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Bladder Preservation by Combined Modality Therapy for Invasive Bladder Cancer : A Five-Year Follow-up (근침윤성 방광암에서 화학방사선 병용을 통한 방광보존치료)

  • Cho Jae Ho;Lim Jihoon;Seong Jinsil;Pyo Hong Ryull;Koom Woong Soup;Suh Chang Ok;Hong Sung Jun
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.359-368
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    • 2001
  • Purpose : To determine the long-term results of bladder-preserving approach by transurethral resection of the bladder (TURB), systemic chemotherapy, and radiation therapy for muscle-invasive bladder cancer Methods and materiaals : From 1991 Jan. through 1994 Dec., 25 patients with muscle invading clinical stage T2 to T4NxM0 bladder cancer were treated with induction by maximal TURB and (arm 1, n=4) three cycles of chemotherapy [MVAC(methotrexate, vincristine, adriamycin, ciplatin)] followed by 64.8 Gy of radiation with concomitant cisplatin, or two cycles of chemotherapy [MCV (methotrexate, ciplatin, vincristine)] after irradiation with concomitant cisplatin (arm 2, n=14), or concurrent chemoradiation only (arm 3, n=7). Tumor response was scored as a clinical complete response (CR) when the cystoscopic tumor-site biopsy and urine cytology results were negative. Those with less than a CR underwent cystectomy. The median follow-up of all patients was 70 months. Resulst : Most treatment toxicities were mild to moderate. Grade 3 acute hematologic toxicity and chronic cystitis were observed in only 1 and 2 patients, respectively. Overall 5 year survival was $67.3\%$. Complete remission rate was $80\%$ (20/25). Sixty-three percent of all survivors retained their bladders. In multivariate analysis, prognostic factors that significantly affect survival were T-stage (p=0.013) and Complete remission (p=0.002). Conclusion : Combined modality therapy with TURB, chemotherapy, and radiation has a $67.3\%$ overall 5 year survival rate. This result is similar to cystectomy-based studies for patients of similar clinical stages.

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Hypofractionated Radiation Therapy for Early Glottic Cancer - Preliminary Results - (초기 성문암 환자에서의 소분할 조사법을 이용한 방사선치료 - 예비적 결과 -)

  • Wu Hong-Gyun;Hong Semie;Shin Seong Soo;Park Charn Il
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.301-305
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    • 2001
  • Purpose : This study was peformed for the evaluation of the feasibility and toxicity of hypofractionated radiation therapy for early glottic cancer Methods and Materials : From February 1999 to February 2000, 20 patients with Histologically confirmed Stage I, II glottic cancer were enrolled into this study. There were 18 males and 2 females, the median age of the patients was 59 years. The distribution of stage distribution was as fellows; T1aN0-16 patients, T1bN0-1 patient, T2N0-3 patients. Eighteen patients underwent laryngomicroscopic biopsy only, and two patients underwent laser cordectomy. All patients received radical radiation therapy (2.5 Gy per fraction, 24 fractions, total 60 Gy). Median duration of treatment was 36 days (range $31\~45\;days$). Results : Radiation therapy were well tolerated. Most common acute reactions were odynophagia and hoarseness, and these reactions resolved after radiation therapy. There were one case of RTOG grade 3 odynophagia $(5\%)$, six cases of grade 3 hoarseness $(30\%)$. Response of radiation therapy was evaluated one month after completion of treatment. All patients revealed complete response. During follow up, total three cases of treatment failure were detected. two cases were local recurrence in 10 and 13 months of radiation therapy and one case was local recurrence and distant metastasis in 2 months of radiation therapy. Conclusion : This hypofractionated radiation therapy schedule was feasible and effective for control of early glottic cancer But longer follow up time would be required to assess the long-term disease control and the late complication by shortening radiation therapy duration.

