• Title/Summary/Keyword: Location Factors

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The Clinical Characteristics of Lung Cancer in Patients with Idiopathic Pulmonary Fibrosis (특발성 폐섬유화증에 동반된 폐암 환자의 임상적 특정)

  • Park, Joo-Hun;Lee, Jin-Seong;Song, Koun-Sik;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.674-684
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    • 1999
  • Background : It has been generally known that the incidence of lung cancer is higher in the patients with idopathic pumonary fibrosis (IPF) than those in general population. The reported incidence was variable from 4.8 to 43.2%. There were controversies on the most frequent cell type (squamous cell carcinoma vs. adenocarcinoma) and no study was done about the real concordance of cancer and the fibrotic lesion. And the pulmonary fibrosis may influence not only the development of cancer but also the treatment and prognosis of the cancer, but there was no report on that point. Method : Total 63 patients ($66.8{\pm}7.8$ year, M : F=61 : 2) were diagnosed as IPF combined with lung cancer (IFF-CA) at Asan Medical Center. A retrospective analysis was done about the risk factors of the lung cancer, pulmonary function test, the site of cancer(especially the relationship of the cancer with the fibrotic lesion), the histologic types, and the stage of cancer. The histologic types were compared with those of 2,660 patients with lung cancer who were diagnosed at the same institute for the same period. The effect of IPF on the treatment of the cancer was evaluated with the survival time after the detection of lung cancer. Results : The lung cancer was found in 63(22.9%) out of 281 patients with IPF. But in most of them(45 patients), lung cancer was detected at the same time with IPF and only in 18 patients, the cancer was diagnosed during the follow-up($25.2{\pm}17.7$ months) of IPF. So in our study, 6.7% of patients with IPF developed lung cancer during the course of the disease. The age ($66.8{\pm}7.84$ vs. $63.4{\pm}11.1$ years), percentage of smoker (88.9 vs. 67.2%), and the male gender (96.8 vs. 67.6%) were significantly higher in IPF-CA compared with lone IPF (p<0.05). The odds ratio of smoking was 4.7 compared with non smoking IPF controls. The lung cancer was located more frequently in the upper lobe and 55.5% was in the periphery of lung. The cancer was developed in the fibrotic lesion in 23 patients (35.9%), and in the majority of the patients, the cancer was separated from the fibrosis. The cell type of the lung cancer in IPF-CA was squamous cell carcinoma 34.9%, adenocarcinoma 30.2%, small cell carcinoma 19.0%, large cell undifferenciated carcinoma 6.3%, and others 9.5%. No significant difference in the distribution of histologic type of the lung cancer was found between IPF-CA and lone lung cancer. There was no significant difference in demographic features, cell types, location and the stage of the cancer between the group with concurrent IPF-CA and the group with cancer diagnosed during the follow up of IPF. There was a tendency (but statistically not significant : p=0.081) of higher incidence of adenocarcinoma among the cancers developed in the fibrotic area(43.5%) (F-CA) than in the cancers in non-fibrotic area (22.5%) (NF-CA). The prognosis of the patients with F-CA was poor (median survival : 4 months) compared with the patients with NF-CA (7 months, p=0.013), partly because the prevalence of severe IPF (the extent of fibrosis in HRCT 50%) was higher in F-CA group. Conclusion : These data suggest that the lung cancer in the patients with IPF has similar features to the ordinary lung cancer.

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Studies on the Rice Yield Decreased by Ground Water Irrigation and Its Preventive Methods (지하수 관개에 의한 수도의 멸준양상과 그 방지책에 관한 연구)

