• Title/Summary/Keyword: Failure Period

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A Study on the Deok and Its Practice in Daesoon Thought: The Great Deok of Heaven and Earth of Kang Jeungsan (대순사상에 나타난 덕(德)과 그 실천수행 -강증산의 '천지대덕(天地大德)'과 관련하여-)

  • Joo, So-yeon;Ko, Nam-sik
    • Journal of the Daesoon Academy of Sciences
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    • v.38
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    • pp.1-46
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    • 2021
  • Since ancient times, the word Deok (德, virtue) has been used as a term in ethics. In the east, it originally meant 'to acquire (得),' and during the warring states period, it was used to indicate 'personality' or 'value;' especially for political leaders. Then, in Confucianism, the word Deok developed into an ethical term suggesting that people should acquire Deok in their action so as to achieve human perfection. In Daesoon Thought, Deok originates from the Dao, and the two are close in the same manner that Yin and Yang are close and interrelated. The Dao of Daesoon Thought indicates the Great Dao of Heaven and Earth, which Gucheon Sangje had opened when he performed his Gongbu (holy work) at Daewonsa Temple, is such that the Great Deok was divided into the Deok of Heaven, the Deok of Earth, and the Deok of Humanity. This allows for the realization of Deok in each of the Three Realms. Jo Jeongsan, the successor of Gucheon Sangje, said that he will inherit the Great Deok originated from the Great Dao and enlighten the world to the Dao. The cause of the accumulation of grievances in the Three Realms was due to the failure to sufficiently spread Deok throughout the Three Realms. The Later World is where Deok will be offered in its full extent as it was secured by the Cheonjigongsa (Reordering Works of Heaven and Earth) performed by Gucheon Sangje. However, as the main agent of spreading Deok is the heart-mind, humans need to cultivate their heart-mind in the correct way. When humans finally become Dotong-gunja (beings who are perfectly unified with the Dao) and generously practice Deok in the world, there will be no grievances anywhere in the Three Realms. There are four ways of practicing Deok: Deok by caring for life, Eondeok (Deok of speech), Gongdeok (practicing meritorious Deok), and Podeok (spreading of Deok) to the world. Practicing the Deok by caring for life is to save and protect living beings based on the spirit of Jesaenguise (saving lives and curing the world). Eondeok is practiced when people speak to others in a positive way that fosters widespread goodness based on the spirit of Sangsaeng (mutual beneficence). When people perform Gongdeok they will be rewarded for their actions. Podeok can be realized when the followers of Sangje spread the Great Dao of Heaven and Earth based on the teachings of Daesoon Thought.

Reverse Superficial Sural Artery Flap for the Reconstruction of Soft Tissue Defect Accompanied by Fracture of the Lower Extremity (하지 골절과 동반된 연부조직 결손 재건을 위한 역행성 비복동맥 피판술)

  • Han, Soo-Hong;Hong, In-Tae;Choi, SeongJu;Kim, Minwook
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.253-260
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    • 2020
  • Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm2 and the mean size of the donor sites was 51.9 cm2. The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

Clinical Results of Lateral-Posterior Internal Fixation for the Treatment of Scapular Body Fractures (견갑골 체부 골절에서 외측 후방 금속판 고정술의 치료 결과)

