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Clinical features of congenital muscular torticollis (선천성 근성 사경의 임상적 특징)

  • Jun, Ji Eun;Ryu, Hye Kyeong;Shim, Jae Won;Shim, Jung Yeon;Jung, Hye Lim;Park, Moon Soo;Kim, Deok-Soo
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.241-247
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    • 2007
  • Purpose : Congenital muscular torticollis (CMT) is a common and benign congenital disorder of the musculoskeletal system in neonates and infants. The pathophysiology is that the sternocleidomastoid muscle (SCM) is shortened on the involved side by fibrosis, leading to ipsilateral tilt and contralateral rotation of the face and chin. In this study, we investigated the clinical features of CMT, the role of ultrasonography (USG) in prediction of prognoses and the clinical significance of early detection and treatment. Methods : Forty seven patients (M:F=31:16) were diagnosed as a CMT between March 2003 and May 2006. We reviewed age at diagnosis, physical findings, USG findings, treatment and therapeutic outcome from their medical records. Results : The median age at diagnosis was 90 days (18 days-9 years, 7 months) and the right side of neck was affected in more patients (right : left=26:21). Of 24 patients with a palpable neck mass, 21 had USG; 19 cases showed sternocleidomastoid tumor (SMT). In cases with no neck mass, USG was performed in 11 patients; seven had postural torticollis (POST), three had SMT and one had muscular torticollis (MT). Among 40 patients with follow-up, 36 had total resolution. There was negative correlation between the age at diagnosis and the recovery time, whereas the final outcome was not correlated with USG findings. However, the patients without positive findings in USG had earlier resolution (1 month vs 2.6 months, P=0.0008). The patients with SMT had earlier diagnosis and excellent outcomes. The patients with MT were delayed to diagnosis and had the longest time to resolve. Lastly, the patients with POST had delayed diagnoses, but they had excellent outcomes. Conclusion : Since the patients with delayed diagnoses, in despite of benign courses, may take a long time to resolve and rarely need surgical treatment, it is important to diagnose and treat early. This study showed that USG findings of the SCM may be used as predictive factors.

Optimization for the Physical Properties of Steamed Foam Cakes Prepared with Single-stage Method by Response Surface Methodology (반응표면 분석법에 의한 단단계법 거품형 찜 케이크의 물리적 특성의 최적화)

  • Kwhak, Sung-Ho;Jang, Myung-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.4
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    • pp.557-566
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    • 2005
  • In preparation of steamed foam-cakes, effects of whipping time, amount of wheat flour, and amounts of emulsifier on physical properties of the steamed foam cakes were investigated using RSM (response surface methodology). The three independent variables selected for the RSM experiment were whipping time $(X_1)$, amount of wheat flour $(X_2)$, and amounts of wheat flour $(X_2)$, and concentration of emulsifier $(X_3)$ were set for single-stage mixing, respectively. A rotatable central composite design was used for treatment arrangement. The responses from the product for loaf volume, color values and textural properties were analysed. In the analysis of variance for the foam cakes prepared by single-stage method, significant interactions were observed between independent variables (experimental factors) and physical property like loaf volume (p<0.05); textural properties like hardness, gumminess, and chewiness (p<0.05). Among independent variables, concentration of emulsifier had the most effects on physical properties while whipping time. The ordinary points in surface response showed maximal points with physical property like colorimetric b value while other properties revealed saddle points. The 3-dimensional response surface graphs of the predicted regression models displayed decreasing loaf volumes with increasing whipping times and emulsifier concentrations beyond optimum levels. The optimum conditions for best loaf volume and textural property (hardness, gummimess and chewiness) of the products selected by extracting intersectional areas of the contour maps that commonly overlapped all characteristics were; $11\~13$ min whipping time, $470\~486\;g$ amount of wheat flour, and $19\~20\;g$ emulsifier concentration, in case of single-stage method. The median values extracted from the RSM experimental results for optimum manufacturing conditions for single-stage method, i.e., 12 min whipping time, 478 g amount of wheat flour, and 20 g emulsifier concentration were empirically proven to fit the predicted levels of physical properties from the final foam cakes.

