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Low Grade Astrocytoma-Need Postoperative Radiotherapy or Not? (저분화 성상세포종-수술후 방사선치료가 필수적인가 ?)

  • Hong Seong Eon;Choi Doo Ho;Kim Tee Sung;Leem Won
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.171-180
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    • 1992
  • The precise role of radiotherapy for low grade gliomas including the optimal radiation dose and timing of treatment remains unclear. The information given by a retrosepctive analysis may be useful in the design of prospective randomized studies looking at radiation dose and time of surgical and radiotherapeutic treatment. The records of 56 patients (M:F = 29:27) with histologically verified cerebral low grade gliomas (47 cases of grade 1 or 2 astrocytomas and 9 oligodendrogliomas) diagnosed between 1979 and 1989 were retrospectively reviewed. The extent of surgical tumor removal was gross total or radical subtotal in 38 patients ($68\%$) and partial or biopsy only in the remaining 18 patients ($32\%$). Postooperative radiation therapy was given to 36 patients ($64\%$) of the total 56 patients with minimum dose of 5000 cGy (range=1250 to 7220 cGy). The 5-and 10-year survival rates for the total 56 patients were $44\%$ and $32\%$ respectively with a median survival of 4.1 years. According to the histologic grade the 5- and 10-year survivals were $52\%$ and $35\%$ for the 24 patients respectively with grade I astrocytomas compared to $20\%$ and $10\%$ for the 23 patients with grade II astrocytomas. Survival of oligodendroglioma patients was greater than those with astrocytoma ($65\%$ vs $36\%$ at 5 years), and the difference was also remarkable in the long term period of follow up ($54\%$ vs $23\%$ at 10 years). Those who received high-dose radiation therapy ($\geq$5400 cGy) had significant better survival than those who received low-dose radiation (< 5400cGy) or surgery alone (p<0.05). The 5- and 10-year survival rates were, respectively $59\%$ and $46\%$ for the 23 patients receiving high-dose radiation, $36\%$ and $24\%$ for the 13 patients receiving low-dose radiation, and $35\%$ and $26\%$ for the 20 patients with surgery alone. Survival rates by the extent of surgical resection were similar at 5 years ($46\%$ vs $41\%$), but long term survival was quite different (p<0.01) between total/subtotal resection and partial resection/biopsy ($41\%$ and $12\%$, resepctively). Previously published studies have identified important prognostic factors in these tumor: age, extent of surgery, grade, performance status, and duration of symptoms. But in our cases statistical analysis revealed that grade I histology (p<0.025) and young age (p<0.001) were the most significant good prognostic variables.

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Analysis if Somatic Cell Counts of Raw Milk in Korea -Recommendation to Payment for Milk on the Basis of Quality- (체세포수(Somatic Cell Counts)를 주로한 원유질의 평가 -원유등급제도에 의한 유질향상과 산유량 증가방안-)

  • 손봉환;강구식
    • Korean Journal of Veterinary Service
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    • v.14 no.2
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    • pp.87-103
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    • 1991
  • The somatic cell counts SCC and bacteria counts were done by D milk plant, P milk plant, S milk plant and Inch'${\v{\times}}n$ Vet. Serv. Lab from 1987 to 1990 with Coulter counter, Fossomatic 90, Bactoscan, Rolling ball viscometer and Resazurin reduction test. The results were summarized as follows 1. In the distribution of SCC of the bulk herd milk, D milk plant from Nov. 1989 to Oct. 1990 remarks 80.2% on the range below 500, 000, 14.5% ranging from 1, 000, 000 to 1, 500, 000, 1.2% ranging from 1, 500, 000 to 2, 000, 000, 0.69% ranging from 2, 000, 000 to 3, 000, 000, 0.71% on the range over 3, 000, 000. P milk plant remarks 237, 000 in the first half year and 251, 000 in the second half year in 1990 year. S milk plant remarks annual average of 335, 000 in 1987, 273, 000 in 1988 and 262, 000 in 1989. The individual record of Inch'${\v{\times}}n$ Vet. Serv Lab. remarks 79.35% and 80.2% below 500, 000 8.30% and 7.40% from 500, 000 to 1, 000, 000, 2.37% and 3.2% from 1, 000, 000 to 1, 500, 000, 2.77% and 2.30% from 1, 500, 000 to 2, 000, 000, 1.67% and 2.00% from 2, 000, 000 to 3, 000, 000, 5.53% and 4.40% over 3, 000, 000 in 1989 and 1990, respectively. The grade distirbution of SCC is as follows: D milk plant shows 1st grade-80.20%, 2nd grade-l6.5% and 3rd grade-3.30%. And P milk plant shows all 1st grade. S milk plant shows 87.30%, 8.6% and 4.1% in 1987 and 91.90%, 6.1% and 2.0% in 1988, and 92.40%, 6.1% and l.5% in 1989 on the 1st, 2nd and 3rd grade respectively. 2. The distribution of bacteria P milk plant reached 15.123 in 1st half year and 21.515 in 2nd half year. Also, S milk plant reached 81.5%, 12.5%, 6.0% in 1987, and 86.20%, 9.70%, 4.1% in 1988, and 86.2%, 10.8%, 3.0% in 1989 respectively for 1st, 2nd and 3rd grade. 3. The regional SCC distribution in D milk plant shows 1, 540, 000 in three regions and 714, 000 in one region. And monthly SCC distribution shows 671, 000 in December and 1, 165, 000 in June. 4. As a result of the individual SCC test, 9 times for 16 cows in “I”farm(1986-1988), and 6 times for 13 cows in“D”farm(1987-1988) No.3, 5, 9, 14 cows in“I”farm showed the high SCC beyond 1, 000, 000 over 4-5times. 5. If the SCC over 300, 000 reach 40%, the national producing quality of milk can be reduced by 87, 600M /I annually and in the sum of money, it should be about 35.5 billion Won. 6. The difference between high group and low group for SCC in D milk plant reached over 1, 000, 000. In case that the difference reaches 1, 000, 000 in the farm bulk milk at a farm breeding 20 cows which produce 20kg milk per day, it was estimate that the annual difference of producing quantity and sum of money respectively should be reached 26, 280kg in milk and 10, 643, 400 Won in income.