  • Lee, Yoon-Min;Yeo, Joo-Dong;Song, Seok-Whan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.46-53
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    • 2020
  • Purpose: Scapular body fractures have generally been treated with non-surgical methods. This study reports the clinical and radiological outcomes after lateral-posterior internal fixation for treating displaced scapular body fractures. Materials and Methods: From March 2007 to May 2017, out of 40 patients who underwent internal fixation for scapular fractures, 13 cases of lateral plate fixation of a scapular body fracture were reviewed retrospectively. Preoperative and postoperative displacement, angulation and glenopolar angle (GPA) were measured. The range of shoulder motion, visual analogue scale (VAS), and disabilities of the arm, shoulder, and hand (DASH), and Constant score were assessed at the last follow-up. Results: The mean follow-up period was 17.7 months (range, 6-45 months). The mean preoperative GPA was 23.3°±3.96° (range, 17.8°-28.1°) and the postoperative GPA was 31.1°±4.75° (range, 22.5°-40.1°). Injury to the suprascapular nerve, nonunion, fracture redisplacement, metallic failure, or infection did not occur. At the last follow-up, the mean range of motion was 150.5°±19.3° in forward flexion, 146.6°±2.34° in lateral abduction, 66.6°±19.1° in external rotation, and 61.6°±18.9° in internal rotation. The VAS, DASH, and Constant scores were 1.7±1.3, 6.2±2.4, and 86±7.9 points, respectively. Conclusion: A scapular body fracture with severe displacement, angulation and marked decreased GPA can be stabilized by lateralposterior plate fixation using the appropriate surgical technique with good functional and radiological results.

Long-Term Survival Analysis of Unicompartmental Knee Arthroplasty (슬관절 부분 치환술의 장기 생존 분석)

  • Park, Cheol Hee;Lee, Ho Jin;Son, Hyuck Sung;Bae, Dae Kyung;Song, Sang Jun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.427-434
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    • 2019
  • Purpose: This study evaluated the long term clinical and radiographic results and the survival rates of unicompartmental knee arthroplasty (UKA). In addition, the factors affecting the survival of the procedure were analyzed and the survival curve was compared according to the affecting factors. Materials and Methods: Ninety-nine cases of UKA performed between December 1982 and January 1996 were involved: 10 cases with Modular II, 44 cases with Microloc, and 45 cases with Allegretto prostheses. The mean follow-up period was 16.5 years. Clinically, the hospital for special surgery (HSS) scoring system and the range of motion (ROM) were evaluated. Radiographically, the femorotibial angle (FTA) was measured. The survival rate was analyzed using the Kaplan-Meier method. Cox regression analysis was used to identify the factors affecting the survival according to age, sex, body mass index, preoperative diagnosis, and type of implant. The Kaplan-Meier survival curves were compared according to the factors affecting the survival of UKA. Results: The overall average HSS score and ROM was 57.7 and 134.3° preoperatively, 92.7 and 138.4° at 1 year postoperatively, and 79.1 and 138.4° at the last follow-up (p<0.001, respectively). The overall average FTA was varus 0.8° preoperatively, valgus 4.1° at postoperative 2 weeks, and valgus 3.0° at the last follow-up. The overall 5-, 10-, 15- and 20-year survival rates were 91.8%, 82.9%, 71.0%, and 67.0%, respectively. The factors affecting the survival were the age and type of implant. The risk of the failure decreased with age (hazard ratio=0.933). The Microloc group was more hazardous than the other prostheses (hazard ratio=0.202, 0.430, respectively). The survival curve in the patients below 60 years of age was significantly lower than those of the patients over 60 years of age (p=0.003); the survival curve of the Microloc group was lower compared to the Modular II and Allegretto groups (p=0.025). Conclusion: The long-term clinical and radiographic results and survival of UKA using old fixed bearing prostheses were satisfactory. The selection of appropriate patient and prosthesis will be important for the long term survival of the UKA procedure.

Single Center Experience of the Balloon-Stent Technique for the Treatment of Unruptured Distal Internal Carotid Artery Aneurysms: Sharing a Simple and Reliable Tip to Use Scepter-Atlas Combination (원위내경동맥에 위치한 비파열성 동맥류의 치료에 있어 풍선-스텐트 테크닉에 대한 단일기관의 경험: Scepter-Atlas 조합을 사용하기 위한 간단하지만 확실한 방법)