Studies on the Acute Toxicity of an Insecticide Cartap to Several Species of Freshwater Animals (몇가지 담수산동물(淡水産動物)에 대한 살충제 Cartap의 급성독성(急性毒性)에 관한 연구(硏究))

  • Byun, Sang-Ji;Choi, Seung-Yoon;Kim, Gwang-Po
    • Korean Journal of Environmental Agriculture
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    • v.3 no.2
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    • pp.43-49
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    • 1984
  • The acute toxicity of an insecticide cartap to several species of freshwater animals was evaluated in the laboratory with special reference to the species specificity, effects of water temperatures and pH values. The aquatic animals tested were the Carassius auratus L., Aphyocypris chinensis $G{\"{U}}NTHER$, Misgurus anguillicaudatus CANTOR, Moina macrocopa STRAUS. The susceptibility of aquatic animals to cartap was different with the species of animals. At the water temperature of $25^{\circ}C$ and pH 7, TLm values of the insecticide to the C. auratus L., A. chinensis G. and M. anguillicaudatus were 0.88, 0.26 and 0.13 ppm in 48 hours, respectively, and to Moina macrocopa S., 306 ppm in 3 hrs. In the case of the three species of fish, TLm 48 values were significantly decreased with rise in temperature. In the case of water flea, where TLm value was 107 ppm at $20^{\circ}C$, there was no consistent response to temperature change, with the highest figure at $25^{\circ}C$ than at either 20 or $30^{\circ}C$. and the susceptibility of C.auratus L. and A. chinensis G. greatly decreased with the increase of pH in water. The toxicity to M. anguillicaudatus and M. macrocopa was significantly higher at pH 9 than at pH 6 or 7. In conclusion, the toxicological reactions of the freshwater animals to cartap were variably influenced by the water temperatures and pH values of water and species of animals.

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Toxicity Test of Carbosulfan and Phenthoate on Killifish (Carbosulfan과 Phenthoate의 송사리(Oryzias latipes, Medaka)에 대한 독성시험)

  • Bae, Chul-Han;Lee, Jeong-Seok;Cho, Kyung-Won;Park, Hyun-Ju;Cho, Dong-Hun;Shin, Kwan-Seop;Jung, Chang-Kook;Park, Yeon-Ki
    • The Korean Journal of Pesticide Science
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    • v.8 no.4
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    • pp.309-318
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    • 2004
  • Acute toxicity test and chronic toxicity test were conducted with killifish (Oryzias latipes, Medaka) to evaluate toxicity effect of pesticides. Acute toxicity test was investigated mortality in 48 hours and 96 hours after treatment, chronic toxicity test was examined with the early life stage of 30 days after hatching be started embryos of Medaka. The test substances were two pesticides, Carbosulfan and Phenthoate, applied to the paddy rice plant and well-known to the high fish toxicity. As the result of acute toxicity test, median concentration $(LC_{50})$ at 96 hours in Medata was Carbosulfan 0.102 mg/L and Phenthoate 0.167 mg/L, and Fish early life stage toxicity test was conducted on basis of the result of acute toxicity test and concluded from the investigation of hatching success, period of hatching, survival post hatching, length and weight of surviving fishes and abnormal fish. The results of early life stage toxicity test were represented by no observed effect concentration (NOEC), lowest observed effect concentration (LOEC) and maximum acceptable toxicant concentration (MATC). NOEC was Carbosulfan 0.0067ppm and Phenthoate 0.011ppm, LOEC of PCP-Na, Carbosulfan and Phenthoate were 0.017ppm and 0.029ppm, MATC of Carbosulfan and Phenthoate were 0.011ppm and 0.018ppm. These studies will be expected to supply more varied chronic toxicity effects at lower concentration than acute toxicity test. Therefore, evaluation data will be more realistic and the risk assessment of pesticide will be leveled up.