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The Changes of Cerebral Metabolic Parameters, Serum Levels of Neuron-Specific Enolase and S-100$\beta$ Protein During Retrograde Cerebral Perfusion Under Profound Hypothermic Total Circulatory Arrest (초저체온하 완전순환정지 시에 이용되는 역행성 뇌관류의 시간에 따른 뇌대사 지표, 혈청 내 neuron-specific enolase, 및 S-100 베타단백의 변화)

  • 김경환
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.653-661
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    • 2001
  • Background: Retrograde cerebral perfusion(RCP) is one of the methods used for brain protection during aortic arch surgery. The author previously published the data, however, for the safety of it, there still remains many controversies. The author performed RCP and checked various parameters to clarify the possibility of early detection of cerebral injury. Material and Method: The author used pigs(Landrace species) weighing 25 to 30kg and performed RCP for 120 minutes. After weaning of cardiopulmonary bypass, we observed pigs for another 120 minutes. Rectal temperature, jugular venous oxygen saturation, central venous pressure were continuously monitored, and the hemodynamic values, histological changes, and serum levels of neuron-specific enolose(NSE) and S100$\beta$ protein were checked. Central venous pressure during RCP was maintained in the range of 20 to 25 mmHg. Result: Flow rates(ml/min) during RCP were 224.3$\pm$87.5(20min), 227.1$\pm$111.0(40min), 221.4$\pm$119.5(60min), 230.0$\pm$136.5(80min), 234.3$\pm$146.1(100min), and 184.3$\pm$50.5(120min). Serum levels of NSE did not increase after retrograde cerebral perfusion. Serum levels of S100$\beta$ protein(ng/ml) were 0.12$\pm$0.07(induction of anesthesia), 0.12$\pm$0.07(soon after CPB), 0.19$\pm$0.12(20min after CPB), 0.25$\pm$0.06(RCP 20min), 0.29$\pm$0.08(RCP 40min), 0.41$\pm$0.05(60min), 0.49$\pm$0.03(RCP 80min), 0.51$\pm$0.10(RCP 100min), 0.46$\pm$0.11(RCP 120min), 0.52$\pm$0.15(CPBoff 60min), 0.62$\pm$0.15(60min after rewarming), 0.76$\pm$0.17(CPBoff 30min), 0.81$\pm$0.20(CPBoff 60min), 0.84$\pm$0.23(CPBoff 90min) and 0.94$\pm$0.33(CPBoff 120min). The levels of S100$\beta$ after RCP were significantly higher than thosebefore RCP(p<0.05). The author could observe the mitochondrial swellings using transmission electron microscopy in neocortex, basal ganglia and hippocampus(CA1 region). Conclusion: The author observed the increase of serum S100$\beta$ after 120 minutes of RCP. The correlation between its level and brain injury is still unclear. The results should be reevaluated with longterm survival model also considering the confounding factors like cardiopulmonary bypass.

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CHEMICAL DEGRADATION OF LIGHT-CURED DENTAL COMPOSITE RESINS (수종 치과용 광중합형 복합레진의 화학적 분해)

  • Yang, Kuy-Ho;Choi, Nam-Ki;Park, Mi-Ran;Park, Eun-Hae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.403-411
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    • 2001
  • The aim of this study was to evaluate the resistance to degradation of four commercial composite resins in an alkaline solution. The brands studied were Unifil(GC, Japan), Palfique(Tokuyama Japan). Definite$Degussa-H\ddot{u}ls$ AG, Germany). Revolution(Kerr, U.S.A.). Preweighed discs of each brand were exposed 0.1N NaOH solution at $60^{\circ}C$. After 14 days they were removed, neutralized with HCl, washed with water and dried. Resistance to degradation was evaluated on the basis of following parameters: (a) mass loss(%) - determined from pre-and post-exposed specimen weights; (b) Si loss(ppm) - obtained from ICP-AE analysis of solution exposed to specimens; and (c) degradation depth$({\mu}m)$ - measured microscopically (SEM) from polished circular sections of exposed specimens. The results were follows: 1. The mass loss of Unifil was 3.21%, it was the highest of materials. But, there was no significant difference among the materials. 2. The degree of degradation layer depth was $107.69\sim47.40{\mu}m$, the sequence of the degree pf degradation layer depth was in descending order by Unifil, Palfique, Revolution, Definite. There was significant difference among the materials except Palfique and Definite. 3. The Si loss of Paltique was 8940.0ppm, it was the highest. There was significant difference among the materials, except Revolution and Definite(p<0.05). 4. The correlation coefficient between mass loss and degradation depth was relatively high(r = 0.06, p<0.05). 5. There was no significant coefficient correlation between Si loss and mass loss, and/or the degree of degradation layer depth and Si loss. 6. When observed with SEM, destruction of bonding is observed between resin matrix and filler. Above results suggested that the hydrolytic degradation is considered as evaluation factor of composite resins.