  • 한욱동
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.16 no.1
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    • pp.3225-3262
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    • 1974
  • The purposes of this thesis are to clarify experimentally the variation of ground water temperature in tube wells during the irrigation period of paddy rice, and the effect of ground water irrigation on the growth, grain yield and yield components of the rice plant, and, furthermore, when and why the plant is most liable to be damaged by ground water, and also to find out the effective ground water irrigation methods. The results obtained in this experiment are as follows; 1. The temperature of ground water in tube wells varies according to the location, year, and the depth of the well. The average temperatures of ground water in a tubewells, 6.3m, 8.0m deep are $14.5^{\circ}C$ and $13.1^{\circ}C$, respercively, during the irrigation period of paddy rice (From the middle of June to the end of September). In the former the temperature rises continuously from $12.3^{\circ}C$ to 16.4$^{\circ}C$ and in the latter from $12.4^{\circ}C$ to $13.8^{\circ}C$ during the same period. These temperatures are approximately the same value as the estimated temperatures. The temperature difference between the ground water and the surface water is approximately $11^{\circ}C$. 2. The results obtained from the analysis of the water quality of the "Seoho" reservoir and that of water from the tube well show that the pH values of the ground water and the surface water are 6.35 and 6.00, respectively, and inorganic components such as N, PO4, Na, Cl, SiO2 and Ca are contained more in the ground water than in the surface water while K, SO4, Fe and Mg are contained less in the ground water. 3. The response of growth, yield and yield components of paddy rice to ground water irrigation are as follows; (l) Using ground water irrigation during the watered rice nursery period(seeding date: 30 April, 1970), the chracteristics of a young rice plant, such as plant height, number of leaves, and number of tillers are inferior to those of young rice plants irrigated with surface water during the same period. (2) In cases where ground water and surface water are supplied separately by the gravity flow method, it is found that ground water irrigation to the rice plant delays the stage at which there is a maximum increase in the number of tillers by 6 days. (3) At the tillering stage of rice plant just after transplanting, the effect of ground water irrigation on the increase in the number of tillers is better, compared with the method of supplying surface water throughout the whole irrigation period. Conversely, the number of tillers is decreased by ground water irrigation at the reproductive stage. Plant height is extremely restrained by ground water irrigation. (4) Heading date is clearly delayed by the ground water irrigation when it is practised during the growth stages or at the reproductive stage only. (5) The heading date of rice plants is slightly delayed by irrigation with the gravity flow method as compared with the standing water method. (6) The response of yield and of yield components of rice to ground water irrigation are as follows: \circled1 When ground water irrigation is practised during the growth stages and the reproductive stage, the culm length of the rice plant is reduced by 11 percent and 8 percent, respectively, when compared with the surface water irrigation used throughout all the growth stages. \circled2 Panicle length is found to be the longest on the test plot in which ground water irrigation is practised at the tillering stage. A similar tendency as that seen in the culm length is observed on other test plots. \circled3 The number of panicles is found to be the least on the plot in which ground water irrigation is practised by the gravity flow method throughout all the growth stages of the rice plant. No significant difference is found between the other plots. \circled4 The number of spikelets per panicle at the various stages of rice growth at which_ surface or ground water is supplied by gravity flow method are as follows; surface water at all growth stages‥‥‥‥‥ 98.5. Ground water at all growth stages‥‥‥‥‥‥62.2 Ground water at the tillering stage‥‥‥‥‥ 82.6. Ground water at the reproductive stage ‥‥‥‥‥ 74.1. \circled5 Ripening percentage is about 70 percent on the test plot in which ground water irrigation is practised during all the growth stages and at the tillering stage only. However, when ground water irrigation is practised, at the reproductive stage, the ripening percentage is reduced to 50 percent. This means that 20 percent reduction in the ripening percentage by using ground water irrigation at the reproductive stage. \circled6 The weight of 1,000 kernels is found to show a similar tendency as in the case of ripening percentage i. e. the ground water irrigation during all the growth stages and at the reproductive stage results in a decreased weight of the 1,000 kernels. \circled7 The yield of brown rice from the various treatments are as follows; Gravity flow; Surface water at all growth stages‥‥‥‥‥‥514kg/10a. Ground water at all growth stages‥‥‥‥‥‥428kg/10a. Ground water at the reproductive stage‥‥‥‥‥‥430kg/10a. Standing water; Surface water at all growh stages‥‥‥‥‥‥556kg/10a. Ground water at all growth stages‥‥‥‥‥‥441kg/10a. Ground water at the reproductive stage‥‥‥‥‥‥450kg/10a. The above figures show that ground water irrigation by the gravity flow and by the standing water method during all the growth stages resulted in an 18 percent and a 21 percent decrease in the yield of brown rice, respectively, when compared with surface water irrigation. Also ground water irrigation by gravity flow and by standing water resulted in respective decreases in yield of 16 percent and 19 percent, compared with the surface irrigation method. 4. Results obtained from the experiments on the improvement of ground water irrigation efficiency to paddy rice are as follows; (1) When the standing water irrigation with surface water is practised, the daily average water temperature in a paddy field is 25.2$^{\circ}C$, but, when the gravity flow method is practised with the same irrigation water, the daily average water temperature is 24.5$^{\circ}C$. This means that the former is 0.7$^{\circ}C$ higher than the latter. On the other hand, when ground water is used, the daily water temperatures in a paddy field are respectively 21.$0^{\circ}C$ and 19.3$^{\circ}C$ by practising standing water and the gravity flow method. It can be seen that the former is approximately 1.$0^{\circ}C$ higher than the latter. (2) When the non-water-logged cultivation is practised, the yield of brown rice is 516.3kg/10a, while the yield of brown rice from ground water irrigation plot throughout the whole irrigation period and surface water irrigation plot are 446.3kg/10a and 556.4kg/10a, respectivelely. This means that there is no significant difference in yields between surface water irrigation practice and non-water-logged cultivation, and also means that non-water-logged cultivation results in a 12.6 percent increase in yield compared with the yield from the ground water irrigation plot. (3) The black and white coloring on the inside surface of the water warming ponds has no substantial effect on the temperature of the water. The average daily water temperatures of the various water warming ponds, having different depths, are expressed as Y=aX+b, while the daily average water temperatures at various depths in a water warming pond are expressed as Y=a(b)x (where Y: the daily average water temperature, a,b: constants depending on the type of water warming pond, X; water depth). As the depth of water warning pond is increased, the diurnal difference of the highest and the lowest water temperature is decreased, and also, the time at which the highest water temperature occurs, is delayed. (4) The degree of warming by using a polyethylene tube, 100m in length and 10cm in diameter, is 4~9$^{\circ}C$. Heat exchange rate of a polyethylene tube is 1.5 times higher than that or a water warming channel. The following equation expresses the water warming mechanism of a polyethylene tube where distance from the tube inlet, time in day and several climatic factors are given: {{{{ theta omega (dwt)= { a}_{0 } (1-e- { x} over { PHI v })+ { 2} atop { SUM from { { n}=1} { { a}_{n } } over { SQRT { 1+ {( n omega PHI) }^{2 } } } } LEFT { sin(n omega t+ { b}_{n }+ { tan}^{-1 }n omega PHI )-e- { x} over { PHI v }sin(n omega LEFT ( t- { x} over {v } RIGHT ) + { b}_{n }+ { tan}^{-1 }n omega PHI ) RIGHT } +e- { x} over { PHI v } theta i}}}}{{{{ { theta }_{$\infty$ }(t)= { { alpha theta }_{a }+ { theta }_{ w'} +(S- { B}_{s } ) { U}_{w } } over { beta } , PHI = { { cpDU}_{ omega } } over {4 beta } }}}} where $\theta$$\omega$; discharged water temperature($^{\circ}C$) $\theta$a; air temperature ($^{\circ}C$) $\theta$$\omega$';ponded water temperature($^{\circ}C$) s ; net solar radiation(ly/min) t ; time(tadian) x; tube length(cm) D; diameter(cm) ao,an,bn;constants determined from $\theta$$\omega$(t) varitation. cp; heat capacity of water(cal/$^{\circ}C$ ㎥) U,Ua; overall heat transfer coefficient(cal/$^{\circ}C$ $\textrm{cm}^2$ min-1) $\omega$;1 velocity of water in a polyethylene tube(cm/min) Bs ; heat exchange rate between water and soil(ly/min)

