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Treatment Outcome for Nasopharyngeal Carcinoma in University Malaya Medical Centre from 2004-2008

  • Ee Phua, Vincent Chee;Loo, Wei Hoong;Yusof, Mastura Md;Ishak, Wan Zamaniah Wan;Tho, Lye Mun;Ung, Ngie Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4567-4570
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    • 2013
  • Background: Nasopharyngeal carcinoma (NPC) is the commonest radiocurable cancer in Malaysia. This study aimed to determine the treatment outcomes and late effects of radiotherapy for NPC patients treated in University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with NPC referred for treatment to the Oncology unit at UMMC from 2004-2008 were retrospectively analyzed. Treatment outcomes were 5 years overall survival (OS), disease free survival (DFS), cause-specific survival (CSS), locoregional control (LRC) and radiotherapy-related late effects. The Kaplan-Meier method was used for survival analysis and differences in survival according to AJCC stage was compared using the log-rank test. Results: A total of 176 patients with newly diagnosed NPC were treated in UMMC during this period. Late presentation was common, with 33.5% presenting with T3-4 disease, 84.7% with N1-3 disease and 75.6% with AJCC stage 3-4 disease. Radical RT was given to 162 patients with 22.7% having RT alone and 69.3% having CCRT. The stipulated OTT was 7 weeks and 72.2% managed to complete their RT within this time period. Neoadjuvant chemotherapy was given to 14.8% while adjuvant chemotherapy was administered to 16.5%. The 5 years OS was 51.6% with a median follow up of 58 months. The 5 years OS according to stage were 81.8% for stage I, 77.9% for stage II, 47.4% for stage III and 25.9% for stage IV. The 5 years overall CSS, DFS and LRC were 54.4%, 48.4% and 70.6%, respectively. RT related late effects were documented in 80.2%. The commonest was xerostomia (66.7%). Other documented late effects were hearing deficit (17.3%), visual deficit (3.1%), neck stiffness (3.1%), dysphagia (3.4%), cranial nerve palsy (2.5%), pneumonitis (0.6%) and hypothyroidism (1.2%). Conclusions: The 5 years OS and LRC in this study are low compared to the latest studies especially those utilizing IMRT. Implementation of IMRT for NPC treatment should be strongly encouraged.

Extrusion enhances apparent metabolizable energy, ileal protein and amino acid digestibility of palm kernel cake in broilers

  • Faridah, Hanim Shakirin;Goh, Yong Meng;Noordin, Mohamed Mustapha;Liang, Juan Boo
    • Asian-Australasian Journal of Animal Sciences
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    • v.33 no.12
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    • pp.1965-1974
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    • 2020
  • Objective: This study consisted of two stages; the first was to determine the effect of extrusion and sieving treatments on the chemical properties of palm kernel cake (PKC), and accordingly, a follow-up experiment (second stage) was conducted to determine and compare the apparent metabolizable energy (AME), and protein and amino acid digestibility of extruded and sieved PKC. Methods: Two physical treatments, namely extrusion (using temperature profiles of 90℃/100℃/100℃, 90℃/100℃/110℃, and 90℃/100℃/120℃) and sieving (to 8 particles sizes ranging from >8.00 to 0.15 mm) were carried out to determine their effects on chemical properties, primarily crude protein (CP) and fiber contents of PKC. Based on the results from the above study, PKC that extruded with temperature profile 90/100/110℃ and of sieved size between 1.5 to 0.15 mm (which made up of near 60% of total samples) were used to determine treatments effect on AME and CP and amino acid digestibility. The second stage experiment was conducted using 64 male Cobb 500 chickens randomly assigned to 16 cages (4 cages [or replicates] per treatment) to the following four dietary groups: i) basal (control) diet, ii) basal diet containing 20% untreated PKC, iii) basal diet containing 20% extruded PKC (EPKC), and iv) basal diet containing 20% sieved PKC (SPKC). Results: Extrusion and sieving had no effect on CP and ash contents of PKC, however, both treatments reduced (p<0.05) crude fiber by 21% and 19%, respectively. Overall, extrusion and sieving reduced content of most of the amino acids except for aspartate, glutamate, alanine and lysine which increased, while serine, cysteine and tryptophan remained unchanged. Extrusion resulted in 6% increase (p<0.05) in AME and enhanced CP digestibility (p<0.05) by 32%, as compared to the untreated PKC while sieving had no effect on AME but improved CP digestibility by 39% which was not significantly different from that by extrusion. Conclusion: Extrusion is more effective than sieving and serves as a practical method to enhance AME and digestibility of CP and several amino acids in broiler chickens.

