• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1411-1416
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• 2002

Purpose : Although the use of intravenous gamma-globulin(IVGG) in Kawasaki disease(KD) is effective in reducing clinical symptoms and coronary artery complications, 20-30% of patients have persistent or recrudescent fever and ongoing clinical symptoms. In these patients, the additional infusion of IVGG is considered. The authors studied the characteristics of patients who received IVGG retreatment, and compared them with the patients who did not need IVGG retreatment, for determination of IVGG retreatment. Methods : We reviewed the medical records of 117 KD patients who could be followed up at least six months. We studied the conventional laboratory findings, electrocardiogram(EKG), signal averaged ECG(SAECG) and echocardiogram. Results : Twenty three patients had early cardiac complications during the six months of follow-up. Four patients had late cardiac complications after six months. The early cardiac complication rate was higher in the IVGG retreatment group than the single infusion group(P<0.0001). The late complication rate was also higher in the retreatment group(P<0.0001). The patients who received methyl-prednisolone(m-PD) pulse therapy had much higher rates of early and late cardiac complications than those who received a single IVGG infusion. Among the clinical data and laboratory findings, only CRP increased significantly in patients who have had the cardiac complications. The IVGG retreatment group had increased CRP than the single infusion group. Conclusion : The patients with increased initial CRP may have an increased incidence of complications and an increased possibility of IVGG retreatment. We thought that retreated KD patients might have inflammations severe enough to need high dose IVGG as shown by high CRP levels, and IVGG retreatment could not prevent coronary artery lesions sufficiently.

• Radiation Oncology Journal
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• v.13 no.2
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• pp.149-156
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• 1995

Purpose : Since February 1991 a Prospective study for non-small cell lung cancer patients who underwent radical resection and had a risk factor of positive resection margin or regional lymph node metastasis has been conducted to evaluate the effect of MVP chemotherapy and radiotherapy on the pattern of failure, disease free and overall survival. and tolerance of combined treatment. Materials and Methods: Twenty nine patients were registered to this study until Sep. 1993; of these 26 received planned therapy Within 3 weeks after radical resection, two cycles of MVP(Mitomycin C $6mg/m^2,$ Vinblastin $6mg/m^2,$ Cisplatin $60mg/m^2$) chemotherapy was given with 4 weeks intervals. Radiotherapy (5040cGy tumor bed dose and 900cGy boost to high risk area) was started 3 to 4 weeks after chemotherapy. Results: One and two year overall survival rates were $76.5\%\;and\;58.6\%$ respectively. Locoregional failure developed in 6 patients$(23.1\%)$ and distant failure in 9 patients$(34.6\%)$ Number of involved lymph nodes, resection margin positivity showed some correlation with failure pattern but T-stage and N-stage showed no statistical significance. The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70 days showed lower incidence of distant metastasis. Postoperative combined therapy were well tolerated without definite increase of complication rate, and compliance rate in this study was $90\%$. Conclusion: 1) MVP chemotherapy showed no effect on locoregional recurrence, but appeared to decrease the distant metastasis rate and 2) combined treatments were well tolerated in all patients. 3) The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70days showed lower incidence of distant metastasis. 4) Addition of chemotherapy to radiotherapy failed to increase the overall or disease free survival.

• Radiation Oncology Journal
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• v.17 no.1
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• pp.16-22
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• 1999