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Transcatheter Arterial Chemoembolization Combined with Interferon-α is Safe and Effective for Patients with Hepatocellular Carcinoma after Curative Resection

  • Zuo, Chaohui;Xia, Man;Liu, Jingshi;Qiu, Xiaoxin;Lei, Xiong;Xu, Ruocai;Liu, Hanchun;Li, Jianliang;Li, Yongguo;Li, Qinglong;Xiao, Hua;Hong, Yuan;Wang, Xiaohong;Zhu, Haizhen;Wu, Qunfeng;Burns, Michael;Liu, Chen
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.245-251
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    • 2015
  • Objectives: Intrahepatic recurrence is the major cause of death among patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative surgical resection. Several approaches have been reported to decrease the recurrence rate. The objective of our study was to compare the clinical effects of transcatheter arterial chemoembolization (TACE) combined with interferon-alpha (IFN-${\alpha}$) therapy on recurrence after hepatic resection in patients with HBV-related HCC with that of TACE chemotherapy alone. Methods: We retrospectively analyzed the data from 228 patients who were diagnosed with HBV-related HCC and underwent curative resection between January 2001 to December 2008. The patients were divided into TACE (n = 126) and TACE-IFN-${\alpha}$ (n = 102) groups for postoperative chemotherapy. The TACE regimen consisted of 5-fluorouracil (5-FU), cisplatin (DDP), and the emulsion mixed with mitomycin C (MMC) and lipiodol. The recurrence rates, disease-free survival (DFS), overall survival (OS), and risk of recurrence were evaluated. Results: The clinicopathological parameters and adverse effects were similar between the 2 groups (P > 0.05). The median OS for the TACE-IFN-${\alpha}$ group (36.3 months) was significantly longer than that of the TACE group (24.5 months, P < 0.05). The 3-and 5-year OS for the TACE-IFN-${\alpha}$ group were significantly longer than those of the TACE group (P < 0.05) and the recurrence rate was significantly lower (P < 0.05). The TACE and IFN-${\alpha}$ combination therapy, active hepatitis HBV infection, the number of tumor nodules, microvascular invasion, liver cirrhosis, and the BCLC stage were independent predictors of OS and DFS. Conclusions: The use of the TACE and IFN-${\alpha}$ combination chemotherapy after curative hepatic resection safely and effectively improves OS and decreases recurrence in patients with HBV-related HCC who are at high risk. Our findings can serve as a guide for the selection of postoperative adjuvant chemotherapy for patients with HBV-related HCC who are at high risk of recurrence.

Effect of Whalakyuoleyng-dan plus Yinsamyangwui-tang on Anti-angionesis (활락효영단합인삼양위탕(活絡效靈丹合人蔘養胃湯)이 혈관신생(血管新生) 억제(抑制)에 미치는 영향(影響))

