• Radiation Oncology Journal
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• v.26 no.2
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• pp.104-112
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• 2008

Purpose: To assess the toxicity and tumor response induced by $DCVac/IR^{(R)}$ dendritic cell(DC) immunotherapy combined with irradiation for refractory colorectal cancer patients with multiple liver metastases. Materials and Methods: Between May 2004 and November 2006, applicants from a pool of refractory colorectal cancer patients with multiple liver metastases were enrolled. The patients were registered after having signed the informed consent form, which had been approved by the Institutional Review Board from the Dong-A University and Busan National University Hospital. DCs were obtained from peripheral blood of each patient, and then cultured in vitro. A total of $6{\times}10^6$ DCs were packed into a vial($DCVac/IR^{(R)}$, 0.5 ml) at the convenience of each patient's schedule. On the day before and on the day of each vaccination, each patient received a 4 Gy radiation dose to the target tumor. On the day of vaccination, the indicated dose of autologous DCs was injected into the irradiated tumor using ultrasound-guided needle injection procedures. A total of four vaccinations were scheduled at three 2-week intervals and one 4 week interval at the Dong-A University and Busan National University Hospital. If the tumor status was deemed to be stable or responding to therapy, an additional vaccination dose or two was approved at 4 week intervals beyond the fourth immunization. A tolerance test for DCs was conducted by injecting a range of doses($3{\times}10^6\;to\;12{\times}10^6$ DCs) after the 3rd injection. Moreover, the maximal tolerable dose was applied to additional patients. Treatment safety was evaluated in all patients who had at least one injection. Treatment feasibility was evaluated by the 10th week by assessing the response of patients having at least 4 injections. For systemic toxicities, the evaluation was performed using the National Cancer Institute Common Toxicity Criteria, whereas adverse effects were recorded using common WHO toxicity criteria. Results: Of the 24 registered patients, 22 received the DCs injections. Moreover, of the 14 patients that applied for the tolerance test, only 11 patients completed it because 3 patients withdrew their testing agreement. A grade 3 or more side effect, which was possibly related to the DC injection, did not occur in additional patients. The $12{\times}10^6$ DC injection was identified as the maximum tolerable dose, and was then injected in an additional 8 patients. Patients tolerated the injection fairly well, with no fatal side effects. In order to assess the feasibility of DC immunotherapy, the response was evaluated in other hepatic lesions outside of the targeted hepatic lesion. The response evaluation was performed in 15 of the 17 patients who received at least 4 injections. Stable and progressive disease was found in 4 and 11 patients, respectively. Conclusion: The DC-based immunotherapy and radiotherapy is theoretically synergistic for the local control and systemic control. The $DCVac/IR^{(R)}$ immunotherapy combined with irradiation was tolerable and safe in the evaluated cases of refractory colorectal cancer with multiple liver metastases. Future work should include well designed a phase II clinical trials.

• Journal of Genetic Medicine
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• v.7 no.2
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• pp.125-132
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• 2010

Purpose: Preimplantation genetic diagnosis (PGD), also known as embryo screening, is a pre-pregnancy technique used to identify genetic defects in embryos created through in vitro fertilization. PGD is considered a means of prenatal diagnosis of genetic abnormalities. PGD is used when one or both genetic parents has a known genetic abnormality; testing is performed on an embryo to determine if it also carries the genetic abnormality. The main advantage of PGD is the avoidance of selective pregnancy termination as it imparts a high likelihood that the baby will be free of the disease under consideration. The application of PGD to genetic practices, reproductive medicine, and genetic counseling is becoming the key component of fertility practice because of the need to develop a custom PGD design for each couple. Materials and Methods: In this study, a survey on the contents of genetic counseling in PGD was carried out via direct contact or e-mail with the patients and specialists who had experienced PGD during the three months from February to April 2010. Results: A total of 91 persons including 60 patients, 49 of whom had a chromosomal disorder and 11 of whom had a single gene disorder, and 31 PGD specialists responded to the survey. Analysis of the survey results revealed that all respondents were well aware of the importance of genetic counseling in all steps of PGD including planning, operation, and follow-up. The patient group responded that the possibility of unexpected results (51.7%), genetic risk assessment and recurrence risk (46.7%), the reproduction options (46.7%), the procedure and limitation of PGD (43.3%) and the information of PGD technology (35.0%) should be included as a genetic counseling information. In detail, 51.7% of patients wanted to be counseled for the possibility of unexpected results and the recurrence risk, while 46.7% wanted to know their reproduction options (46.7%). Approximately 96.7% of specialists replied that a non-M.D. genetic counselor is necessary for effective and systematic genetic counseling in PGD because it is difficult for physicians to offer satisfying information to patients due to lack of counseling time and specific knowledge of the disorders. Conclusions: The information from the survey provides important insight into the overall present situation of genetic counseling for PGD in Korea. The survey results demonstrated that there is a general awareness that genetic counseling is essential for PGD, suggesting that appropriate genetic counseling may play a important role in the success of PGD. The establishment of genetic counseling guidelines for PGD may contribute to better planning and management strategies for PGD.