Purpose : This study was done to analyze prognostic factors and patterns of failure of patients with histologically confirmed adenocarcinoma of the uterine cervix. Materials and Methods : From June 1988 to December 1990, a retrospective analysis was undertaken for 45 patients who were treated with curative radiation therapy for adenocarcinoma of the uterine cervix at the department of Therapeutic Radiology of Keimyung University Hospital. According to FIGO staging classification, f2 patients were stage Ib, 9 patients were lla, 19 patients were IIB, and 5 patients were lIIb. Median age of the patients was 54 years. The radiation therapy consisted of a combination of external and intracavitary irradiation. Only the pelvis was treated for external irradiation, but 6 patients were treated with extended field irradiation including paraaortic nodes. Intracavitary irradiation was performed with high dose rate sources (Co-60). Neoadiuvant chemotherapy was undertaken for 10 patients. Median and maximum follow-up duration was 64 and 116 months, respectively. Results : The overall 5-year survival rate was 55.2$\%$, and the 5-year survival rates for stage Ib, IIa, IIb, and IIIb were 100$\%$, 50.8$\%$, 46.8$\%$, and 40$\%$ (3-year survival rate), respectively. Of the many clinicopathologic variables evaluated for prognosis, only the stage and the tumor size were significant prognostic factors. Statistically, pelvic failure rates for stage Ib, IIa, IIb, and IIIb were 0$\%$, 33.3$\%$, 57.9$\%$, and 60$\%$, respectively. Distant metastasis rates were 0$\%$, 33.3$\%$, 21.1$\%$, and 40$\%$ for stage Ib, IIa, IIb, and IIIb, respectively. Especially the 6 patients who were irradiated with extended field to treat the paraaortic nodes were free of distant metastasis all. But, 9 patients (23.1$\%$) of the 39 patients who were not irradiated the paraaortic nodes were suffered and expired from uncontrolled distant metastasis. Conclusions : As compared with other studies, the survival rates were similar, but distant metastasis rates including paraaortic nodes metastasis were likely somewhat higher than expected, especially for patients with stage II. So, we think that the effect of prophylactic paraaortic nodes irradiation should be studied prospectively, especially for patients with pelvic nodes involvement or advanced stage of disease.

• Tuberculosis and Respiratory Diseases
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• v.57 no.3
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• pp.257-264
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• 2004

Background : There are many combinations of treatment for locally advanced non-small cell lung cancer (NSCLC). Recent studies have showed the efficacy of concurrent chemoradiotherapy (CCRT) in NSCLC. At present, however, there is no consensus about the optimal dosages and timing of radiation and chemotherapeutic agents. The aims of study were to determine the feasibility, toxicity, response rate, and survival rate in locally advanced NSCLC patients treated with doxetaxel and cisplatin based CCRT. Method : Sixteen patients with unresectable stage III NSCLC were evaluated from May 2000 until September 2001. Induction chemoradiotherapy consisted of 3 cycles of docetaxel (75 $mg/m^2/IV$ on day 1) and cisplatin (60 $mg/m^2/IV$ on day 1) chemotherapy every 3 weeks and concomitant hyperfractionated chest irradiation (1.15 Gy/BID, total dose of 69 Gy) in 6 weeks. Patient who had complete or partial response, and stable disease were applied consolidation chemotherapy of docetaxel and cisplatin. Results : All patients showed response to CCRT. Four patients achieved complete response (25%), partial responses in 12 patients (75%). The major common toxicities were grade III or more of neutropenia (87.3%), grade III esophagitis (68.8%), pneumonia (18.8%) and grade III radiation pneumonitis (12.5%). Thirteen patients were ceased during follow-up period. Median survival time was 19.9 months (95% CI; 4.3-39.7 months). The survival rates in one, two, and three years are 68.7%, 43.7%, and 29.1%, respectively. Local recurrence was found in 11 patients (66.8%), bone metastasis in 2, and brain metastasis in 1 patient. Conclusion : The response rate and survival time of CCRT with docetaxel/cisplatin in locally advanced NSCLC were encouraging, but treatment related toxicities were high. Further modification of therapy seems to be warranted.

