• Title/Summary/Keyword: Failure Study

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

  • Kang One Chul;Choi Eun Kyung;Chung Weon Kuu;Kim Jong Hoon;Chang Hyesook;Kim Yong Man;Kim Young Tak;Nam Joo Hyun;Mok Jung-Eun;Lee Moo-Song
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.311-323
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    • 1998
  • Purpose : Prospective, single arm, Phase I/II clinical trial was performed to assess the efficacy and toxicity of the concurrent chemotherapy and definitive radiotherapy (RT) in patients with previously untreated locally advanced carcinoma of the uterine cervix. Methods and Materials : From Mar 1992 to January 1997, a total of 73 patients with advanced cervical carcinoma were entered on the protocol but 5 patients were excluded in analysis because of patients' refusal of treatment. Their ages ranged from 31 to 77 years, median 58 years. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution was as follows: IIB 46, IIIA 2, IIIB 15 and IVA 5. RT consisted of external beam irradiation to 4,140-5,040 cGy/23-28 fractions plus high dose rate intracavitary treatments to deliver a dose of 30-35 Gy to point A in 6-7 fractions. During the intracavitary treatments parametrial boost was delivered for point B dose of 60 Gy in stage IIB and 65 Gy in stage IIIB. Two cycles of concurrent 5-fluorouracil and cisplatin (FP) chemotherapy (5-fluorouracil 1,000 mg/m2/day continuous infusion for 4 days, day 1-4, 29-32 and cisplatin 20 mg/m2/day intravenous bolus for 3 days day 1-3, 29-31) administered starting on day 1 of RT. Results : The median follow-up was 24 months (range 4-68+). Sixty-four patients were evaluable for survival rate in this protocol: The 5-year actuarial and disease-free survival rate were 52% and 64%, respectively. The 5-rear actuarial survival for stage IIB and III+IVA patients were 58% and 36%, respectively The 5-year disease-free survival rate for stage IIB and III+IVA patients were 71% and 40%, respectively. Of the 68 patients evaluated for patterns of failure, overall recurrence rate was 27.9% (19/68) : local failure in 5.9% (4/68), distant metastasis in 10.3% (7/68) and both in 11.8% (8/68). Of the 64 patients evaluated for response at one month after the completion of treatment the complete response rate was 78% (50/64). Concurrent chemoradiation appear to be a well-tolerated regimen but there were two treatment-related deaths. Conclusion : Concurrent chemotherapy of FP with high-dose definitive RT in locally advanced carcinoma of the uterine cervix is feasible and effective with acceptable toxicities. This chemoradiation regimen may offer a modest survival benefit for advanced stage. Further follow-up of these patients will evaluate the impact of this regimen on the long-term local control and their survival.

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A comparative study on the correlation between Korean foods and the fractures of PFG and all ceramic crowns for posterior applications (구치용 도재소부금관과 전부도재관에 파절을 일으키는 한국음식에 관한 연구)

