well as mixtures of chlorinated aliphatics (Pseudomonas 1999 Maui Meeting). ToMO is a multicomponent enzyme with greatest similarity to the aromatic monooxygenases of Burkholderia pickettii PKO1 and P.mendocina KR1. Using P.sturzeri OX1, it was found that PCE induces P.mendocina KR1 Using P.situtzeri OX1, it was found that PCE induces ToMO activity measured as naphthalene oxygenase activity 2.5-fold, TCE induces 2.3-fold, and toluene induces 3.0 fold. With the mutant P.stutzeri M1 which does not express ToMO, it was also found there was no naphthalene oxygenate activity induced by PCE and TCE; hence, PCE and TCE induce the tow path. Using P.putida PaW340(pPP4062, pFP3028) which has the tow promoter fused to the reporter catechol-2, 3-dioxygenase and the regulator gene touR, it was determined that the tow promoter was induced 5.7-, 7.1-, and 5.2-fold for 2-, 3-, 4-chlorophenol, respectively (cf. 8.9-fold induction with o-cresol) : however, TCE and PCE did not directly induce the tou path. Gas chromatography and chloride ion analysis also showed that TCE induced ToMO expression in P.stutzeri OX1 and was degraded and mineralized. This is the first report of significant PCE induction of any enzyme as well as the first report of chlorinated compound induction of the tou operon. The results indicate TCE and chlorinated phenols can be degraded by P.stutzeri OX1 without a separate inducer of the tou pathway and without competitive inhibition.

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Optical Properties of MgMoO4:Dy3+,Eu3+ Phosphors Prepared with Different Eu3+ Molar Ratios (Eu3+ 이온의 몰 비 변화에 따른 MgMoO4:Dy3+,Eu3+ 형광체의 광학 특성)

  • Kim, Jung Dae;Cho, Shinho
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.29 no.3
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    • pp.186-191
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    • 2016
  • The effects of $Eu^{3+}$ doping on the structural, morphological, and optical properties of $MgMoO_4:Dy^{3+},Eu^{3+}$ phosphors prepared by solid-state reaction technique were investigated. XRD patterns exhibited that all the synthesized phosphors showed a monoclinic system with a dominant (220) diffraction peak, irrespective of the content of $Eu^{3+}$ ions. The surface morphology of $MgMoO_4:Dy^{3+},Eu^{3+}$ phosphors was studied using scanning electron microscopy and the grains showed a tendency to agglomerate as the content of $Eu^{3+}$ ions increased. The excitation spectra of the phosphor powders were composed of a strong charge transfer band centered at 294 nm in the range of 230~340 nm and two intense peaks at 354 and 389 nm, respectively, arising from the $^6H_{15/2}{\rightarrow}^6P_{7/2}$ and $^6H_{15/2}{\rightarrow}^4M_{21/2}$ transitions of $Dy^{3+}$ ions. The emission spectra of the $Mg_{0.85}MoO_4$:10 mol% $Dy^{3+}$ phosphors without incorporating $Eu^{3+}$ ions revealed a strong yellow band centered at 573 nm resulting from the $^4F_{9/2}{\rightarrow}^6H_{13/2}$ transition of $Dy^{3+}$. As the content of $Eu^{3+}$ was increased, the intensity of the yellow emission was gradually decreased, while that of red emission band located at 614 nm began to appear, approached a maximum value at 10 mol%, and then decreased at 15 mol% of $Eu^{3+}$. These results indicated that white light emission could be achieved by controlling the contents of the $Dy^{3+}$ and $Eu^{3+}$ ions incorporated into the $MgMoO_4$ host crystal.