  • Yu-jung Park;Jieun Roh;Seung Kug Baik;Jeong A Yeom;Chul-Hoo Kang;Hee Seok Jeong;Sang Won Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1258-1273
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    • 2021
  • Purpose The balloon-stent technique (BST) has certain strengths as an assisted technique for the treatment of complex aneurysms. After Atlas release, the BST can be executed without an exchange maneuver of the balloon to the stent-delivery catheter. The purpose of this article is to share our experience with the BST using the Scepter-Atlas combination. Materials and Methods Device inspection led us to a simple method to avoid failure in loading Atlas to the Scepter. From March 2018 to December 2019, 57 unruptured distal internal carotid artery (dICA) aneurysms were treated with coil embolization; among which, 25 aneurysms in 23 patients were treated with BST. Clinical and angiographic data were retrospectively collected and reviewed. Results The technical success rate of the Scepter-Atlas combination increased from 50% to 100% after careful inspection. BST angiographic results were comparable to the stent-assisted coil (SAC) group treated during the immediately post-embolization same period (modified Raymond-Roy classification [MRRC] 1 & 2 84% in BST, 96.3% in SAC) and during short-term follow-up (MRRC 1 & 2 95.8% in BST, 88.4% in SAC). A small number of patients showed periprocedural complications, but none had clinical consequences. Conclusion BST using the Scepter-Atlas combination can provide an effective and safe method for the treatment of dICA aneurysms. Scepters can be used as delivery catheters for Atlas.

The Effects of Technological Competitiveness by Country on The Increase of Unicorn Companies (국가별 기술경쟁력이 유니콘기업 증가에 미치는 영향에 관한 연구)

  • Kyu Hoon Cho;Dong Woo Yang
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.19 no.1
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    • pp.55-73
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    • 2024
  • Unicorn companies are attracting attention around the world as they are recognized for their high corporate value in a short period of time as an innovative business models. Their growth process presents good lessons for the startup ecosystem and have a positive impact on national economic development and job creation. However, previous studies related to unicorn companies are focused on 'event studies' and 'case studies' such as characteristics of founders, environmental factors, business models and success/failure cases of companies already recognized as unicorns rather than a multifaceted approach. The occurrence of unicorn companies and Macroscopic analysis of related factors is lacking. Against this background, this study are considering the characteristics of unicorns examined through previous research and the current status unicorns with a high proportion of technology companies, the purpose was to analyze the impact of the country's technological competitiveness, such as 'technology human resource index', 'R&D index', and 'technology infrastructure index', on the increase in unicorn companies. For statistical analysis, data published by various international organizations, the Bank of Korea, and Statistics Korea from 2017 to 2020 and unicorn company data compiled by CB Insights were used as panel data for 44 countries to be tested by multiple regression analysis. As a result of the study, it was confirmed that the number of science majors had a positive (+) effect on the increase of unicorn companies in the case of technology human resource index, and in the case of R&D index, the total amount of R&D investment had a positive (+) effect on the increase of unicorn companies, while the number of Triad Patents Families and the number of scientific and technological papers published had a negative (-) effect on the increase of unicorn companies. Finally, in the case of technology infrastructure index, it was confirmed that the number of the world's 500th-ranked universities had a positive (+) effect on the increase of unicorn companies. This study is the first to reveal the causal relationship between national technological competitiveness and unicorn company growth based on country-specific and time-series empirical data, which were insufficiently covered in previous studies. and compared to the UN's ranking of the global industrial competitiveness index and the OECD's total R&D investment by country, Korea is considered to have technological and growth potential, while the number of unicorn companies driving growth as leaders of the innovative economy is relatively small, so the research results can be used when establishing policies to discover and foster unicorn companies in the future.