  • Kim, Jeong-Ho;Lee, Jai-Bong
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.156-163
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    • 2009
  • Statement of problem: Recently, there have been increased esthetic needs for posterior dental restorations. The failure of posterior dental ceramic restoration are possible not only by the characters of the component materials but also by the type of food. Purpose: The research aim was to compare the in vitro fracture resistance of simulated first molar crowns fabricated using 4 dental ceramic systems, full-porcelain-occlusal-surfaced PFG, half-porcelain-occlusal-surfaced PFG, Empress 2, Ice Zirkon and selected Korean foods. Material and methods: Eighty axisymmetric crowns of each system were fabricated to fit a preparation with 1.5- to 2.0-mm occlusal reduction. The center of the occlusal surface on each of 15 specimens per ceramic system was axially loaded to fracture in a Instron 4465, and the maximum load(N) was recorded. Afterwards, selected Korean foods specimens(boiled crab, boiled chicken with bone, boiled beef rib, dried squid, dried anchovy, round candy, walnut shell) were prepared. 15 specimens per each food were placed under the Instron and the maximum fracture loads for them were recorded. The 95% confidence intervals of the characteristic failure load were compared between dental ceramic systems and Korean foods. Afterwards, on the basis of previous results, 14Hz cyclic load was applied on the 4 systems of dental ceramic restorations in MTS. The reults were analyzed by analysis of variance and Post Hoc tests. Results: 95% confidence intervals for mean of fracture load 1. full porcelain occlusal surfaced PFG Crown: 2599.3 to 2809.1 N 2. half porcelain occlusal surfaced PFG Crown: 3689.4 to 3819.8 N 3. Ice Zirkon Crown: 1501.2 to 1867.9 N 4. Empress 2 Crown: 803.2 to 1188.5 N 5. boiled crab: 294.1 to 367.9 N 6. boiled chicken with bone: 357.1 to 408.6 N 7. boiled beef rib: 4077.7 to 4356.0 N 8. dried squid: 147.5 to 190.5 N 9. dried anchovy: 35.6 to 46.5 N 10. round candy: 1900.5 to 2615.8 N 11. walnut shell: 85.7 to 373.1 N under cyclic load(14Hz) in MTS, fracture load and masticatory cycles are: 1. full porcelain occlusal surfaced PFG Crown fractured at 95% confidence intervals of 4796.8-9321.2 cycles under 2224.8 N(round candy)load, no fracture under smaller loads. 2. half porcelain occlusal surfaced PFG Crown fractured at 95% confidence intervals of 881705.1-1143565.7 cycles under 2224.8 N(round candy). no fracture under smaller loads. 3. Ice Zirkon Crown fractured at 95% confidence intervlas of 979993.0-1145773.4 cycles under 382.9 N(boiled chicken with bone). no fracture under smaller loads. 4. Empress 2 Crown fractured at 95% confidence intervals of 564.1-954.7 cycles under 382.9 N(boiled chicken with bone). no fracture under smaller loads. Conclusion: There was a significant difference in fracture resistance between experimental groups. Under single load, Korean foods than can cause fracture to the dental ceramic restorations are boiled beef rib and round candy. Even if there is no fracture under single load, cyclic dynamic load can fracture dental posterior ceramic crowns. Experimental data with 14 Hz dynamic cyclic load are obtained as follows. 1. PFG crown(full porcelain occlusion) was failed after mean 0.03 years under fracture load for round candy(2224.8 N). 2. PFG crown(half porcelain occlusion) was failed after mean 4.1 years under fracture load for round candy(2224.8 N). 3. Ice Zirkon crown was failed after mean 4.3 years under fracture load for boiled chicken with bone(382.9 N). 4. Empress 2 crown was failed after mean 0.003 years under fracture load for boiled chicken with bone(382.9 N).

Changes of Brain Natriuretic Peptide Levels according to Right Ventricular HemodynaMics after a Pulmonary Resection (폐절제술 후 우심실의 혈역학적 변화에 따른 BNP의 변화)

  • Na, Myung-Hoon;Han, Jong-Hee;Kang, Min-Woong;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Choi, Jae-Sung;Yoon, Seok-Hwa;Choi, Si-Wan
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.593-599
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    • 2007
  • Background: The correlation between levels of brain natriuretic peptide (BNP) and the effect of pulmonary resection on the right ventricle of the heart is not yet widely known. This study aims to assess the relationship between the change in hemodynamic values of the right ventricle and increased BNP levels as a compensatory mechanism for right heart failure following pulmonary resection and to evaluate the role of the BNP level as an index of right heart failure after pulmonary resection. Material and Method: In 12 non small cell lung cancer patients that had received a lobectomy or pnemonectomy, the level of NT-proBNP was measured using the immunochemical method (Elecsys 1010(R), Roche, Germany) which was compared with hemodynamic variables determined through the use of a Swan-Garz catheter prior to and following the surgery. Echocardiography was performed prior to and following the surgery, to measure changes in right ventricular and left ventricular pressures. For statistical analysis, the Wilcoxon rank sum test and linear regression analysis were conducted using SPSSWIN (version, 11.5). Result: The level of postoperative NT-proBNP (pg/mL) significantly increased for 6 hours, then for 1 day, 2 days, 3 days and 7 days after the surgery (p=0.003, 0.002, 0.002, 0.006, 0.004). Of the hemodynamic variables measured using the Swan-Ganz catheter, the mean pulmonary artery pressure after the surgery when compared with the pressure prior to surgery significantly increased at 0 hours, 6 hours, then 1 day, 2 days, and 3 days after the surgery (p=0.002, 0,002, 0.006, 0.007, 0.008). The right ventricular pressure significantly increased at 0 hours, 6 hours, then 1 day, and 3 days after the surgery (p=0.000, 0.009, 0.044, 0.032). The pulmonary vascular resistance index [pulmonary vascular resistance index=(mean pulmonary artery pressure-mean pulmonary capillary wedge pressure)/cardiac output index] significantly increased at 6 hours, then 2 days after the surgery (p=0.008, 0.028). When a regression analysis was conducted for changes in the mean pulmonary artery pressure and NT-proBNP levels after the surgery, significance was evident after 6 hours (r=0.602, p=0.038) and there was no significance thereafter. Echocardiography displayed no significant changes after the surgery. Conclusion: There was a significant correlation between changes in the mean pulmonary artery pressure and the NT-proBNP level 6 hours after a pulmonary resection. Therefore, it can be concluded that changes in NT-proBNP level after a pulmonary resection can serve as an index that reflects early hemodynamic changes in the right ventricle after a pulmonary resection.