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Effect of Ischemic Preconditioning for Preventing Ischemic Injury of the Spinal Cord (척추 신경의 허혈성 손상 예방을 위한 허혈성 전처치의 효과)

  • 홍종면;차성일;송우익;홍장수;임승운;임승운;임승평
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.823-830
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    • 2001
  • Background: Paraplegia is a serious complication of thoracic or thoracoabdominal aortic operations, which is related to ischemic injury of the spinal cord induced by low perfusion pressure during cross clamping of the aorta. Ischemic preconditioning of heart or brain with reversible sublethal ischemic injury induces resistance to subsequent lethal ischemia. The aim of this study is to investigate whether ischemic tolerance could be induced by the preconditioning of the spinal cord using swine model. Material and Method: The animals were randomly assigned to three groups: sham group(n=3), control group(n=6) and pre-conditioning group(n=8). In the sham group, we performed the left thoracotomy only without any ischemic injury. In the preconditioning group, the swine received reversible spinal cord ischemic injury by aortic clamping for 20 minutes, whereas control group had no previous aortic cross- clamping. Forty-eight hours later, the aorta was clamped for 30 minutes in both groups. Neurological examination was done 24 hours later, then the animals were euthanized for histopathology and malonedialdehyde(MDA) spectrophotometry assay of the spinal cord. Result: Statistically significant difference in neurological outcome was observed between the control and preconditioning groups at 24 hours after ischemic injury. The incidence of paraplegia and severe paresis was 100% in the control group, and 62.5% in the preconditing group(p=0.028). There was no statistically significant difference in histopathology and MDA assay of the ischemic spinal cord between these two groups with borderline statistical difference in MDA assay(p=0.0745). Conclusion: In the present swine study, ischemic preconditioning could induce tolerance against 30 minute ischemic insult of the spinal cord, although the animals did not completely recover(stand-up or walk). We expect that combining this preconditioning with other currently existing protection methods might lead to a synergistic effect, which warrants further investigation.

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Surgical Result of the Modified Blalock-Taussig Shunt in Early Infancy (조기 영아기에서의 변형 블라록-타우시히 단락술의 수술 결과)

  • 이정렬;곽재건;최재성
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.573-579
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    • 2002
  • Background: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. Material and Method: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. Result: The mean age at operation was 43.0$\pm$36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). Conclusion: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.

Characteristics of Culture of Oyster Mushroom (Pleurotus ostreatus) on Addition Rate of Acer tegmentosum (산겨릅나무(Acer tegmentosum) 톱밥의 첨가량에 따른 느타리버섯의 재배적 특성)

  • Lee, Chan-Jung;Jhune, Chang-Sung;Cheong, Jong-Chun;Moon, Ji-Won;Kong, Won-Sik;Suh, Jang-Sun;Park, Gi-Chun;Shin, Yu-Su
    • The Korean Journal of Mycology
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    • v.41 no.1
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    • pp.21-27
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    • 2013
  • This study was carried out to investigated optimum mixing ratio of Korean natural Acer tegmentosum for production of functional oyster mushroom. Total nitrogen and carbon sources of Acer tegmentosum were 0.2% and 44.4%, respectively and C/N ratio was 234. Total nitrogen source and pH of substrate mixed with Acer tegmentosum were 2.7~2.9 and 4.8~5.0, respectively. The contents of $P_2O_5$, $K_2O$ and MgO at Acer tegmentosum media were higher than that of the control. Mycerial growth was the fastest at Acer tegmentosum 10%, and slower by increase of Acer tegmentosum substrate. Yields of fruiting body was the highest to 159 g/850 mL at 10% of Acer tegmentosum and dimeter and thick of pileus were the highest, too. The L value of pileus and stipes were decreased by increase of Acer tegmentosum substrate, but there was no significant difference in the a-value and the b-value. The contents of $P_2O_5$ and $K_2O$ of fruiting body were increased at Acer tegmentosum substrate, but there was no significant difference in contents of CaO, MgO and $Na_2O$.