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National Survey of Mycobacterial Diseases Other Than Tuberculosis in Korea (비결핵항산균증 전국 실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.277-294
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    • 1995
  • Background: The prevalence of tuberculosis in Korea decreased remarkably for the past 30 years, while the incidence of disease caused by mycobacteria other than tuberculosis is unknown. Korean Academy of Tuberculosis and Respiratory Diseases performed national survey to estimate the incidence of mycobacterial diseases other than tuberculosis in Korea. We analyzed the clinical data of confirmed cases for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1981 to October 1994. We collected the data retrospectively by correspondence with physicians in the hospitals that referred the specimens to Korean Institute of Tuberculosis, The Korean National Tuberculosis Association for the detection of mycobacteria other than tuberculosis. In confirmed cases, we obtained the records for clinical, laboratory and radiological findings in detail using protocols. Results: 1) Mycobacterial diseases other than tuberculosis were confirmed that 1 case was in 1981, 2 cases in 1982, 4 cases in 1983, 2 cases in 1984, 5 cases in 1985, 1 case in 1986, 3 cases in 1987, 1 case in 1988, 6 cases in 1989, 9 cases in 1990, 14 cases in 1990, 10 cases in 1992, 4 cases in 1993, and 96 cases in 1994. Cases since 1990 were 133 cases(84.2%) of a total. 2) Fifty seven percent of patients were in the age group of over 60 years. The ratio of male to female patients was 2.6:1. 3) The distribution of hospitals in Korea showed that 61 cases(38.6%) were referred from Double Cross Clinic, 42 cases(26.6%) from health centers, 21 cases(13.3%) from tertiary referral hospitals, 15 cases(9.5%) from secondary referral hospitals, and 10 cases(6.3%) from primary care hospitals. The area distribution in Korea revealed that 98 cases(62%) were in Seoul, 17 cases(10.8%) in Gyeongsangbuk-do, 12 cases(7.6%) in Kyongki-do, 8 cases(5.1%) in Chungchongnam-do, each 5 cases(3.2%) in Gyeongsangnam-do and Chungchongbuk-do, 6 cases(3.8%) in other areas. 4) In the species of isolated mycobacteria other than tuberculosis, M. avium-intracellulare was found in 104 cases(65.2%), M. fortuitum in 20 cases(12.7%), M. chelonae in 15 cases(9.5%), M. gordonae in 7 cases(4.4%), M. terrae in 5 cases(3.2%), M. scrofulaceum in 3 cases(1.9%), M. kansasii and M. szulgai in each 2 cases(1.3%), and M. avium-intracellulare coexisting with M. terrae in 1 case(0.6%). 5) In pre-existing pulmonary diseases, pulmonary tuberculosis was 113 cases(71.5%), bronchiectasis 6 cases(3.8%), chronic bronchitis 10 cases(6.3%), and pulmonary fibrosis 6 cases(3.8%). The timing of diagnosis as having pulmonary tuberculosis was within 1 year in 7 cases(6.2%), 2~5 years ago in 32 cases(28.3%), 6~10 years ago in 29 cases(25.7%), 11~15 years ago in 16 cases(14.2%), 16~20 years ago in 15 cases (13.3%), and 20 years ago in 14 cases(12.4%). Duration of anti-tuberculous treatment was within 3 months in 6 cases(5.3%), 4~6 months in 17 cases(15%), 7~9 months in 16 cases(14.2%), 10~12 months in 11 cases(9.7%), 1~2 years in 21 cases(18.6%), and over 2 years in 8 cases(7.1%). The results of treatment were cure in 44 cases(27.9%) and failure in 25 cases(15.8%). 6) Associated extra-pulmonary diseases were chronic liver disease coexisting with chronic renal failure in 1 case(0.6%), diabetes mellitus in 9 cases(5.7%), cardiovascular diseases in 2 cases(1.3%), long-term therapy with steroid in 2 cases(1.3%) and chronic liver disease, chronic renal failure, colitis and pneumoconiosis in each 1 case(0.6%). 