• Journal of radiological science and technology
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• v.31 no.1
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• pp.17-23
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• 2008

Purpose : Because there is a difference depending on the environment as for an inspection equipment the important part of bone density scan and the precision/accuracy of a tester, the management of quality must be made systematically. The equipment failure caused by overload effect due to the aged equipment and the increase of a patient was made frequently. Thus, the replacement of equipment and additional purchases of new bonedensity equipment caused a compatibility problem in tracking patients. This study wants to know whether the clinical changes of patient's bonedensity can be accurately and precisely reflected when used it compatiblly like the existing equipment after equipment replacement and expansion. Materials and methods : Two equipments of GE Lunar Prodigy Advance(P1 and P2) and the Phantom HOLOGIC Spine Road(HSP) were used to measure equipment precision. Each device scans 20 times so that precision data was acquired from the phantom(Group 1). The precision of a tester was measured by shooting twice the same patient, every 15 members from each of the target equipment in 120 women(average age 48.78, 20-60 years old)(Group 2). In addition, the measurement of the precision of a tester and the cross-calibration data were made by scanning 20 times in each of the equipment using HSP, based on the data obtained from the management of quality using phantom(ASP) every morning (Group 3). The same patient was shot only once in one equipment alternately to make the measurement of the precision of a tester and the cross-calibration data in 120 women(average age 48.78, 20-60 years old)(Group 4). Results : It is steady equipment according to daily Q.C Data with $0.996\;g/cm^2$, change value(%CV) 0.08. The mean${\pm}$SD and a %CV price are ALP in Group 1(P1 : $1.064{\pm}0.002\;g/cm^2$, $%CV=0.190\;g/cm^2$, P2 : $1.061{\pm}0.003\;g/cm^2$, %CV=0.192). The mean${\pm}$SD and a %CV price are P1 : $1.187{\pm}0.002\;g/cm^2$, $%CV=0.164\;g/cm^2$, P2 : $1.198{\pm}0.002\;g/cm^2$, %CV=0.163 in Group 2. The average error${\pm}$2SD and %CV are P1 - (spine: $0.001{\pm}0.03\;g/cm^2$, %CV=0.94, Femur: $0.001{\pm}0.019\;g/cm^2$, %CV=0.96), P2 - (spine: $0.002{\pm}0.018\;g/cm^2$, %CV=0.55, Femur: $0.001{\pm}0.013\;g/cm^2$, %CV=0.48) in Group 3. The average error${\pm}2SD$, %CV, and r value was spine : $0.006{\pm}0.024\;g/cm^2$, %CV=0.86, r=0.995, Femur: $0{\pm}0.014\;g/cm^2$, %CV=0.54, r=0.998 in Group 4. Conclusion: Both LUNAR ASP CV% and HOLOGIC Spine Phantom are included in the normal range of error of ${\pm}2%$ defined in ISCD. BMD measurement keeps a relatively constant value, so showing excellent repeatability. The Phantom has homogeneous characteristics, but it has limitations to reflect the clinical part including variations in patient's body weight or body fat. As a result, it is believed that quality control using Phantom will be useful to check mis-calibration of the equipment used. A value measured a patient two times with one equipment, and that of double-crossed two equipment are all included within 2SD Value in the Bland - Altman Graph compared results of Group 3 with Group 4. The r value of 0.99 or higher in Linear regression analysis(Regression Analysis) indicated high precision and correlation. Therefore, it revealed that two compatible equipment did not affect in tracking the patients. Regular testing equipment and capabilities of a tester, then appropriate calibration will have to be achieved in order to calculate confidential BMD.

