From October 1989 to March 1992, ten patients diagnosed as primary central nervous system (CNS) lymphoma were treated with radiation therapy at Asan Medical Center. To obtain pathologic diagnosis, five patients had stereotactic biopsy and the others underwent craniotomy & tumor removal. According to the classification by International Working Formulation, seven of 10 patients showed diffuse large cell types and the remaining 3 had diffuse mixed cell types. Computed tomographic scans of the brain disclosed solitary (6 cases) or multiple (4 cases) intracranial lesions. All patients received 4000 cGy/20 fx to the whole brain followed by an additional 2000 cGy/10 fx boost to the primary lesion. Six patients with initial cerebrospinal fluid (CSF involvement were treated with whole brain irradiation and intrathecal Methotrexate (IT-MTX) chemotherapy. One of them received an additional spinal irradiation after 3 cycles of IT-MTX chemotherapy because of MTX induced arachnoiditis. One patient received 3 cycles of systemic chemotherapy prior to rodiation therapy and one received 5 cycles of salvage chemotherapy for recurrence. With a median follow up time of 8 months, all patients were followed from 7 to 26 months. Radiologically seven patients showed complete remission and the remaining three showed partial remission at one month after radiotherapy. The 1 and 2 year survival rate was $86{\%}\;and\;69{\%}$ respectively. Until now, two patients expired at 7 and 14 months. These patients developed extensive CSF seeding followed by local failure. Considering initial good response to radiation therapy and low incidence of extraneural dissemination in primary CNS lymphoma, we propose to increase total tumor dose to the primary lesion by hyperfractionated radiotherapy or stereotactic radiosurgery. For the patients with CSF involvement at diagnosis, we propose craniospinal irradiation with IT MTX chemotherapy.
Kim Jae Young;Cho Chul Koo;Shim Jae Won;Yoo Seong Yul;Kim Mi Sook;Yun Hyong Geun
Radiation Oncology Journal
/
v.14
no.4
/
pp.307-315
/
1996
Purpose : The authors conducted a retrospective analysis of patients with the carcinoma of uterine cervix treated with curative radiation therapy to evaluate the prognostic factors that would affect the results of the therapy and to get the critical ideas in determining more aggressive treatment schedule. Methods and Materials : From January 1987 to December 1988. Four hundreds and sixty patients with uterine cervical carcinomas treated with radiotherapy at KCCH were registered to this retrospective study. One hundred and three patients were treated with external radiation therapy alone, and 357 patients were treated with external radiation followed by low dose rate intracavitary radiation therapy. The follow-up rate was 88% and median follow-up duration was 48 months. Results : The overall 5 year survival rate of the patients was 67.7%, and when classified by FIGO stages, 5 year survival rates were 81.2%, 76.3%, 73.1%, 50%. 52.3%, 11.5% for stages Ib, IIa, IIb, IIIa, IVa respectively. Tumor size(p=0.0002), endocervical growth pattern(p=0.003), lymph node invasion(p=0.0001), mean hemoglobin level(p=0.0001), and pathologic cell type(p=0.0001) were significant prognostic factors and decrease in survival for young age patient group was marginally important (p=0.03). Conclusion : Significant prognostic factors in the radiation therapy of the uterine cervical carcinoma were tumor size, growth pattern of tumor, lymph node invasion, pathologic cell type, hemoglobin level of patients during treatment and lower survival rate in young age group was obvious, too. Patients with large size tumor(${\geq)$4cm), especially combined with endocervical growth patterns or advanced stages(III or more) need more aggressive treatment to improve the outcome of treatment. And positive feature of lymph node invasion affected the result of therapy, so improvement in the diagnostic and therapeutic trial is essential.