Prediction of Succession and Silvicultural Control in the Black Locust(Robinia pseudoacacia L.) Plantation (아까시나무(Robinia pseudoacacia L.) 조림지(造林地)에서 천이(遷移)의 예측(豫測)과 조림학적(造林學的) 제어(制御))

  • Yun, Chung Weon;Oh, Seung Hwan;Lee, Joon Hyouk;Joo, Sung Hyun;Hong, Sung Cheon
    • Journal of Korean Society of Forest Science
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    • v.88 no.2
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    • pp.229-239
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    • 1999
  • To get ecological information necessary for the prediction on succession and the silvicultural control of the black locust(R. pseudoacacia) plantation, classification of vegetation unit. competition of major species, and succession were analyzed. The results were as follows. Vegetation units classified in R. pseudoacacia forest were Quercus variabilis community, Persicaria perfoliata community, Styrax japonica community, Acalypha australis community, Typical community. Species diversity indices showed significant difference among the vegetation units. As a result of stand ordination by CCA method, arrangement of stands on Axis I was correlated significantly with altitude, sand, silt and available phosphorus contents, and that on Axis II was with total nitrogen, exchangeable calcium and kalium contents. It was judged that R. pseudoacacia plantation would be replaced by the mixed forest including Quercus spp., Acer spp., and Prunus spp. etc., native to Korea with the progression of succession as the results of analyses on competition of major species and successional tendency in R. pseudoacacia plantation.

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Efficacy and Survival-associated Factors with Gefitinib Combined with Cisplatin and Gemcitabine for Advanced Non-small Cell Lung Cancer

  • Fang, Hong;Lin, Rong-Yan;Sun, Ming-Xia;Wang, Qian;Zhao, Yu-Liang;Yu, Jing-Lin;Tian, Yan;Wang, Xiao-Yun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10967-10970
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    • 2015
  • Objective: To analyze the efficacy and survival associated factors of gefitinib combined with cisplatin and gemcitabine for advanced non-small cell lung cancer. Materials and Methods: A total of 57 patients with advanced non-small cell lung cancer (NSCLC), who received platinum-based chemotherapy regimens for more than 1 cycle, were treated with gefitinib combined with cisplatin and gemcitabine until disease progression. Efficacy, survival time and adverse reactions were observed. The Kaplan-Meier method was adopted for analysis of survival and Cox regression for associated influencing factors. Results: The patients were followed up until October 31, 2013, and the median follow-up time was 19 months. Of 57 patients, there were 4 (7.0%) with complete remission (CR), 8 (14.0%) with partial remission, 31 (54.4%) with stable disease, and 14 (24.6%) with disease progression. The remission rate was 21.1% and the disease control rate was 75.4%. The median progression-free survival (PFS) time and the median overall survival time were 10 months and 15.2 months. The one-year, two-year and three-year survival rates were 47.4%, 23.3% and 10.0%. Gender and pathological types were the independent risk factors influencing PFS time (P=0.028, P=0.009). Tumor pathological type and early efficacy were independent factors for the prognosis (P=0.018, P=0.000). Adverse reactions were mostly rashes of I~II degree and diarrhea and slightly increasing level of aminopherase. The skin adverse event incidence of III degree or above was 1.8% (1/57) and brain metastasis was foudn in 31.6% (18/57). Conclusions: Gefitinib combined with cisplatin andgemcitabine, is effective for patients with IIIb~IV NSCLC who received multiple cycles of chemotherapy.