7) The clinical presentations of mycobacterial diseases other than tuberculosis were 86 cases (54.4%) of chronic pulmonary infections, 1 case(0.6%) of cervical or other site lymphadenitis, 3 cases(1.9%) of endobronchial tuberculosis, and 1 case(0.6%) of intestinal tuberculosis. 8) The symptoms of patients were cough(62%), sputum(61.4%), dyspnea(30.4%), hemoptysis or blood-tinged sputum(20.9%), weight loss(13.3%), fever(6.3%), and others(4.4%). 9) Smear negative with culture negative cases were 24 cases(15.2%) in first examination, 27 cases(17.1%) in second one, 22 cases(13.9%) in third one, and 17 cases(10.8%) in fourth one. Smear negative with culture positive cases were 59 cases(37.3%) in first examination, 36 cases (22.8%) in second one, 24 cases(15.2%) in third one, and 23 cases(14.6%) in fourth one. Smear positive with culture negative cases were 1 case(0.6%) in first examination, 4 cases(2.5%) in second one, 1 case (0.6%) in third one, and 2 cases(1.3%) in fourth one. Smear positive with culture positive cases were 48 cases(30.4%) in first examination, 34 cases(21.5%) in second one, 34 cases(21.5%) in third one, and 22 cases(13.9%) in fourth one. 10) The specimens isolated mycobacteria other than tuberculosis were sputum in 143 cases (90.5%), sputum and bronchial washing in 4 cases(2.5%), bronchial washing in 1 case(0.6%). 11) Drug resistance against all species of mycobacteria other than tuberculosis were that INH was 62%, EMB 55.7%, RMP 52.5%, PZA 34.8%, OFX 29.1%, SM 36.7%, KM 27.2%, TUM 24.1%, CS 23.4%, TH 34.2%, and PAS 44.9%. Drug resistance against M. avium-intracellulare were that INH was 62.5%, EMB 59.6%, RMP 51.9%, PZA 29.8%, OFX 33.7%, SM 30.8%, KM 20.2%, TUM 17.3%, CS 14.4%, TH 31.7%, and PAS 38.5%. Drug resistance against M. chelonae were that INH was 66.7%, EMB 66.7%, RMP 66.7%, PZA 40%, OFX 26.7%, SM 66.7%, KM 53.3%, TUM 53.3%, CS 60%, TH 53.3%, and PAS 66.7%. Drug resistance against M. fortuitum were that INH was 65%, EMB 55%, RMP 65%, PZA 50%, OFX 25%, SM 55%, KM 45%, TUM 55%, CS 65%, TH 45%, and PAS 60%. 12) The activities of disease on chest roentgenogram showed that no active disease was 7 cases(4.4%), mild 20 cases(12.7%), moderate 67 cases(42.4%), and severe 47 cases(29.8%). Cavities were found in 43 cases(27.2%) and pleurisy in 18 cases(11.4%). 13) Treatment of mycobacterial diseases other than tuberculosis was done in 129 cases(81.7%). In cases treated with the first line anti-tuberculous drugs, combination chemotherapy including INH and RMP was done in 86 cases(66.7%), INH or RMP in 30 cases(23.3%), and not including INH and RMP in 9 cases(7%). In 65 cases treated with the second line anti-tuberculous drugs, combination chemotherapy including below 2 drugs were in 2 cases(3.1%), 3 drugs in 15 cases(23.1%), 4 drugs in 20 cases(30.8%), 5 drugs in 9 cases(13.8%), and over 6 drugs in 19 cases (29.2%). The results of treatment were improvement in 36 cases(27.9%), no interval changes in 65 cases(50.4%), aggravation in 4 cases(3.1%), and death in 4 cases(3.1%). In improved 36 cases, 34 cases(94.4%) attained negative conversion of mycobacteria other than tuberculosis on cultures. The timing in attaining negative conversion on cultures was within 1 month in 2 cases(1.3%), within 3 months in 11 cases(7%), within 6 months in 14 eases(8.9%), within 1 year in 2 cases(1.3%) and over 1 year in 1 case(0.6%). Conclusion: Clinical, laboratory and radiological findings of mycobacterial diseases other than tuberculosis were summarized. This collected datas will assist in the more detection of mycobacterial diseases other than tuberculosis in Korea in near future.