Lee, Sue Young;Cho, Sung Hee;Kim, Sun Mi;Jeong, Dae Chul;Chung, Seung Yeon;Lee, Kyung Yil;Kang, Jin Han
Pediatric Infection and Vaccine
/
v.11
no.1
/
pp.90-100
/
2004
Objective : Urinary tract infection(UTI) is a frequent serious bacterial infection in young infants. The clinical presentation may be non-specific and variable, depends on factors such as the age and the level of infection. Children with renal involvement may be at risk of permanent renal damage. Experimental studies have shown that renal lesions caused by acute febrile UTI may be prevented or diminished by early diagnosis and treatment. Therefore, it is important to find a method that can permit early diagnosis and identification of patients who are at risk for progressive renal damage. We designed this study to identify related factors in culture positive UTI infants, and also to identify related factors in culture negative UTI infants, who are febrile with pyuria, by using renal imaging and functional studies including renal sonography, DMSA scan and VCUG. Methods : Retrospectively analyzed the medical records of 136 febrile infants with pyuria over 2 years(from January 2001 to February 2003). Urine culture was done in all cases, and regardless of urine culture findings, renal imaging study was done if symptomatic UTI suspected. Results : Total 57 organisms were isolated in 53 patients. E. coli was the most common organism(86%), followed by E. faecalis, M. morganii, Proteus species, P. aeruginosa, S. aureus and E. fergusonii. Most of the isolates had high sensitivity on cephalosporins or amikacin and had low sensitivities on aminopenicillins. Abnormal acute phase DMSA scan or VCUG findings were seen in both urine culture positive and negative group without statistical differences(P>0.05). In febrile infants with pyuria, fever over 48 hours, older age and high CRP related to abnormal acute phase DMSA scan findings regardless urine culture results. Conclusion : 1st or 3rd generation cephalosporins with amikacin could be the first choice of treatment for UTI. Febrile infants with positive urine culture dose mean urinary tract infection but not acute pyelonephritis which directly relates to cortical damage which could be confirmed by acute phase DMSA scan. Even cases with negative urine culture findings, acute pyelonephritis should be concerned in febrile infants with pyuria who are older than 3 months of age, has fever over 48 hours or high CRP level. And in such cases, acute phase DMSA scan and VCUG should be evaluated for early treatment and long term prognosis.
Purpose: CA 19-9 need to examine a number of sample volume, and the postwar 200 U/ml concentration hook effect appears slight. Thus, the antibody-antigen reaction, and by reducing the amount of (sample volume), they can hook effect to minimize the impact of the sample volume and relevance know, I saw the hook effect. In addition, the current maximum of using the standard concentration of the reagent in 240 U/ml increase more than the standard concentration can be seen knows. Material and Method: 5 U/ml and under, make a few low concentration of serum pool from the high concentration of the sample hook effect together with a standard concentration of about 500 to meet the production. The reagents used in experiments are currently using SNUH NM experiment. Orignal method along with the experiment is to 25 ul sample volume (1 / 4), 50 ul (1 / 2), 100 ul (Orignal method) in the experiment. My greatest concentration of the reagent concentration of approximately two times the standard concentration of production. When was the last to make the first experiment, as measured by the standard concentration after that. The new inspection information through a standard solution modified by entering values in them. Results: 100 ul, and to apply the new standard concentration y = 1.3021x - 10.97, $R^2$ = 0.9844. Overall, the results showed a similar orignal method. Because of the concentration in the value of more than 240 U/ml, but it is an overall value that can be made out of a similar value When I put the 50 ul y = 1.045x + 9.5861, $R^2$ = 0.9428. Overall orignal method and the results of a similar value. 50 ul, and to apply the new standard concentration y=1.2006x+11.252, $R^2$=0.9423. Showing a slightly lower value compared with orignal method. Because of the concentration in the value of more than 240 U/ml, but it is an overall value that can be made out of a similar value. When I put the man 25 ul y=0.6012x+24.755, $R^2$=0.4033. Results showed that very small amounts of sample are insecure inside and showed a lower middle cpm orignal method and showed a lot of mismatched. Conclusions: 25 ul of the sample volume is not possible to use the instability had, when I put the 50 ul of the orignal method can be used to show a similar concentration. The new values are slightly lower concentration, The new values are slightly lower concentration, concentration, which are likely due to the lack of data has had a little gap between the sample showed 80 to 200 U/ml additional experiments seem to do. Apply a new 100 ul concentration values are applied to a large crowd is not even in sight. But this way the concentration of 100 to more 400 U/ml gather further experiments should possible adds.
The purpose of this study was to introduce the toxicological study review to evaluate the safety of PDMS on the 69th JECFA meeting. Polydimethylsiloxane is a polymer and its ADI was established at 23rd JECFA meeting in 1979. The ADI was maintained although the specification was expanded at its 26th, 29 th, 37 th meetings. Recently, it was reported that PDMS with low molecular weight and viscosity has high absorption rate and different toxicity, so it was submitted at 69th meeting. Toxicological studies of PDMS were submitted from the sponsor and additional information is collected from a document searching. The toxicological studies were reviewed in accordance with the 'Guidelines for the preparation of toxicological working papers for the Joint FAO/WHO Expert Committee on Food Additives'. In the available acute, sub-chronic and chronic toxicity studies on PDMS, dose-related increases in incidence and severity of ocular lesions(corneal crystal, inflammation of the corneal epithelium etc.) were consistently observed after oral dosing. It seems to be a local irritant effect, but the mechanism by which the ocular lesions arose is unclear, although the lack of absorption of PDMS indicates that it is unlikely to be a direct systemic effect. Consequently, the relevance of the ocular lesions for food use of PDMS could not be determined. The ADI of PDMS was re-established from 0-1.5 mg/kg bw/day to 0-0.8 mg/kg bw/day by applying additional safety factor 2 based on its ocular toxicity. The result of 0-0.8 mg/kg bw/day is a temporary ADI until further data are provided to 2010.