Combined Treatment of Residual, Recurrent and Unresectable Gastric Cancer (수술후 잔존 위암, 재발성 위암 및 절제 불가능한 위암의 병용 요법)

  • Bae, Hoon-Sik
    • Radiation Oncology Journal
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    • v.8 no.1
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    • pp.85-93
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    • 1990
  • A series of 25 patients with residual, recurrent, and unresectable gastric cancer received various combination of surgery, radiotherapy (RT), chemotherapy (CT), and hyperthermia (HT). They were placed into 7 categories; 1) CT and HT-14 patients; 2) RT and HT-15 patients; 3) surgery, RT and HT-2 patients; 4) surgery, RT, HT and CT-1 patient; 5) RT, HT and CT -1 patient; 6) RT and CT-1 patient; 7) RT alone-1 patient. Three patients had curative resection. 21 patients received irradiation with tightly contoured portals to spare as much small bowel, kidney and marrow as possible. Hyperthermia was applied regionally once or twice a week for 23 patients using 8 MHz radiofrequency capacitive heating device (Thermotron RF-8). HT was given approximately 30 min after RT 7 patients were treated with CT: 4 patients received HT and concomitant Mitomycin-C; 3 patients received HT and sequential 5-FU+Adriamycin+Mitomycin-C. There was not any treatment related deaths. There was also no evidence of treatment related problems with liver, kidney, stomach, or spinal cord except only one case of transient diabetic ketoacidosis. The tumor response was evaluable in 22 patients. None achieved complete remission.11 ($50\%$) achieved partial remission. The response rate was correlated with total radiation dose and achieved maximum temperature. 9 of 14 ($64\%$) received more than 4000 cGy showed partial remission; especially, all 3 patients received more than 5500 cGy achieved partial response.8 of the 12 patients ($67\%$) who achieved maximal temperature more than $41^{\circ}C$ showed partial response in comparing with $25\%$ (2 of 8 patients, below $41^{\circ}C$). The numbers of HT, however, was not correlated with the response. 3 of the 25 patients ($12\%$) remain alive. The one who was surgically unresectable and underwent irradiation alone is in progression of the disease with distant metastases. The remaining two patients with curative resection are alive with free of disease, 24 and 35 months, respectively. The median survival by response are 11.5 months in responders and 4.6 months in non-responders.

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Radical Radiotherapy for Carcinoma of the Prostate (전립선암의 근치적 방사선치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.40-44
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    • 2001
  • Purpose : To evaluate effect and tolerance of external beam radiotherapy for carcinoma of the prostate and define the optimal radiotherapeutic regimen. Materials and methods : We retrospectively analyzed the records of 60 patients with prostate cancer who were treated with external beam radiotherapy with curative intent in our institution between September, 1987 and March, 2000. Histologic diagnosis was established by transurethral resection or ultrasonography guided biopsy. The major presenting symptoms were a nodule at routine prostatic examination and frequency and urgency of urination, along with dysuria. The median age was 63 years with range of 51 to 87 years. There were 6 patients in Stage A, 20 in Stage 8, 26 in Stage C, and 8 in Stage Dl. All patients were treated with megavoltage equipment producing 10 MV photons. The 4 field pelvic brick technique was used to a dose of 45 Gy or 50.4 Gy at 1.8 Gy per day in 5 to 6 weeks, after which a small boost field was delivered 2.0 Gy per day to a total dose of 66 to 70 Gy. The follow-up period ranged from 1 to 8 years. Results : Actuarial 5-year and 7-year survival rates for Stage A, B, C, and D1 were $100\%\;and\;84\%$, $83\%\;and\;72\%$, $67\%\;and\;54\%$, and $v$, respectively. The corresponding 5-year and 7-year relapse free survival rates were $84\%\;and\;84\%$, $77\%\;and\;67\%$, $48\%\;and\;40\%$, and $33\%\;and\;25\%$, respectively. Relapse free 5-year survival rates for Stage B were $80\%,\;80\%,\;and\;50\%$ for well, moderately, and poorly differentiated tumors, respectively. These were $64\%,\;44\%,\;and\;33\%$ for Stage C, respectively. The local control rates at 5 years were $84\%,\;85\%,\;78\%,\;and\;60\%$ for Stage A, B, C, and D1, respectively. Mild to moderate complications were observed in $22\%$ of patients. Severe complications requiring surgical procedures were documented in only $3\%$ of patients. Conclusion : This study confirms that external beam irradiation is an effective and safe treatment for prostatic cancer, providing long-term local control and good survival with acceptable complications.