• The Journal of Korean Medicine
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• v.30 no.1
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• pp.120-127
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• 2009

Objectives: Sahyangsohapwon (SS) is a herbal medication that has been widely used with circulatory and neural diseases. This study was conducted to assess the effect of SS on the autonomic nervous system by using heart rate variability measurement. Methods: The eligible subjects were enrolled from the healthy male group of ages 20 to 35 years. They were divided into two groups, the SS group (n=26) and the control (n=24). We monitored the ECG of subjects from the time period 14:00 to 18:00. In the SS group, subjects were administered with a dose of SS at the time 15:00, whereas the control group had none. For each hour HRV measurement was monitored every 15 minutes for 512 seconds from the time period 14:00 to 18:00. The mean value, which was calculated using the 4 values during each hour (i.e. 14:00, 14:15, 14:30, 14:45), was used as the representative value for each individual hour. For the measurement values, RR-interval and SDNN (standard deviation of the NN intervals) were used as time domain analysis, and HF (high frequency), LF (low frequency), and LF/HF ratio were used as frequency domain analysis. Results: The LF value showed an increase after one hour of SS administration and showed gradual diminution for each and every hour. The repeated measures of ANOVA for the comparison of the LF value between the SS group and the control group showed significant differences. While, RR interval, SDNN, HF, and LF/HF ratio values showed no significant differences between the two groups. Conclusions: We suggest that the SS might be useful for stabilizing autonomic nervous system by inhibiting sympathetic nerve activation in healthy people.

• Journal of Veterinary Clinics
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• v.32 no.6
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• pp.491-498
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• 2015

We investigated the effect of constant rate infusion (CRI) with doxapram on cardiopulmonary function during total intravenous anesthesia (TIVA) with remifentanil and propofol CRI in dogs. Fifteen male Beagle dogs were randomly divided into 3 groups. All groups were premedicated with medetomidine ($20{\mu}g/kg$, IV) and anesthetized by remifentanil/propofol CRI for one and half hour. At the initiating of the anesthesia, different doses of doxapram for each group were administrated as the followings; D1 group - doxapram 0.25 mg/kg bolus followed by doxapram $8.33{\mu}g/kg/min$, D2 group - doxapram 2 mg/kg bolus followed by doxapram $66.66{\mu}g/kg/min$, control group - normal saline. The anesthetic depth for surgery was well maintained in all groups throughout the anesthetic periods. The respiratory rate was significantly higher in D2 group than that of control group (p < 0.05). The values of $PaO_2$ and $SaO_2$ were significantly increased in both D1 and D2 groups compared with control group (p < 0.05). High dose of doxapram (D2 group) significantly decreased the level of $PaCO_2$ compared with control group (p < 0.05). The values of systolic, mean and diastolic arterial pressure were significantly increased in doxapram 2 group (p < 0.05). There were no significant differences in the values of heart rate and pH of arterial blood. Therefore, doxapram CRI may be useful to alleviate the suppression of cardiopulmonary function including hypoxia and hypotension during TIVA with remifentanil and propofol in dogs.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.213-218
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• 2007

Purpose: To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease. Materials and Methods: Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy. Results: Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1-and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2-and 3-year overall survival rates were 31.6% and 15.8%, respectively. Conclusion: The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer.

• Nuclear Engineering and Technology
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• v.55 no.6
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• pp.2335-2347
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• 2023

As medical facilities are usually built at urban areas, special concrete aggregates and evaluation methods are needed to optimize the design of concrete walls by balancing density, thickness, material composition, cost, and other factors. Carbon treatment rooms require a high radiation shielding requirement, as the neutron yield from carbon therapy is much higher than the neutron yield of protons. In this case study, the maximum carbon energy is 430 MeV/u and the maximum current is 0.27 nA from a hybrid particle therapy system. Hospital or facility construction should consider this requirement to design a special heavy concrete. In this work, magnetite is adopted as the major aggregate. Density is determined mainly by the major aggregate content of magnetite, and a heavy concrete test block was constructed for structural tests. The compressive strength is 35.7 MPa. The density ranges from 3.65 g/cm³ to 4.14 g/cm³, and the iron mass content ranges from 53.78% to 60.38% from the 12 cored sample measurements. It was found that there is a linear relationship between density and iron content, and mixing impurities should be the major reason leading to the nonuniform element and density distribution. The effect of this nonuniformity on radiation shielding properties for a carbon treatment room is investigated by three groups of Monte Carlo simulations. Higher density dominates to reduce shielding thickness. However, a higher content of high-Z elements will weaken the shielding strength, especially at a lower dose rate threshold and vice versa. The weakened side effect of a high iron content on the shielding property is obvious at 2.5 µSv=h. Therefore, we should not blindly pursue high Z content in engineering. If the thickness is constrained to 2 m, then the density can be reduced to 3.3 g/cm³, which will save cost by reducing the magnetite composition with 50.44% iron content. If a higher density of 3.9 g/cm³ with 57.65% iron content is selected for construction, then the thickness of the wall can be reduced to 174.2 cm, which will save space for equipment installation.