Kim, Tae-Man;Ku, Ji-Young;Dho, Ho-Seog;Cho, Chun-Hyung;Ko, Jae-Hun
Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
/
v.14
no.4
/
pp.343-356
/
2016
The Korea Radioactive Waste Agency (KORAD) has developed a dual-purpose metal cask for the dry storage of spent nuclear fuel that has been generated by domestic light-water reactors. The metal cask was designed in compliance with international and domestic technology standards, and safety was the most important consideration in developing the design. It was designed to maintain its integrity for 50 years in terms of major safety factors. The metal cask ensures the minimization of waste generated by maintenance activities during the storage period as well as the safe management of the waste. An activation evaluation of the main body, which includes internal and external components of metal casks whose design lifetime has expired, provides quantitative data on their radioactive inventory. The radioactive inventory of the main body and the components of the metal cask were calculated by applying the MCNP5 ORIGEN-2 evaluation system and by considering each component's chemical composition, neutron flux distribution, and reaction rate, as well as the duration of neutron irradiation during the storage period. The evaluation results revealed that 10 years after the end of the cask's design life, $^{60}Co$ had greater radioactivity than other nuclides among the metal materials. In the case of the neutron shield, nuclides that emit high-energy gamma rays such as $^{28}Al$ and $^{24}Na$ had greater radioactivity immediately after the design lifetime. However, their radioactivity level became negligible after six months due to their short half-life. The surface exposure dose rates of the canister and the main body of the metal cask from which the spent nuclear fuel had been removed with expiration of the design lifetime were determined to be at very low levels, and the radiation exposure doses to which radiation workers were subjected during the decommissioning process appeared to be at insignificant levels. The evaluations of this study strongly suggest that the nuclide inventory of a spent nuclear fuel metal cask can be utilized as basic data when decommissioning of a metal cask is planned, for example, for the development of a decommissioning plan, the determination of a decommissioning method, the estimation of radiation exposure to workers engaged in decommissioning operations, the management/reuse of radioactive wastes, etc.
Lee Ji-Eun;Lee Hyun-Ok;Paik Kyung-Hoon;Lee Suk-Hyang;Jin Dong-Kyu
Childhood Kidney Diseases
/
v.8
no.1
/
pp.33-42
/
2004
Purpose : Children with nephrotic syndrome(NS) are under high risk for metabolic bone disease(MBD) as a complication of long-term glucocorticoid therapy. We prospectively evaluated the effect of oral bisphosphonate(alendronate) therapy in children with NS, which has proven efficacy in adult patients with glucocorticoid induced MBD. Methods : Among 58 children with NS, aged 5 to 8 years and haying a disease duration of more than 2 years, 30(51.7%) were enrolled to meet the selection criteria, less than -1.0 Z-scores of lumbar spine bone mineral density(BMD) by dual energy X-ray absorptiometry (DEXA). These 30 children were divided into three groups and each were assigned to receive alendronate, calcitriol, and no-medication, respectively for one year. Lumbar spine BMD was followed up every 6 months and the biochemical indexes were measured before and 1 year after the treatment. There were no significant difference among groups with respect to the average age, the initial BMD, and the cumulative steroid doses. Analysis of the treatment efficacy was done by the % change of BMD and by the changes in Z-scores of lumbar spine BMD. Results : Mean age and disease duration of patients at the initial lumbar spine BMD evaluation was $7.4{\pm}1.7$ years and $2.2{\pm}1.2$ years, respectively. Twenty-three of 30 children(76%) had osteopenia, and seven(23%) had osteoporosis. There was no difference in the biochemical values among the groups, before and 1 year after the treatment(P<0.05). Twenty two children(73.3%) with frequent relapsing or steroid dependant NS had more frequent MBD, compared to the 8 children(26.6%) with infrequent relapsing NS. The one year % changes of BMD were 8.56 in alendronate group, 5.79 in calcitriol group, and 1.9 in no-medication group. The changes in Z-score of lumbar spine BMD increased in the alendronate group and the calcitriol group, but not in the no-medication group. One year % changes of BMD were different among groups(P=0.0002). Significant differences were found between the alendronate and the no-medication group, and between the calcitriol and the no-medication group(P<0.05). There was no difference between the alendronate and the calcitriol group. No serious adverse effect was observed in the alendronate group. Conclusion : Children with NS receiving high dose steroids are under the high risk of BMD and should undergo regular BMD evaluation. Z-score of lumbar spine BMD was a useful parameter in diagnosing low bone mass in children. Alendronate weekly oral therapy was effective and relatively safe in increasing the lumbar spine BMD in children with NS having steroid induced MBD.