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Clinical Characteristics of Arthrogryposis, Renal Tubular Dysfunction, Cholestasis(ARC) Syndrome in Korea (ARC(Arthrogryposis, Renal Tubular Dysfunction, Cholestasis) 증후군의 발병양상에 관한 연구)

  • Lee Soon Min;Kim Ji Hong;Lee Jae Seung;Han Suk Joo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.222-230
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    • 2005
  • Purpose : ARC syndrome refers to an association of arthrogryposis, renal tubular dysfunction, and cholestasis. The VPS33B gene was recently identified as the causative gene. So far, 41 cases of ARC syndrome have been reported worldwide, and it has rarely been reported in Korea. This study was conducted to report the clinical findings of seven ARC syndrome cases in Korean children, focusing especially on renal tubular dysfunction. Methods : The hospital records of 7 cases diagnosed as ARC syndrome at Severance Hospital between Mar. 1995 and Aug. 2005 were reviewed and analyzed. Results : Of the 7 cases, 4 were boys and 3 were girls. Six patients(85$\%$) were born with normal birth weight at term, and one was born at preterm. All cases presented with cholestasis and severe jaundice. According to the type of arthrogryposis described by Brown et al, type 3 and 4 were found in 2 patients and type,6, 7, and the undistributed type in one patient respectively. Other associated clinical findings were as follows : failure to thrive in 6(85$\%$), lax skin in 5(71$\%$), and gray platelet syndrome in 4(57$\%$). Urine analysis revealed 6 cases(85$\%$) with proteinuria, 3(43$\%$) with hematuria, 5(71$\%$) with glycosuria, 2(29$\%$) with phosphaturia and 2(29$\%$) with calciuria. Serum electrolytes showed 4 cases(57$\%$) with hyponatremia, 3(43$\%$) with hypokalemia, and 1(14$\%$) with creatinine elevation. Renal tubular dysfunctions were diagnosed as renal tubular acidosis in 6 cases(85$\%$), nephrogenic diabetes insipidus in 2(29$\%$), and Fanconi syndrome in 2(29$\%$). During the follow-up period, 2(29$\%$) had no treatment, 5(85$\%$) had continuous supplementation to correct the electrolyte imbalance and acidosis, and 1(14$\%$) had dialysis. Only one patient had a family history of ARE syndrome in a sibling. Four cases(57$\%$) were diagnosed at the mean age of 8.2 months, and one case was lost during follow-up. Ages of the survived 2 cases were 13 and 25 months, respectively. Conclusion : The rare disease of ARC syndrome Is associated with severe renal dysfunction. However, this study revealed that the renal manifestation of ARC syndrome in Korean children is relatively mild and survival rate is higher than that of previous studies. Contrary to previous reports, this study showed that familial cases are rare and sporadic occurence is possible in Korea. Thus, the diagnosis of this syndrome requires a careful evaluation of the venal function in cases of congenital arthrogryposis, and a mandatory genetic counseling of affected family for prevention of familial occurance. (J Korean Soc Pediatr Nephrol 2005;9:222-230)

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Results of Curative Treatment for Cancer of the Tonsil (편도암의 근치적 치료 결과)