Design and Performance Evaluation of Small Size Counting and Imaging Gamma Probe System (소형 계수용 및 영상용 감마프로브 시스템의 설계와 성능평가)

  • Yang, Myo-Geun;Kwark, Cheol-Eun;Sim, yong-Geol;Kim, Hee-Joung;Choi, Yong;Chung, Jung-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • Journal of Biomedical Engineering Research
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    • v.18 no.3
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    • pp.291-299
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    • 1997
  • As a microimaging device detecting gamma rays emitted from small lesions or tumors during operation, the intraoperative surgical probe has been proposed and is now under development. We have designed a multipurpose portable gamma prove system and evaluated the performance both for the absolute counting purpose of residual radioactivities and for the localizing capability of gamma events using the NaI(Tl) crystal and two types of photomultiplier tubes(PMTs). Counting efficiencies in the range of routine clinical use of radiation dose were measured using the assembly of single channel PMTs and 0.5 inch thick NaI(Tl) crystal of 1 inch diameter. The positioning of gamma events for imaging purpose requires the multiple channel PMTs with appropriate positioning electronics. We have designed a simple and reliable positioning circuit based on the concept of modified Anger. In preliminary experiments using the multiple channel PMT of 3 inch diameter and the dim lighth source, we were able to trace and localize the correct position with reduced positioning error by the use of two multiplier/divider chipset and simplified peripherals. The energy resolutions for the counting gamma probe measured as full width at half maximum(FWHM) for Cs-137, F-18, Tc-99m were 12%, 13%, and 36%, respectively. The spatial resolution for the imaging gamma probe measured as FWHM for green LED was 2.9 mm. The results indicate that the currently developing probe is very promising and could be very useful for many applications in nuclear medicine. Future studies will include developing collimators, improving interface hardwares, and evaluating the system with clinical data.

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Application of peak based-Bayesian statistical method for isotope identification and categorization of depleted, natural and low enriched uranium measured by LaBr3:Ce scintillation detector

  • Haluk Yucel;Selin Saatci Tuzuner;Charles Massey
    • Nuclear Engineering and Technology
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    • v.55 no.10
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    • pp.3913-3923
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    • 2023
  • Todays, medium energy resolution detectors are preferably used in radioisotope identification devices(RID) in nuclear and radioactive material categorization. However, there is still a need to develop or enhance « automated identifiers » for the useful RID algorithms. To decide whether any material is SNM or NORM, a key parameter is the better energy resolution of the detector. Although masking, shielding and gain shift/stabilization and other affecting parameters on site are also important for successful operations, the suitability of the RID algorithm is also a critical point to enhance the identification reliability while extracting the features from the spectral analysis. In this study, a RID algorithm based on Bayesian statistical method has been modified for medium energy resolution detectors and applied to the uranium gamma-ray spectra taken by a LaBr3:Ce detector. The present Bayesian RID algorithm covers up to 2000 keV energy range. It uses the peak centroids, the peak areas from the measured gamma-ray spectra. The extraction features are derived from the peak-based Bayesian classifiers to estimate a posterior probability for each isotope in the ANSI library. The program operations were tested under a MATLAB platform. The present peak based Bayesian RID algorithm was validated by using single isotopes(241Am, 57Co, 137Cs, 54Mn, 60Co), and then applied to five standard nuclear materials(0.32-4.51% at.235U), as well as natural U- and Th-ores. The ID performance of the RID algorithm was quantified in terms of F-score for each isotope. The posterior probability is calculated to be 54.5-74.4% for 238U and 4.7-10.5% for 235U in EC-NRM171 uranium materials. For the case of the more complex gamma-ray spectra from CRMs, the total scoring (ST) method was preferred for its ID performance evaluation. It was shown that the present peak based Bayesian RID algorithm can be applied to identify 235U and 238U isotopes in LEU or natural U-Th samples if a medium energy resolution detector is was in the measurements.

Experimental and epidemiological studies on the life cycle of Echinostoma hortense Asada, 1926(Trematoda: Echinostomatidae) (남한강류역(南漢江流域)의 호르텐스극구흡충(棘口吸蟲) 감염실태(感染實態)와 생활사(生活史)에 관(關)한 연구(硏究))