Clinical Study on Effect of Carthmi-Flos Herbal acupuncture therapy on Osteoarthritis in Knee Joint (홍화약침(紅花藥鍼)의 퇴행성(退行性) 슬관절염(膝關節炎)에 대한 임상적 연구(硏究))

  • Hur, Tae-Young;Yun, Min-Young;Cho, Eun-hee;Lee, Ok-Ja;Kim, Kyung-sik;Cho, Nam-Geun
    • Journal of Acupuncture Research
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    • v.19 no.2
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    • pp.189-200
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    • 2002
  • Objective : This study is designed to find out the effects of Carthmi-Flos herbal acupuncture theraphy on knee joint with osteoarthritis. Methods : 32 cases of diagnostic patient with the osteoarthritis of knee joints by biochemical method, X-ray analysis and hematologic & serologic tests are divided Carthmi-Flos herbal acupuncture theraphy Group(HAG, 16 peples) and non-Carthmi-Flos herbal acupuncture theraphy Group(NHAG, 16 peoples) at Ik-San Oriental medical hospital in wonkwang university from 1th June 2000 to 31th January 2002. After treatment, we evaluated the effect per each group . Results : 1. In the both HAG and NHAG females were much more than males. Sixty aged patients were the most in the HAG(56.3%) and Seventy aged patients were the most in the NHAG(68.8%). 2. Over 5 years duration of disease in HAG was the most(37.5%). 6 months and over 5 years duration of disease in NHAG was the most(each 31.3%). 3. Two groups were not improved chronic stage(over 5 years). 4. The effect of treatment by condition of patients was follows: After treatment, Grade IV & III were decreased 75.0% in HAG and 56.2% in NHAG 5. In the distribution of treatment progression : 15 cases(93.7%) were recoverd in HAG but 14 cases(87.5%) in NHAG. 6. After comparing the results before and after treatment, we found 93.3% of patients showed recovery at anterior area and 88.9% showed at posterior. Conclusion : These results shows that Carthmi-Flos(CF) herbal acupuncture treatment has good effect on osteoarthritis in knee joint. Futhermore it is possible that CF acupuncture is one of the promising candidates for long-term therapy of osteoarthritis.

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A Study on the Quantified Evaluation and Application of Stream Environment (하천환경의 정량적 평가 및 활용에 관한 연구)

  • Kim, Jong Oh;Kim, Ok Sun;Kim, Sun Hye
    • Journal of Wetlands Research
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    • v.6 no.3
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    • pp.83-93
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    • 2004
  • The purpose of this study was to develop the environmental management strategy of streams based on the quantified evaluation method of the stream environment. The six streams in Jinju city flowing into the Nam-river were selected for the case study. The stream environment evaluation was performed considering the following three independent field surveys. First, the stream naturalnesses considering 20 evaluation elements were investigated for each unit section of the streams having the length of 500m and the width of 100m, and then were evaluated into 5 grades. Second, water qualities of the streams were evaluated into 5 grades based on the results of eight times water quality survey. Third, the landuse patterns in the stream basins were evaluated into 5 grades according to the residential area ratio. Finally, the stream environments were classified into 5 grades by integrating the above three subfactors - stream naturalness, water quality, and residential landuse. According to the evaluation results of stream environments, the three environmental management strategies of streams were suggested. As the results of the case study, Panmun stream and Ghajwa stream were evaluated to the forth grade that need active environmental restoration, and Nabul stream and Yonga stream were evaluated to the second grade that need partial environmental restoration while Youngchun river and Dogsan stream were evaluated to the first grade showing the desirable stream environmental condition. The above environmental evaluation results for each stream will be an important reference for the further stream restoration or management plan.