Timing and placement of fertilizer applications are two managerial means to improve the fertilizer use efficiency. The relative importance of these two means is determined by the application rate. With the realistic rate of N application recommended to the small farmers in the tropics, at present and in the near future, basal application in right manner, seems to be more important than split application at different times. In wetland rice soils, deep placement by whatever available means is desirable. But in the situations where perfect deep placement is very difficult to implement, the whole-layer application may be worth trying, until better methods become available. In rainfed uplands, N fertilizer application plans should be contingent upon the amount and distribution of rainfall: apply a less risky rate as subsurface banding near the crop rows to start with; then, depending upon the rainfall prospects in the season, apply or omit the additional dose. Because the patterns of crop response to N fertilizer can be significantly different between the research farms and farmers' fields, it seems imperative to have information on the patterns of crop response to N under farmers' management conditions, for the development of realistic fertilizer application recommendations. To enable the farmers to adopt improved fertilizer application technologies, it is essential to develop and make available to farmers convenient fertilizer applicators. Past experience with the improved fertilizer use technologies indicates that, in the long run, the development of fertilizers that are not only effective and convenient for farmers to use but also easy to produce without major modifications of existing fertilizer production systems is the ultimate solution to the problem of low N fertilizer use efficiency.
Keum Ki Chang;Lee Chang Geol;Chung Eun Ji;Lee Sang Wook;Kim Woo Cheol;Chang Sei Kyung;Oh Young Taek;Suh Chang Ok;Kim Gwi Eon
Radiation Oncology Journal
/
v.13
no.4
/
pp.377-383
/
1995
Purpose : To obtain the optimal treatement method in patients with endometrial carcinoma(clinical stage FIGO I, II) by comparative analysis between preoperative radiotherapy (pre-op RT) and postoperative radiotherapy (post-op RT). Material and Methods : A retrospective review of 62 endometrial carcinoma patients referred to the Yonsei Cancer Center for radiotherapy between 1985 and 1991 was undertaken. Of 62 patients, 19 patients(Stagel : 12 patients. Stagell;7 patients) received pre-op RT before TAH(Total Abdominal Hysterectomy) and BSO (Bilateral Salphingoophorectomy) (Group 1) and 43 patients(Stage 1;32 patients, Stage 2; 11 patients) received post-op RT after TAH and BSO (Group 2). Pre-op irradiation was given 4-6 weeks prior to surgery and post-op RT administered on 4-5 weeks following surgery. All patients except 1 patient(Group 2: ICR alone) received external irradiation. Seventy percent(13/19) of pre-op RT group and 54 percent(23/42) of post-op RT group received external pelvic irradiation and intracavitary radiation therapy(ICR). External radiation dose was 39.6-55 Gy(median 45 Gy) in 5-6. 5weeks through opposed AP/PA fields or 4-field box technique treating daily, five days per week, 180 cGy per fraction. ICR doses were prescribed to point A(20-39.6 Gy, median 39 Gy) in Group 1 and 0.5cm depth from vaginal surface (18-30 Gy,median 21 Gy) in Group 2. Results : The overall 5 year survival rate was $95{\%}$. No survival difference between pre-op and post-op RT group.($89.3{\%}$ vs $97.7{\%}$, p>0.1) There was no survival difference by stage, grade and histology between two groups. The survival rate was not affected by presence of residual tumor of surgical specimen after pre-op RT in Group 1 (p>0.1), but affected by presence of lymph node metastasis in post-op RT group(P<0.5). The complication rate of pre-op RT group was higher than post-op RT. ($16{\%}$ vs $5{\%}$) Conclusion : Post-op radiotherapy offers the advantages of accurate surgical-pathological staging and low complication rate.
Purpose : To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radio-therapy, a retrospective analysis was undertaken. Materals and Methods : I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radio-therapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dese rate intracavitary radiation. Results : Overall 5 year survival rate and relapse free survival rate were $75.4\%,\;73.5\%$, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node matastasis. tumor size and vaginal resection margin involvement were significant prognostic factos. Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only $56\%$ and nine of twenty two patients recurred. Conculsion : Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and /or other methods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen.
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