  • Ahn, Yung-Kyum;Ryang, Yong-Suk
    • Parasites, Hosts and Diseases
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    • v.24 no.2
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    • pp.121-136
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    • 1986
  • Recently there have been some reports on human infections of Echinostoma hortense in Korea. It was found that a few species of freshwater fishes were playing the role of the second intermediate host of E. hortense. However, molluscan intermediate host has not been identified yet in Korea. The present study aimed to establish the life cycle of E. hortense in laboratory. Experimental studies such as egg production from the rat, development of the eggs in vitro, exposure of miracidia to freshwater snails, shedding pattern of cercariae from infected snails, morphology of cercariae, cercarial infection to the second intermediate host and infection of metacercariae to the definitive hosts were done. In addition, epidemiological surveys on the infection status in inhabitants and house rats, and on the natural infection of larval echinostomes in the snails and fishes were carried out along the South Hangang-river. The results obtained were as follows: 1. The eggs deposited from adults in physiological saline were cultivated at room temperature($20{\sim}24^{\circ}C$). The miracidia were firstly observed on 8 days after cultivation, and 85.5% of the eggs contained the mature miracidia on 11 days after cultivation. More than 90% formed the miracidia when cultivated at temperature $22{\sim}27^{\circ}C$. Hatching of the miracidia began on 12 days after cultivation and continued for a week. The size of the miracidia was $103.0{{\times}}51.4{\mu}m$ in average. The motility of the miracidia were active up to 8 hours after shedding, but they were all dead within 10 hours after shedding. 2. A freshwater snail, Radix auricularia coreana was cultivated in aquaria. A hatched $F_1$ snails from the egg masses were exposed to 20 miracidia respectively. Escape of cercariae started on 15 days after infecton. Radix auricularia coreana was experimentally identified as the first intermediate host of E. hortense in Korea. 3. Cercarial shedding started on $15{\sim}20$ days after infection by snail, continued for about 10 days (8.8 days in average). Infected snails were dead within 32 days after the miracidial infection. About 1,335 cercariae($328{\sim}1,994$) per snail were shed in its life, and 119 cercariae in average per snail per day were shed. The cercariae were motile for more than 24 hours, and then squirming at the bottom until death. The body and tail sizes of cercariae were $356{\times}186{\mu}m$ and $510{\times}68{\mu}m$ in average, respectively. The rediae parasitized in the snail hosts were found mainly around the pericardial regions, and their size was $1,575{\times}258{\mu}m$ in average. The numbers of developing cercariae in a mature redia were 14 in average ($7{\sim}20$ in range). The numbers of rediae in a snail were 102 in average on 15 days after miracidial infection and 221 in average on 28 days. 4. Three uninfected Misgurnus anguillicaudatus, less than 6.5cm long were used in for the cercarial infection. They were all exposed with 755 cercariae, and examined at 5-day intervals starting from 10 days after infection. All the fishes were infected with metacercariae of E. hortense and a total of 275 was found infected(36.4%). The metacercariae were fed to rats and the adult worms were obtained on 15 days after infection. 5. The infected rats began to deposit the eggs on 11 days after infection. The number of eggs deposited per day per worm (EPD/worm) was $400{\sim}500$ on 3 weeks after infection and was increased to $1,000{\sim}1,500$ on 4 to 17 weeks, then decreased to 800 on 21 weeks after infection. 6. A total of 745 stool specimens collected from 576 male and 169 female residents of 8 different villages along South Hangang basin was examined. Out of 745 specimens, the eggs of Echinostoma sp. were found in 2 cases (0.3%). Of 34 house rats one showed egg-positive (2.9%). 7. Total 971 Radix auricularia coreana collected from 7 sampling stations were examined for shedding of cercariae. Three snails (0.3%) shed the cercariae of E. hortense. A total of 119 out of 542 freshwater fishes (22.0%) had the metacercariae of E. hortense. The fishes parasitized with the metacercariae were 4 out of 14 examined species. The infection rates of 4 species were 34.1% (106 out of 311) in Misgurnus anguillicaudatus, 30.4% (7 out of 23) in Misgurnus mizolepis, 4.3% (2 out of 46) in Moroco oxycephalus and 22.2% (4 out of 18) in Odontobutis obscura interrupta. In summarizing the above results, the first intermediate host of E. hortense was found as Radix auricularia coreana in Korea. Also, it took about 46 days for the shortest completion of a life cycle of E. hortense in summer; that is, 10 days for miracidial development in eggs, 15 days for cercarial development in the snail, about 10 days for metacercarial development in the second intermediate hosts, and 11 days for the maturation as the adults in the definitive hosts. The natural infection rates of E. hortense in the intermediate hosts were relatively high but those in the definitive hosts were low in the middle areas of South Hangang basin.

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