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Inhibitory Effect of Injinchunggantang-derivative on Hepatic Fibrosis (인진청간탕가미방이 간조직의 섬유화 억제에 미치는 영향)

  • 강경태;김영철;이장훈;우홍정
    • The Journal of Korean Medicine
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    • v.23 no.2
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    • pp.39-56
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    • 2002
  • Objective : The aim of this study is to investigate the inhibitory effect of lnjinchunggantang-derivative on acute and sub-acute hepatic fibrosis induced by $CCl_4$, and to compare the efficiency of lnjinchunggantang-derivative, Salviae Radix and Scirpi Tuber.Zeloariae Rhizoma on acute and sub-acute hepatic fibrosis induced by $CCl_4$. Method : Western blotting for collagen type N, quantitative RT-PCR and gross & histological findings on liver tissue (Hematoxylin & Eosin stain, Reticulin stain, Masson-Trichrome stain) were studied. Results : In the study on collagen type N expression, lnjinchunggantangcderivative, Scirpi Tuber.Zeloariae Rhizoma and Salviae Radix showed inhibitory effect in western blotting. In quantitative RT-PCR assay, lnjinchunggantang-derivative showed inhibitory effect on collagen type N expression in acute hepatic fibrosis model, whereas lnjinchunggantang-derivative, Scirpi Tuber.Zeloariae Rhizoma and Salviae Radix showed inhibitory effect on collagen type N expression in sub-acute hepatic fibrosis model. In the gross findings of acute and sub-acute hepatic fibrosis models,lnjinchunggantang-derivative, Salviae Radix and Scirpi Tuber. Zeloariae Rhizoma showed inhibitory effect on hepatic fibrosis in the order. In the histological findings of acute and sub-acute hepatic fibrosis models in Hematoxylin & Eosin, Reticulin and Masson-Trichrome staining, the liver of $CCl_4$-only group showed atrophy and necrotic change with white nodules whereas that of $CCl_4$+ Injinchunggantang-derivative showed no significant histological change with well preservation of the tone of the tissue, and Scirpi Tuber. Zeloariae Rhizoma and Salviae Radix group showed minimal fibrotic changes. In the scoring system of the extent of the inhibition of the hepatic fibrosis, lnjinchunggantang-derivative group showed statistically significant inhibitory effect(p<0.05) whereas Scirpi Tuber.Zeloariae Rhizoma and Salviae Radix group showed no statistically significant effect in the acute hepatic fibrosis model. In the sub-acute hepatic fibrosis model, lnjinchunggantang-derivative, Scirpi Tuber.Zeloariae Rhizoma and Salviae Radix group showed statistically significant effect (p<0.01). Conclusion : These results show that lnjinchunggantang-derivative, Salviae Radix and Scirpi Tuber.Zeloariae Rhizoma have inhibitory effect in the order on hepatic fibrosis induced by $CCl_4$ by suppressing the expression of collagen type N, ultimately preventing liver cirrhosis. To obtain more credible results in this experiment, developement of a new experimental model more similar to human hepatic fibrosis is still needed.

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Studies on Rapid Advancement of Generations for a Breeding Efficiency Promotion of Rape Oil Improvement IV. Effect of Green Plant Vernalization on Shortening the Growing Period of Summer Cultured Rape in Field (유채 성분육종 효율을 증진키 위한 세대단축 기술개발에 관한 연구 제4보 Winter형 유채의 유묘기 록체 저온감응이 하계고온 포장재배에 미치는 효과)

  • Lee, J.I.;Kwon, B.S.;Kim, W.C.
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.28 no.1
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    • pp.133-138
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    • 1983
  • In Korea, Brassica species planted in summer remain in rosette and do not flower. Seed production of vernalized rape seedlings grown in summer was evaluated to establish method of generation shortening and genetically pure seed production without isolation of seed fields. When vernalized rape seedlings of different maturity groups were transplanted in summer, all plants bolted and flowered, and average days from sowing to bolting and flowering was 37 and 58. respectively. It took 85days for early maturity group, 88 days for medium maturity group, and 108 days for late maturity group to mature. Seed yield of vernalized plants grown in summer was 8.8 gr per plant and 53kg per l0a which was 23% of seed yield of rape planted in autumn. However, enough seeds were produced to test oil composition and cake and to plant for a next generation. If seedlings are raised, they can be transplanted in more than 1, 000 times of original seed field, indicating that genetically pure seed can be produced without caging seed fields with nets and isolation of seed fields since other Brassica species do not flower in summer.