Radiotherapy in Incompletely Resected Gastric Cancers (불완전 절제된 위암의 방사선 치료)

  • Kim Jong Hoon;Choi Eun Kyung;Cho Jung Gil;Kim Byung Sik;Oh Sung Tae;Kim Dong Kwan;Chang Hyesook
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.17-25
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    • 1998
  • Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of 3070%, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than 15% of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was 40% and disease free survival was 48%. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was 28%, and 4 year disease specific survival rate was 40%. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

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A new strategy for transcatheter closure of patent ductus arteriosus with recent-generation devices (경피적 동맥관 폐쇄술에서 최근의 기구들의 전략적 이용과 결과)

  • Kim, Sang Yee;Lee, Soo Hyun;Kim, Nam Kyun;Choi, Jae Young;Sul, Jun Hee
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.488-493
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    • 2009
  • Purpose : The aim of this study was to assess the efficacy and safety of recent-generation patent ductus arteriosus (PDA) closure devices applied by a new selection strategy according to the characteristics of each PDA. Methods : From February 2003 to January 2006, 138 patients underwent transcatheter closure of PDA (study group). According to the size and morphology of each ductus, a COOK Detachable Coil or 'flex' PFM Nit-Occlud was used for a small ductus (group 1, n=43); 'medium' PFM Nit-Occlud (group 2, n=49) for a moderate ductus; and an Amplatzer Duct Occluder (group 3, n=46) for a large ductus. The 83 patients who underwent transcatheter closure of PDA from February 2000 to January 2003 were defined as the comparison group. The Qp/Qs ratio, pulmonary/aorta pressure ratio, and MD of the ductus were compared. Immediate and follow-up results including residual shunts and complications were also evaluated and compared among groups. Results : In all 138 patients, complete occlusions were confirmed without major complications, while procedure failure (n=2, 2.2%), device embolization (n=1, 1.1%), and persistent residual shunt (n=4, 4.5%) were documented in the comparison group. Total complication rates were lower in the study group than in the comparison group (study group, 1.4%; comparison group, 9.0%; P<0.05). Conclusion : A novel strategy adopting the merits of various recent-generation devices for transcatheter closure of PDA provides excellent clinical results with minimal risk.

Experimental Study for Confirmation of Relaxation Zone in the Underground Cavity Expansion (지중 내 공동 확장에 따른 이완영역 확인을 위한 실험적 연구)