A Study on Animation Character Face Design System Based on Physiognomic Judgment of Character Study in the Cosmic Dual Forces and the Five Elements Thoughts (음양오행(陰陽五行)사상의 관상학에 기반한 애니메이션 캐릭터 얼굴 설계 시스템 연구)

  • Hong, Soo-Hyeon;Kim, Jae-Ho
    • Journal of Korea Multimedia Society
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    • v.9 no.7
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    • pp.872-893
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    • 2006
  • In this study, I classify the elements of physiognomic judgment of character with regard to form and meaning from a visual perspective based on physiognomic judgment of character study in 'the cosmic dual forces and the Five Elements theory'. Individual characters for each type are designed using graphic data. Based on that, design system of individual characters for each personality type is investigated using Neural Network system. Faces with O-Haeng (Five Elements) shapes are shown to constitute the system with ${\pm}0.3%$ degree of error tolerance for the non-loaming input data. For the shapes of Chinese characters 'tree, fire, soil, gold and water', their MSE(Mean Square Error) are 0.3, 0.3, 0.2, 0.5, 0.2. It seems to be the best regarding the scoring system which ranges from 0 to 5. Therefore, this system might be regarded to produce the most accurate facial shape of character automatically when we input character's personality we desire to make.

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Development and Evaluation of the Supplementary Foods for Korean Infants and Children (지역 식품을 이용한 이유 보충식의 개발과 이의 영양학적 검토 및 저장성에 관한 연구)

  • Ahn, Kyung-Mi;Moon, Soo-Jae;Choi, Hong-Sik;Kwak, Tong-Kyung
    • Journal of Nutrition and Health
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    • v.18 no.4
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    • pp.259-271
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    • 1985
  • The purpose of this study was to develop supplementary foods for infants and young children in order to improve their nutritional status. Three formulas composed of rice, soybeans, fish, dry skim milk and sesame in varying proportions were studied. The three formulas, $RS_{1}S_{2}$, $RFS_{1}S_{2}$, and $RMS_{1}S_{2}$, were consisted of Rice(R), Soybean$(S_{1})$, Sesame$(S_{2})$ (60 : 35 : 5) , Rice, Fish(F), Soybean, Sesame (60 : 10 : 25 : 5) , and Rice, Dry Skin Milk (M), Soybean, Sesame (60 : 10 : 25 : 5), respectively. A proximate analysis and amino acid determination were made on the developed formulas. In the animal assay, growth rate, PER and FER were evaluated and biochemical analyses were also carried out. A storage test and the cost evaluation were also conducted. The summarized results are as follows : 1) The proximate composition of the three formulas were 7.3-7.4% of moisture, 15.9-21.5% of crude protein, 7.8-9.6% of crude fat and 2.5-2.8% ash. 2) The result of amino acid analysis showed that the 1st limiting amino acids of $RS_{1}S_{2}$ and $RFS_{1}S_{2}$ were lysine (amino acid score, 76.6) and threonine (amino acid score, 93.3), and that of $RMS_{1}S_{2}$ and the commercially prepared formula were sulfur containing amino acids (amino acid score, 82.0 and 54.4). When the contents of the amino acids of the three formulas were compared with mother's milk and cow's milk, the balance of the amino acid of each formula was superior to mother's milk but inferior to cow's milk. 3) In the animal assay, the growth rate of all groups increased gradually during the experimental period. 4) The C- PER, which was corrected on the basis of the casein PER of 2.5 was 2.99, 3.38 and 3.10 in the $RS_{1}S_{2}$, $RFS_{1}S_{2}$ and $RMS_{1}S_{2}$ respectively. The C- PER of $RFS_{1}S_{2}$ and $RMS_{1}S_{2}$ were Significantly (P<.05) higher than that of the casein. 5) The FER of the casein, $RS_{1}S_{2}$, $RFS_{1}S_{2}$, and $RMS_{1}S_{2}$ were 0.37, 0.39, 0.43 and 0.39, respectively. The FER of $RFS_{1}S_{2}$ and $RMS_{1}S_{2}$ were also significantly (P<.05) higher than that of the casein. 6) The concentrations of hematocrit, hemoglobin, total protein and albumin in the serum of the rats of all groups were not significantly different among groups. 7) The storage stability test showed that the total plate count (TPC), the coliforms count and the bacterial spore count in the ingredients were quiet low. However, after 30 and 60 days storage, the count in $RFS_{1}S_{2}$ increased and were higher at room temperature than refrigerated temperature. 8) In the cost evaluation, the cost of the developed formulas was \1,826-2,626 / kg. This was less than that of the commercially prepared formula (\3,300-4,073 / kg) and that of the imported formula (\4,250-8,720 / kg).