• Tuberculosis and Respiratory Diseases
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• v.53 no.6
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• pp.612-618
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• 2002

Background : Bronchoscopy is an important diagnostic and a therapeutic tool in chest medicine. However, most patients feel that a bronchoscopy is an unpleasant procedure, and it is important to sedate the patients appropriately, particularly where repetitive examinations are required. Midazolam is a sedative drug with amnestic qualities and a rapid 2 hour half-life. This study have attempted to determine the safety, appropriate dosage, and the effect of midazolam premedication in patients who underwent a bronchoscopy. Methods : One hundred and eighty consecutive patients undergoing bronchoscopy were enrolled in this study. The patients received a midzolam doses of 0.03 mg/kg, 0.06 mg/kg, or a placebo. An additional dose of lidocaine, the total number of coughs, and the duration of the procedures were recorded with monitoring the the blood pressure, heart rate, and oxygen saturation. The level of satisfaction was assessed by the patient, bronchoscopist, and the nurse. Results : The blood pressure, pulse rates, oxygen saturation, number of coughs, lidocaine dose, and procedure time in the 3 groups were similar. There was a trend for the midazolam 0.03 mg/kg group to satisfy bronchoscopists more than the other two groups. The nurses' acceptability was lower in the midazolam 0.06 mg/kg group than the other groups. The patients' acceptablity was greater in both the midazolam 0.03 mg/kg and 0.06 mg/kg groups than in the control group. Conclusion : Sedation with low doses of intravenous midazolam is a safe technique for fiberoptic bronchoscopy with a low morbidity and high acceptable to patients and bronchoscopists.

• Radiation Oncology Journal
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• v.18 no.1
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• pp.40-45
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• 2000

Purpose : To evaluate the histopathological prognostic factors, relapse pattern and survival in patients with endometrial carcinoma who were treated with surgery and postoperative adjuvant radiotherapy (RT). Methods and Materials : From September 1991 to December 1997, 27 patients with endometrial carcinoma treated with surgery and postoperative adjuvant RT at Asan Medical Center were entered in this study. Surgery was peformed with total abdominal hysterectomy in six, total abdominal hysterectomy with pelvic lymph node dissection in eight and radical hysterectomy in 13 patients. External RT of 50.4 Gy was done to all patients and among these, additional high dose rate vaginal vault irradiation of 20$\~$25 Gy with fractional dose of 4$\~$5 Gy was boosted In 16 patients. The patients were followed for 6$\~$95 months(median 30). Results : The number of patients according to FIGO stage were I 18 (67$\%$), II 1 ($4\%$) and III 7 ($26\%$). Patients with poor histologic grade, deep myometrial invasion, adnexal involvement, lymphovascular invasion showed more pelvic lymph node involvement, but no statistical significance was indicated. The 5 year overall and disease free survival were 100$\%$ and 76.8$\%$, respectively. Relapse sites were pelvic, para-aortic lymph node, and multiple metastases including lung, and no vaginal relapse was developed. Factors that were associated with disease free survival were FIGO stage (p=0.01), lymphovascular invasion (p=0.03), pelvic lymph node involvement (p=0.0001). There was only one Grade 1 rectal bleeding without moderate to severe complications. Conclusion : Postoperative adjuvant RT is considered to reduce the loco-regional failure, resulting the improvement of survival. The group of patients with the risk of vaginal failure without vaginal vault irradiation should be investigated according to stage and grade.