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Preliminary Results of Management for Primary CNS Lymphoma (원발성 중추신경계 림프종의 치료에 관한 예비적 결과)

  • Ahn, Seung-Do;Chang, Hye-Sook;Choi, Eun-Kyong
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.79-82
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    • 1993
  • 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.

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Postirradiation Changes of White Blood Cells and Lymphocyte Subpopulations in Cancer Patients (암환자의 방사선치료에서 흉부 및 전골반강 조사직후 백혈구 및 림프구아헝 변화에 대한 연구)

  • Ahn, Sung-Ja;Chung, Woong-Ki;Nam, Taek-Keun;Nah, Byung-Sik;Noh, Young-Hee
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.53-59
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    • 1996
  • Purpose : Radiation-induced alteration in the immune function is well known phenomenon in cancer patients. Our purpose is to evaluate the extent of immune suppression immediately after mediastinal or pelvic irradiation, which include significant volume of active bone marrow in adults. Materials and Methods'48 cancer patients with mediastinal(N=29) and pelvic irradiation(N=19) were the basis of this analysis. Age ranged from 36 to 76 and mean and median value was 57 years, respectively Sex ratio was 1.3(M: F=27/21). The immunological parameters were the complete blood cell(CBC) with differential cell(D/C) count, T cell subset(CD3, CD4, CD8 CDl9), NK cell test(CDl6, CD56), and serum immunoglobulin(IgG, IgA, IgM) level. Results : The mean value of white blood cell(WBC) was reduced from 7017 to 4470 after irradiation(p=0.0000). In the differential count, the number of lymphocyte, neutrophil, and basophil was markedly reduced with statistical significance(p<0.01) and the number of monocyte was not changed and, on the contrary, that of eosinophil was increased by irradiation. In the lymphocyte subpopulation analysis, the number of all subpopulations, CD3(T cell), CD4(helper T cell), CD8(suppressor T cell), CDl6(NK cell), CDl9(B, cell) was reduced with statistical significance. The mean ratio of CD4 to CD8 in all patients was 1.09 initially and reduced to 0.99 after radiotherapy(p=0.34) , but the proportional percentage of all subpopulations was not changed except CD19(B cell) after irradiation. In the immunoglobulin study, initial values of Ig G, Ig A, and Ig M were relatively above the normal range and the only Ig M was statistically significantly reduced after radiotherapy(p=0.02). Conclusion : Mediastinal and pelvic irradiation resulted in remarkable suppression of lymphocyte count in contrast to the relatively good preservation of other components of white blood cells. But the further study on the functional changes of lymphocyte after radiotherapy may be necessary to conclude the effects of the radiation on the immunity of the cancer Patients.

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Short-term Results of Endobronchial Brachytherapy for Malignant Airway Obstructions (악성 기도 폐쇄에 대한 기관내 근접 조사 방사선치료의 단기 임상 경험)