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Detection of Hepatic Lesion: Comparison of Free-Breathing and Respiratory-Triggered Diffusion-Weighted MR imaging on 1.5-T MR system (국소 간 병변의 발견: 1.5-T 자기공명영상에서의 자유호흡과 호흡유발 확산강조 영상의 비교)

  • Park, Hye-Young;Cho, Hyeon-Je;Kim, Eun-Mi;Hur, Gham;Kim, Yong-Hoon;Lee, Byung-Hoon
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.1
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    • pp.22-31
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    • 2011
  • Purpose : To compare free-breathing and respiratory-triggered diffusion-weighted imaging on 1.5-T MR system in the detection of hepatic lesions. Materials and Methods: This single-institution study was approved by our institutional review board. Forty-seven patients (mean 57.9 year; M:F = 25:22) underwent hepatic MR imaging on 1.5-T MR system using both free-breathing and respiratory-triggered diffusion-weighted imaging (DWI) at a single examination. Two radiologists retrospectively reviewed respiratory-triggered and free-breathing sets (B50, B400, B800 diffusion weighted images and ADC map) in random order with a time interval of 2 weeks. Liver SNR and lesion-to-liver CNR of DWI were calculated measuring ROI. Results : Total of 62 lesions (53 benign, 9 malignant) that included 32 cysts, 13 hemangiomas, 7 hepatocellular carcinomas (HCCs), 5 eosinophilic infiltration, 2 metastases, 1 eosinophilic abscess, focal nodular hyperplasia, and pseudolipoma of Glisson's capsule were reviewed by two reviewers. Though not reaching statistical significance, the overall lesion sensitivities were increased in respiratory-triggered DWI [reviewer1: reviewer2, 47/62(75.81%):45/62(72.58%)] than free-breathing DWI [44/62(70.97%):41/62(66.13%)]. Especially for smaller than 1 cm hepatic lesions, sensitivity of respiratory-triggered DWI [24/30(80%):21/30(70%)] was superior to free-breathing DWI [17/30(56.7%):15/30(50%)]. The diagnostic accuracy measuring the area under the ROC curve (Az value) of free-breathing and respiratory-triggered DWI was not statistically different. Liver SNR and lesion-to-liver CNR of respiratory-triggered DWI ($87.6{\pm}41.4$, $41.2{\pm}62.5$) were higher than free-breathing DWI ($38.8:{\pm}13.6$, $24.8{\pm}36.8$) (p value < 0.001, respectively). Conclusion: Respiratory-triggered diffusion-weighted MR imaging seemed to be better than free-breathing diffusion-weighted MR imaging on 1.5-T MR system for the detection of smaller than 1 cm lesions by providing high SNR and CNR.

The study of Intercostal Nerve Block and Patient-Controlled Analgesia for Post-Thoracotomy Pain (개흉술 후 동통억제에 대한 신경차단법 및 환자자가 치료법의 비교연구)

  • 김우종;이길노
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.920-926
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    • 1997
  • Remarkable effect of pain relief and prevention of the postoperative Complications after thoracotomy has been achieved by continuous intravenous analgesia. This study was carried out with thirty patients who underwent posterolateral thoraco tony. The patients were divided into three groups: Group I(n= 10), the patients with intermittent intramuscular analgesia(piroxicam 20 mg), Group II(n=10), the patients with continuous epidural analgesia(0.5% bupivacaine 30m1 + normal saline 30 ml + morphine 10 mg), and Group III(n= 10) the patients with controlled intravenous infusion of analgesics(fentanyl 2500 mfg +normal saline 10 ml). The results w re as follows; 1) There were no significant changes of vital signs, between groups. 2) Tidal volume and FVC were significantly improved in the group II and III compared with the group I during the first postoperative day. 3) A significant reduction of immediate post-thoracotomy pain was achieved in the group II and III compared with the group I. 4) The limitation of motion in the operative side was less in the group II and III compared with the group I. 5) A signi(icant reduction of the postoperative analgegics consumption was noticed in group II and III. 6) Significant complications were not occured during follow-up period in all groups.

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CLINICAL CHARACTERISTICS AND TREATMENT COURSES OF THE CHILDREN WITH SELECTIVE MUTISM (선택적 함구증 아동의 임상특성 및 치료경과)

  • Chung, Sun-Ju;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.74-89
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    • 1995
  • Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

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