  • Park, Won;Ahn, Yong-Chan;Lim, Do-Hoon;Baek, Chung-Whan;Son, Young-Ik;Park, Keun-Chil;Kim, Kyoung-Ju;Lee, Jeung-Eun;Kang, Min-Kyu;Park, Young-Je;Nam, Hee-Rim;Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.261-268
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    • 2003
  • Purpose: To report the results of curative treatment for patients with tonsil cancer by retrospective analysis. Materials and Methods: From Jan. 1995 till Dec. 2000, 27 patients with squamous cell carcinoma of the tonsil received curative treatment at Samsung Medical Center. Therapeutic decision was made through multidisciplinary conference, and curative radiation therapy was favored when, (1) the patient's condition was not fit for general anesthesia and surgery, (2) the patient refused surgery, (3) complete resection was presumed impossible, or (4) too severe disability was expected after surgery. Surgery was the main local modality in 17 patients (S$\pm$RT group), and radiation therapy in 10 (RT$\pm$CT group). The median follow-up period was 41 months. Results: AJCC stages were I/II in four, III in two, and IV in 21 patients. The 5-year disease-free survival rate was 73.3$\%$ in all patients, 70.6$\%$ in the S$\pm$RT group, and 77.8$\%$ in the RT$\pm$CT group. Treatment failure occurred in seven patients, all with stage III/IV, and all the failures occurred within 24 months of the start of treatment. Five patients among the S$\pm$CT group developed treatment failures; 2 local, 2 regional, and 1 distant (crude rate=29.4$\%$). Two patients among the RT$\pm$CT group developed failures; 1 synchronous local and regional, and 1 distant (crude rate=20.0$\%$). The 5-year overall survival rate was 77.0$\%$ in all patients, 80.9$\%$ in the S$\pm$RT group, and 70.0$\%$ in the RT$\pm$CT group. Conclusion: We could achieve favorable results that were comparable to previously reported data with respect to both the rates of local control and of survival by applying S$\pm$RT and RT$\pm$CT. RT$\pm$CT is judged to be an alternative option that can avoid the functional disability after surgical resection.

Primary Orbital Lymphoma : A Retrospective Analysis of Results of Radiation Therapy (원발성 안와 림프종의 방사선치료 성적에 관한 후향적 분석)

  • Kim Sussan;Ahn Seung Do;Chang Hyesook;Kim Kyoung Ju;Lee Sang-wook;Choi Eun Kyung;Kim Jong Hoon;Huh Jooryung;Suh Cheol Won;Kim Sung Bae
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.139-146
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    • 2002
  • Purpose : This study evaluated the treatment outcomes, patterns of failure, and treatment related complications of primary lymphoma patients who received definitive radiation therapy. Materials and Methods : A retrospective analysis was undertaken for 31 patients with primary orbital lymphoma at the Asan Medical Center between February 1991 and April 2001. There were 18 males and 13 females with ages ranging from 3 to 73 years (median, 44 years). The involved sites were 9 conjunctivae, 12 eyelids and 10 other orbits. The histological types were 28 MALT lymphomas (low-grade B-cell lymphoma of mucosa-associated lymphoid tissue type), 1 diffuse large B-cell lymphoma, 1 anaplastic large cell lymphoma and 1 lymphoblastic lymphoma. The Ann Arbor stages were all IE $(100\%)$. Ann Arbor stage III or IV patients were excluded from this study, Bilateral orbital involvement occurred in 6 cases. Radiation therapy was given with one anterior port of high energy electrons $(6\~16\;MeV)$ for the lesions located at the anterior structures like the conjunctivae or eyelids. Lesions with a posterior extension or other orbital lesions were treated with 4 or 6 MeV photons with appropriately arranged portals. In particular, lens blocks composed of lead alloy were used in conjunctival or eyelid lesions. Twelve patients received chemotherapy. The median follow-up period was 53 months. Results : The 5-year overall, cause-specific, and disease-free survival was $91\%,\;96\%,\;and\;80\%$, respectively. The complete response rate 6 months after radiation therapy was $100\%$. Local recurrences were observed in 2 patients at 16 and 18 months after completion of radiation treatment. They were salvaged with additional radiation therapy. Two patients developed distant metastases. A MALT lymphoma patient with a lung relapse was successfully salvaged with radiotherapy, but the other lymphoblastic lymphoma patient with bone marrow relapse expired. There were no severe complications but 5 patients developed radiation-induced cataracts and 2 patients developed dry eye. Conclusion : Most primary orbital lymphomas consisted of MALT lymphomas. Radiation therapy was a successful treatment modality for orbital lymphoma without any severe complications. In cases of local relapses, radiation therapy is also a very successful salvage treatment modality.