  • Ahn Yong Chan;Lim Do Hoon;Choi Dong Rak;Kim Moon Kyung;Kim Dae Yong;Huh Seung Jae;Kim Ho Joong;Chung Man Pyo;Kwon O Jung;Rhee Chong Heon
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.299-306
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    • 1996
  • Purpose : Respiratory symptoms related with malignant airway disease have been the main causes of lowered qualify of life and also sometimes may be life-threatening if not properly managed. The authors report the short-term experiences of endobronchial brachytherapy for symptomatic malignant airway obstruction using high dose rate after-loading brachytherapy unit. Materials and Methdos : Twenty-five Patients with symptomatic malignant airway obstruction were treated with endobronchial brachytherapy between the period of December 1994 and March 1996 at Department of Radiation Oncology of Samsung Medical Center Twenty-one ($84\%$) were patients with non-small cell lung cancer, three with tracheal malignancies, and one with recurrence of esophageal cancer. Twenty Patients were given elective external beam radiation therapy, while six were given endobronchial laser evaporation therapy on emergency bases in addition to endobronchial brachytherapy. Three procedures for each patient were planned and total of 70 procedures were completed. Results : Improvement rates of major respiratory symptoms after endobronchial brachytherapy procedures were $88\%$(22/25). $96\%$(22/23), $100\%$ (15/15), and $100\%$(9/9) for cough, dyspnea, hemoptysis and obstructive pneumonia, respectively. ECOG performance scores were improved in $56\%$ of total patients group, while there was no case with worsened ECOG score. Fifteen patients died and the median interval from the start of treatment to death was 4 months (range: $1\~17$ months), while that of ten survivors was 9 months (range $5\~19$ months). There were five patients with controlled intrathoracic disease, who have survived over one rear. All deaths were associated with uncontrolled local and/or distant disease. Four Patients died of massive fatal hemoptysis, three of who received emergency endobronchial laser evaporation therapy before the start of endobronchial brachytherapy. Conclusion : Endobronchial brachytherapy has been confirmed as an excellent palliative treatment modality improving respiratory symptoms as well as patients' general performance status. Based on the current observations, use of endobronchial brachytherapy in curative setting as a boost technique may be warranted.

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Pattern of Decrease of Prostate Specific Antigen after Radical Radiotherapy for the Prostate Cancer (전립선암 환자에서 방사선치료 루 전립선특이항원 농도 변화 양상)

  • Kim Bo-Kyoung;Park Suk Won;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.136-140
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    • 1999
  • Purpose : Prostate specific antigen (PSA) is a useful tumor marker, which is widely used as a diagnostic index and predictor of both treatment and follow-up result in prostate cancer. A prospective analysis was carried out to obtain the period of PSA normalization and the half life of PSA and to analyze the factors influencing the period of PSA normalization. The PSA level was checked before and serially after radical radiotherapy. Materials and Method : Twen쇼 patients with clinically localized prostate cancer who underwent radical external beam radiotherapy were enrolled in this study. Accrual period was from April 1993 to May 1998. Median follow-up period was 20 months. Radiotherapy was given to whole pelvis followed by a boost to prostate. Dose range for the whole pelvis was from 45 Gy to 50 Gy and boost dose to prostate, from 14 Gy to 20 Gy. The post-irradiation PSA normal value was under 3.0 ng/ml. The physical examination and serum PSA level evaluation were performed at 3 month interval in the first one year, and then at every 4 to 6 months. Results : PSA value was normalized in nineteen patients (95%) within 12 months. The mean period of PSA normalization was 5.3 (${\pm}$2.7) months. The half life of PSA Of the nonfailing patients was 2.1 (${\pm}$0.9) month. The nadir PSA level Of the nonfailing Patients waS 0.8 (${\pm}$0.5) ng/ml. The period of PSA normalization had the positive correlation with pretreatment PSA level (R$^{2}$=0.468). The nadir PSA level had no definite positive correlation with the pretreatment PSA level (R$^{2}$=0.075). The half life of serum PSA level also had no definite correlation with pretreatment PSA level (R$^{2}$=0.029). Conclusion :The PSA level was mostly normalized within 8 months (85%). If it has not normalized within 12 months, we should consider the residual disease in prostate or distant metastasis. In 2 patients, the PSA level increased 6 months or 20 months before clinical disease was detected. So the serum PSA level can be used as early diagnostic indicator of treatment failure.

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