  • Kim, Youngho;Kim, Hoyeon;Kim, Yeonsam;You, Seung-Kyong;Han, Jung-Geun
    • Journal of the Korean Geosynthetics Society
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    • v.16 no.4
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    • pp.231-240
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    • 2017
  • Recently, there have been frequent occurrences of ground sink in the urban area, which have resulted in human and material damage and are accompanied by economic losses. This is caused by artificial factors such as soil loss, poor compaction, horizontal excavation due to the breakage of the aged sewage pipe, and lack of water proof at vertical excavation. The ground sink can be prevented by preliminary restoration and reinforcement through exploration, but it can be considered that it is not suitable for urgent restoration by the existing method. In this study, a model experiment was carried out to simulate the in-ground cavities caused by groundwater flow for developing non-excavation urgent restoration in underground cavity and the range of the relaxation zone was estimated by detecting the around the cavity using a relaxation zone detector. In addition, disturbance region and relaxation region were separated by injecting gypsum into cavity formed in simulated ground. The shape of the underground cavity due to the groundwater flow was similar to that of the failure mode III formed in the dense relative density ground due to water pipe breakage in the previous study. It was confirmed that the relaxed region detected using the relaxation zone detector is formed in an arch shape in the cavity top. The length ratio of the relaxation region to the disturbance region in the upper part of the cavity center is 2: 1, and it can be distinguished by the difference in the decrease of the shear resistance against the external force. In other words, it was confirmed that the secondary damage should not occur in consideration of the expandability of the material used as the injecting material in the pre-repair and reinforcement, and various ground deformation states will be additionally performed through additional experiments.

Mitral valve Replacement (승모판막 치환술)

  • Sin, Dong-Geun;Kim, Min-Ho;Jo, Jung-Gu
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.137-145
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    • 1997
  • From July 1983 to December 1993, total 112 consecutive mitral valve replacements in 107 patients were performed in patient with mitral valvular abnormalities. To estimate the risk factor related to operative death, all patient's perioperative data were reviewed retrospectively. Except 20 patients received concomitant aortic valve replacement and 2 patients had incomplete data, 85 patients were included in this study. Mean age were 37.3± 13.1 years ranging from 13 to 72 years. Thirty-seven patients were male and fourty-eight patients were female. Mean follow-up durations were 51.1±33.8 months ranging from 6 months t 11 years. Patients in this study showed improvement in mean NYHA functional clssification, from 3.02±0.73 to 1 78±0.55, and also in cardiothoracic ratio, from 0.61 ±0.09 to 0.58±0.08 at 6 months follow-up after operation. Operative complications were detected in 23 patients(27.1 %) and common postoperative complications were rhythm disturbance in 7 cases, pulmonary complications in 6 cases and low cardiac output syndrome in 6 cases. Early mortality was 10.6%(n=9) and the most common cause of death was a congestive heart failure due to low cardiac output syndrome. Main cause of our higher operative mortality than other study was that operative mortality in the initial period of our mitral surgery was high(5 operative deaths among 19 mitral valve replacement from July 1983 to December 1985). Actuarial survival was 80.8% at 5 years, 71.8% at 11 years including operative deaths. Actuarial freedom from anticoagulant-related bleeding was 85.3% at 5 years, 78.3% at 11 years. 95.1% at 5 years and 88.8% at 11 years among the patient in this study were free from thromboembolism, and 97.5% at 5 years and 75.1% at 11 years were free from reoperation. Preoperative cardiothoracic ratio and patient's age were statistically significant operative risk factors.

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Experimental Study on Combined Failure Damage of Bi-directional Prestressed Concrete Panel under Impact-Fire Loading (충돌 후 화재에 대한 이방향 프리스트레스트 콘크리트 패널부재의 복합 파괴손상에 관한 실험적 연구)

  • Yi, Na-Hyun;Lee, Sang-Won;Choi, Seung-Jai;Kim, Jang-Ho Jay
    • Journal of the Korea Concrete Institute
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    • v.26 no.4
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    • pp.429-440
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    • 2014
  • Since the World Trade Center and Pentagon attacks in 2001, terror, military attack, or man-made disaster caused impact, explosion, and fire accident have frequently occured on civil infrastructures. However, structural behavior researches on major Prestressed Concrete (PSC) infrastructures such as bridges, tunnels, Prestressed Concrete Containment Vessel (PCCVs), and LNG tanks under extreme loading are significantly lacking. Especially, researches on possible secondary fire scenarios after terror, bombing, collision of vehicles and vessels on concrete structures have not been performed domestically where most of the past researches related to extreme loadings on structures focused on an independent isolated extreme loading scenario. Due to the outcry of public concerns and anxiety of potential terrorist attacks on major infrastructures and structures, a study is urgently needed at this time. Therefore, in this study, the bi-directional prestressed concrete 1400×1000×300mm panels applied with 430 kN prestressing force using unbonded prestressing thread bars were experimentally evaluated under impact, fire, and impact-fire combined loadings. Due to test site restrictions, impact tests were performed with 14 kN impactor with drop heights of 10m and 3.5 m to evaluate impact resistance capacity. Also, fire and impact-fire combined loading were tested using RABT fire loading curve. The measured residual strength capacities of PSC and RC specimens applied with impact, fire, impact-fire combined loadings were compared with the residual strength capacity of undamaged PSC and RC specimens for evaluation. The study results can be used as basic research data for related research areas such as protective design and numerical simulation under extreme loading scenarios.