  • Ko, Ki-Wan;Park, Joon-Hyuk;Kang, Hee;Kim, Sung-Hoon;Yu, Young-Beob;Shim, Bum-Sang;Choi, Seung-Hoon;Ahn, Koo-Seok
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.7 no.1
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    • pp.77-97
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    • 2001
  • Anti-angiogenesis is one of therapies which have been high-lightened on the research of cancer treatment. Anti-angiogenesis means that new blood vessels are created from a existing capillary tube and it is a important process on metastasis and permeation when cancer is created or formed. Since angiogenesis have been under research, a complete recovery oriented treatment against cancer have been suggested blocking metastasis, delaying the growth of cancer cell, and blocking the supply of oxygen and nutritive substance through the web of blood vessels. Until now, there are several anti-angiogenesis, which have been known to the public, such as thalidomide, angiostatin, endostatin, 2-methoxyestradiol, TNP-470, and marimastat, etc. Additionally, 17 clinical testing projects about anti-angiogenesis are on the process in NCI(National Cancer Institute). Especially, TNP-470 showed effectiveness against cancer on clinical testing after finishing animal testing. Based on existing researches showing that Yinsamyangwui-tang is effective to strengthening body resistance and Whallakhyolenyng-dan effects cells on the inside of blood vessel because Whallakhyolenyng- dan restrains cell adhesion during the restraining period of a blood vessel, I tried to research the effect of Whalakhyolenyng-dan plus Yinsamyangwui-tang on angiogenesis. I made a conclusion putting into operation through using SK-Hep-1 (KCLB 30052), A549(KCLB 10185), AGS(KCLB 21739), and BCE(Bovine Capillary Endothelial Cell). Followings are the results of my experimental research: 1. According to the researching results of anti-cancer activation against cancer cell, Whallkhyoleyng dan plus Yinsamyangwui-tang decreased the number of cancer cells -- While injecting $600{\mu}g/ml$, injected groups decreased 3.1% more comparing with the contrastive group of SK-Hep-1, 49.7% more comparing with the contrastive group of A549, and 31.0% more comparing with the contrastive group of AGS. 2. According to the researching results of DNA composition effect between BCE and cancer cell, Whallakhyoleyng-dan plus Yinsamyangwui-tang reduced the rate of SK-Hep-1 synthesis inhibition by 59.1% at $600{\mu}g/ml$ intensity comparing with contrastive group; for A549, 72.6%; for AGS, 6.1%, for BCE, 28.9%. 3. According to the researching results about the effect of BCE cell to angiogenesis, angiogenesis was restrained at $400{\mu}g/ml$ intensity during 18 hours observation. 4. In the case of aortic ring assay, the half level of angiogenesis was reduced comparing with the contrastive group while injecting with $400{\mu}g/ml$ intensity; with $800{\mu}g/ml$, under 10% comparing with contrastive group; and with $1600{\mu}g/ml$, complete restrain. According to the above results, Whallakhyoleyng-dan plus Yinsamyangwui-tang was proved to have an anti-angiogenetic effects.

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Calculation of Renal Depth by Conjugate-View Method Using Dual-head Gamma Camera (이중 헤드 감마 카메라를 이용한 Conjugate-View 계수법에 의한 신장 깊이 도출)

  • Kim, Hyun-Mi;Suh, Tae-Suk;Choe, Bo-Young;Chung, Yong-An;Kim, Sung-Hoon;Chung, Soo-Kyo;Lee, Hyoung-Koo
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.378-388
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    • 2001
  • Purpose: In this study, we developed a new method for the determination of renal depth with anterior and posterior renal scintigrams in a dual-head gamma camera, considering the attenuation factor $e^{-{\mu}x}$ of the conjugate-view method. Material and Method: We developed abdomen and kidney phantoms to perform experiments using Technetium-99m dimercaptosuccinic acid ($^{99m}Tc$-DMSA). The phantom images were obtained by dual-head gamma camera equipped with low-energy, high-resolution, parallel-hole collimators (ICONf, Siemens). The equation was derived from the linear integration of omission ${\gamma}$-ray considering attenuation from the posterior abdomen to the anterior abdomen phantom surface. The program for measurement was developed by Microsoft Visual C++ 6.0. Results : Renal depths of the phantoms were derived from the derived equations and compared with the exact geometrical values. Differences between the measured and the calculated values were the range of 0.1 to 0.7 cm ($0.029{\pm}0.15cm,\;mean{\pm}S.D.$). Conclusion: The present study showed that the use of the derived equations for renal depth measurements, combined with quantitative planar imaging using dual-head gamma camera, could provide more accurate results for individual variation than the conventional method.

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Presown Seed Treatments to Elevate Seedling Emergence of Codonopsis pilosula $N_{ANNF}$ (만삼의 입묘율 향상을 위한 파종전 종자처리의 모형화)