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Clinical Analysis of Surgical Treatment and Risk Factors of Thymoma (흉선종의 수술적 치료 및 그 위험인자에 관한 임상적 고찰)

  • Lim, Cheong;Sung, Sook-whan;Kim, Joo-Hyun
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.67-71
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    • 1997
  • Though thymoma is considered benign In a histopathologic specimen, its unusual behavior makes it important for surgeons to manage this neoplasm as cancerous lesion. Hence we clinically analysed the surgical cases of thymoma in our hospital, And we suggest the risk factors for its prognosis From January 1987 to December 1994, we experienced 41 surgical cases of thymoma, excluding thymic carcinoma and cysts. There were 21 male and 20 female; age ranged from 16 to 64 years. Among them, myasthenia gratis was present in 22 patients(53.7%). Surgical treatment consisted of complete resection in 31 patients, partial resection In 7 patients, and biopsy only in 3 patients. According to Masaoka's classification, there were 27 patients in milage 1, 4 patients in stage II, and 10 patients In stage III. Histopathology was of epithelial type in 14 patients, Iymphocytic type in 11, and mixed type in 19. Eleven patients had adjuvant radiotherapy, chemotherapy, or b th and there was no surgical mortality. Postoperative follow-up ranged from 1 to 88 months (mean )6 months) and three patients died and 5 patients suffered recurrences during the follow-up period. Postoperative risk factors were advanced Masaoka stage, invasiveness, and surgical method.

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Treatment Results of Tonsil Cancer : Comparison of Extended Tonsillectomy with Composite Resection (편도암의 수술적용 형태에 따른 치료효과 - 광범위 편도절제술과 복합 편도절제술의 비교 -)

  • Chu Hyung-Ro;Han Seung-Hoon;Kwon Kee-Hwan;Jung Kwang-Yoon;Choi Geon;Choi Jong-Ouck
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.35-39
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    • 1999
  • Objectives: The treatment for squamous cell carcinoma of the tonsil remains controversial. Surgery or radiation therapy alone is effective in treating early tonsil cancer, but results with single treatment modality in advanced disease have been disappointing. We retrospectively analyzed 37 patients with advanced squamous cell carcinoma of the tonsil for two treatment modalities in an effort to identify more efficacious therapeutic options. Materials and Methods: From 1990 through 1997, 37 patients who were treated primarily with surgery, were retrospectively sudied. The patients were grouped into two groups according to the method of treatment, extended tonsillectomy followed by irradiation and/or postradiation neck dissection(Group I) and a combination of composite resection and postoperative radiation(Group II). Results: The three year disease-tree survival in patients with stage IV lesions was 59.09% for the Group I patients, and 56.25% for the Group II patients. This difference was not statistically significant(p=0.775). The primary tumor recurrence rate in Group I was 16.7% in contrast to 23.1% for Group II. The local recurrence rate in the neck was 16.7% for the Group I patients and 23.1% for the Group II patients. There was no significant difference in the frequency of recurrences in the primary or neck in the patients treated with extended tonsillectomy or composite resection(p=0.639). Fistula formation and aspiration occurred in four patients after composite resection. Additionally, there were three trismus, one soft tissue necrosis, and one velopharyngeal insufficiency. Major complications were not observed in the patients treated with extended tonsillectomy and irradiation: velopharyngeal insufficiency was observed in eight patients and soft tissue necrosis in two patients. Conclusion: Extended tonsillectomy followed by irradiation may be an effective therapy with low morbidity in selected patients with tonsil cancer.

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