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Radiation Dose-escalation Trial for Glioblastomas with 3D-conformal Radiotherapy (3차원 입체조형치료에 의한 아교모세포종의 방사선 선량증가 연구)

  • Cho, Jae-Ho;Lee, Chang-Geol;Kim, Kyoung-Ju;Bak, Jin-Ho;Lee, Se-Byeoung;Cho, Sam-Ju;Shim, Su-Jung;Yoon, Dok-Hyun;Chang, Jong-Hee;Kim, Tae-Gon;Kim, Dong-Suk;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.237-246
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    • 2004
  • Purpose: To investigate the effects of radiation dose-escalation on the treatment outcome, complications and the other prognostic variables for glioblastoma patients treated with 3D-conformal radiotherapy (3D-CRT). Materials and Methods: Between Jan 1997 and July 2002, a total of 75 patients with histologically proven diagnosis of glioblastoma were analyzed. The patients who had a Karnofsky Performance Score (KPS) of 60 or higher, and received at least 50 Gy of radiation to the tumor bed were eligible. All the patients were divided into two arms; Arm 1, the high-dose group was enrolled prospectively, and Arm 2, the low-dose group served as a retrospective control. Arm 1 patients received $63\~70$ Gy (Median 66 Gy, fraction size $1.8\~2$ Gy) with 3D-conformal radiotherapy, and Arm 2 received 59.4 Gy or less (Median 59.4 Gy, fraction size 1.8 Gy) with 2D-conventional radiotherapy. The Gross Tumor Volume (GTV) was defined by the surgical margin and the residual gross tumor on a contrast enhanced MRI. Surrounding edema was not included in the Clinical Target Volume (CTV) in Arm 1, so as to reduce the risk of late radiation associated complications; whereas as in Arm 2 it was included. The overall survival and progression free survival times were calculated from the date of surgery using the Kaplan-Meier method. The time to progression was measured with serial neurologic examinations and MRI or CT scans after RT completion. Acute and late toxicities were evaluated using the Radiation Therapy Oncology Group neurotoxicity scores. Results: During the relatively short follow up period of 14 months, the median overall survival and progression free survival times were $15{\pm}1.65$ and $11{\pm}0.95$ months, respectively. The was a significantly longer survival time for the Arm 1 patients compared to those in Arm 2 (p=0.028). For Arm 1 patients, the median survival and progression free survival times were $21{\pm}5.03$ and $12{\pm}1.59$ months, respectively, while for Arm 2 patients they were $14{\pm}0.94$ and $10{\pm}1.63$ months, respectively. Especially in terms of the 2-year survival rate, the high-dose group showed a much better survival time than the low-dose group; $44.7\%$ versus $19.2\%$. Upon univariate analyses, age, performance status, location of tumor, extent of surgery, tumor volume and radiation dose group were significant factors for survival. Multivariate analyses confirmed that the impact of radiation dose on survival was independent of age, performance status, extent of surgery and target volume. During the follow-up period, complications related directly with radiation, such as radionecrosis, has not been identified. Conclusion: Using 3D-conformal radiotherapy, which is able to reduce the radiation dose to normal tissues compared to 2D-conventional treatment, up to 70 Gy of radiation could be delivered to the GTV without significant toxicity. As an approach to intensify local treatment, the radiation dose escalation through 3D-CRT can be expected to increase the overall and progression free survival times for patients with glioblastomas.