LIM Implementation Method for Planning Biotope Area Ratio in Apartment Complex - Focused on Terrain and Pavement Modeling - (공동주택단지의 생태면적률 계획을 위한 LIM 활용방법 - 지형 및 포장재 모델링을 중심으로 -)

  • Kim, Bok-Young;Son, Yong-Hoon;Lee, Soon-Ji
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.3
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    • pp.14-26
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    • 2018
  • The Biotope Area Ratio (BAR) is a quantitative pre-planning index for sustainable development and an integrated indicator for the balanced development of buildings and outdoor spaces. However, it has been pointed out that there are problems in operations management: errors in area calculation, insufficiency in the underground soil condition and depth, reduction in biotope area after construction, and functional failure as a pre-planning index. To address these problems, this study proposes implementing LIM. Since the weights of the BAR are mainly decided by the underground soil condition and depth with land cover types, the study focused on the terrain and pavements. The model should conform to BIM guidelines and standards provided by government agencies and professional organizations. Thus, the scope and Level Of Detail (LOD) of the model were defined, and the method to build a model with BIM software was developed. An apartment complex on sloping ground was selected as a case study, a 3D terrain modeled, paving libraries created with property information on the BAR, and a LIM model completed for the site. Then the BAR was calculated and construction documents were created with the BAR table and pavement details. As results of the study, it was found that the application of the criteria on the BAR and calculation became accurate, and the efficiency of design tasks was improved by LIM. It also enabled the performance of evidence-based design on the terrain and underground structures. To adopt LIM, it is necessary to create and distribute LIM library manuals or templates, and build library content that comply with KBIMS standards. The government policy must also have practitioners submit BIM models in the certification system. Since it is expected that the criteria on planting types in the BAR will be expanded, further research is needed to build and utilize the information model for planting materials.

A Study on the Relationship Between the Off-Axis Cylinder and Corrected Vision of Astigmatism (난시안의 교정축 이탈과 교정시력과의 관계 연구)

  • Kim, Jung Hee;Kang, Sue Ah
    • Journal of Korean Ophthalmic Optics Society
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    • v.12 no.3
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    • pp.83-87
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    • 2007
  • This study was classified and compared astigmatism's refractional abnormal degrees with visual acuity state of full correction which turned on axises of only 5 degree, 10 degree, and 15 degree. Subjects of this study were 57 college students (114 eyes) who had neither eye diseases nor binocular abnormality, were from their twenties to fifties, with myopia. It appeared that 30.8% of subjects who had astigmatism wore glasses with wrong axis of astigmatism. After accurate correction of the visual acuity and degrees of astigmatism, when we moved to corrected axises at 5 degree, 10 degree, 15 degree, failure of visual acuity with one line or more were 56.1%, 84.2%, 93.8%, respectively. When we comapre the completely-corrected visual acuity with the visual acuity with dricted axes, the bigger the width of visual acuity's weakness was the bigger the drifted angle. The change of normal visual acuity according to drifting angle of corrected axises of astigmatism, when we compared with full correction, appeared 0.94 in 5 degree, 0.87 in 10 degree, and 0.79 in 15 degree. Drift of 5 degree from fully corrected axis, corresponded to difference of visual acuity about one line, drift of 10 degree to 1.8 line difference of visual acuity, and drift of 15 degree about to 2.6 line difference. Through this study, we were sure that, in the case of drifting away from the right axis of astigmatism, it lead to visual weakness and asthenopia. Therefore we darely advise that optometrists should make mistake of axis least by confirming accucacy of corrected axis after despensing of spectacles of astigmatism.

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