  • Kang, Jin-Ho;Shim, Young-Do;Jeon, Byong-Sam
    • Korean Journal of Medicinal Crop Science
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    • v.9 no.2
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    • pp.99-107
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    • 2001
  • Germination of Codonopsis pilosula seeds and afterward their seedling emergence have been occasionally very poor due to their dormancy and structural defects. The study was done to determine the treatment effects of priming, $GA_3$, agitation and washing during and after priming, drying and water imbibition after drying on germination of its seeds and then of the successive three combined treatment after priming on the its seedling emergence to model its presown seed treatment. While agitation at the speed of 10 rpm was made or not, priming using $Ca(NO_3)_2$ and $GA_3$ under their different concentrations and light quality illuminated for 12 hours a day were done separately. Then their two best results were compared to determine the better one. Using the above determined best result, washing was done 3 minutes in the tap water or not, and drying of washed seeds was made under 4 different lights, and water imbibition of the dried seeds with differed period were successively done to deduce its presown seed treatment. In the comparison of the best germination rate of priming and $GA_3$, the former showed considerably higher rate than the latter; the priming treatment was done at agitated $Ca(NO_3)_2$ 150 mM solution under darkness or 12 hour red light illumination a day for 2 days. Washing after priming enhanced the rate compared to no-washing. Drying was the best way at which seeds washed were desiccated under $35^{\circ}C$ and 4 hour red light illumination. Water imbibition immediately before sowing must be made for 2 days. Seedling emergence rate was the highest at the seeds from successive 4 treatments, priming, washing, drying and water imbibition before sowing of two others, the priming and washing, or the priming, washing and water imbibition, meaning that its presown seed treatment must follow the procedure of the above 4 successive ones.

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Geochemistry of Stream Water around the Abandoned Boeun Coal Mine, Hoenam Area (보은제일폐탄광 주변 하천수의 지구화학적 특징)

  • Jeon, Seo-Ryeong;Shin, Ik-Jong;Lee, Kyu-Seung
    • Korean Journal of Environmental Agriculture
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    • v.20 no.1
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    • pp.20-27
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    • 2001
  • Stream water chemistry in the abandoned Boeun Jeil coal mine area was studied for a period of 3 months, including rainy and dry season. The stream waters were a nearly neutral and slightly alkali condition, and $Mg-SO_4$ type with Mg>Ca>Na>K and $SO_4>HCO_3>Cl>NO_3$. Chemical composition of the stream water was quite irregular during the experimental period. Concentrations of Na, K, $HCO_3$, U, Sr, and Cr decreased by $10{\sim}30%$ during rainy season, caused by dilution effects with rain. The concentration of Ca, Mg, $NO_3$, Cd, and Co increased during the rainy season, caused by more easily dissolved from bedrocks or mine drainage with slightly acidic condition than dry season. The stream water was enriched in Mg, Ca, $HCO_3$, $SO_4$, Al, Fe, Zn, Ni, Co, Cr, Cd, Sr and U. Concentrations of Na, Mg, Ca, $SO_4$, $HCO_3$, Fe, Zn, Ni, Sr, and U decreased linearly with distance from the mine adit. These elements were strongly controlled by dilution of unpolluted water influx and/or adsorption on the clay minerals and iron oxyhydroxide precipitates. This mine area exhibited two main weathering processes ; 1) oxidation with acidification derived from Fe sulphides, and 2) pH buffering due to Ca and Mg carbonate dissolution. This weathering processes were followed by adsorption of metals on iron oxyhydroxides and precipitation.

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Real-Time 3D Ultrasound Imaging Method Using a Cross Array Based on Synthetic Aperture Focusing: II. Linear Wave Front Transmission Approach (합성구경 기반의 교차어레이를 이용한 실시간 3차원 초음파 영상화 기법 : II. 선형파면 송신 방법)

  • 김강식;송태경
    • Journal of Biomedical Engineering Research
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    • v.25 no.5
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    • pp.403-414
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    • 2004
  • In the accompanying paper, we proposed a real. time volumetric imaging method using a cross array based on receive dynamic focusing and synthetic aperture focusing along lateral and elevational directions, respetively. But synthetic aperture methods using spherical waves are subject to beam spreading with increasing depth due to the wave diffraction phenomenon. Moreover, since the proposed method uses only one element for each transmission, it has a limited transmit power. To overcome these limitations, we propose a new real. time volumetric imaging method using cross arrays based on synthetic aperture technique with linear wave fronts. In the proposed method, linear wave fronts having different angles on the horizontal plane is transmitted successively from all transmit array elements. On receive, by employing the conventional dynamic focusing and synthetic aperture methods along lateral and elevational directions, respectively, ultrasound waves can be focused effectively at all imaging points. Mathematical analysis and computer simulation results show that the proposed method can provide uniform elevational resolution over a large depth of field. Especially, since the new method can construct a volume image with a limited number of transmit receive events using a full transmit aperture, it is suitable for real-time 3D imaging with high transmit power and volume rate.