• Korean Journal of Soil Science and Fertilizer
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• v.10 no.3
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• pp.171-188
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• 1977

The response and effect on main upland crops to potassium were discussed and summarized as follows. 1. Adequate average amounts of potash per 10a were 32kg for forage crop; 22.5kg for vegetable crops; 17.3kg for fruit trees; 13.3kg for potatoes; and 6.5kg for cereal crops. Demand of potassium fertilizer in the future will be increased by expanding the acreage of forage crops, vegetable crops and fruit trees. 2. On the average, optimum potash rates on barley, wheat, soybean, corn, white potato and sweet potato were 6.5, 6.9, 4.5, 8.1, 8.9, and 17.7kg per 10a respectively. Yield increaments per 1kg of potash per 10a were 4-5kgs on the average for cereal crops, 68kg for white potato, and 24kg for sweet potato. 3. According to the soil testing data, the exchangeable potassium in the coastal area was higher than that in the inland area and medium in the mountainous area. The exchangeable potassium per province in decreasing order is Jeju>Jeonnam>Kangweon>Kyongnam. Barley : 4. The response of barley to an adequate rate of potassium seemed to be affected more by differences in climatic conditions than to the nature of the soil. 5. The response and the adequate rate of potassium in the southern area, where the temperature is higher, were low because of more release of potassium from the soil. However, the adequate rate of phosphorus was increased due to the fixation of applied phosphorus into the soil in high temperature regions. The more nitrogen application would be required in the southern area due to its high precipitation. 6. The average response of barley to potassium was lower in the southern provinces than northern provinces. Kyongsangpukdo, a southern province, showed a relatively higher response because of the low exchangeable potassium content in the soil and the low-temperature environment in most of cultivation area. 7. Large annual variations in the response to and adequate rates of potassium on barley were noticed. In a cold year, the response of barley to potassium was 2 to 3 times higher than in a normal year. And in the year affected by moisture and drought damage, the responses to potassium was low but adequate rates was higher than cold year. 8. The content of exchangeable potassium in the soil parent materials, in increasing order was Crystalline Schist, Granite, Sedimentary and Basalt. The response of barley to potash occurred in the opposite order with the smallest response being in Crystalline Schist soil. There was a negative correlation between the response and exchangeable potassium contents but there was nearly no difference in the adequate rates of potassium. 9. Exchangeable potassium according to the mode of soil deposition was Alluvium>Residium>Old alluvium>Valley alluvium. The highest response to potash was obtained in Valley alluvium while the other s showed only small differences in responses. 10. Response and adequate rates of potassium seemed to be affected greatly by differences in soil texture. The response to potassium was higher in Sandy loam and Loam soils but the optimum rate of potassium was higher in Clay and Clay loam. Especially when excess amount of potassium was applied in Sandy loam and Loam soils the yield was decreased. 11. The application of potassium retarded the heading date by 1.7 days and increased the length of culm. the number of spikelet per plant, the 1,000 grain weight and the ratio of grain weight to straw. Soybean : 12. Average response of soybean to potassium was the lowest among other cereal crops but 28kg of grain yield was incrased by applying potash at 8kg/10a in newly reclaimed soils. 13. The response in the parent materials soil was in the order of Basalt (Jeju)>Sedimentay>Granite>Lime stone but this response has very wide variations year to year. Corn : 14. The response of corn to potassium decreased in soils where the exchangeable potassium content was high. However, the optimum rate of applied potassium was increased as the soil potassium content was increased because corn production is proportional to the content of soil potassium. 15. An interaction between the response to potassium and the level of phosphorus was noted. A higher response to potassium and higher rates of applied potassium was observed in soils contained optimum level of phosphorus. Potatoes : 16. White potato had a higher requirement for nitrogen than for potassium, which may imply that potato seems to have a higher capability of soil potassium uptake. 17. The yield of white potato was higher in Sandy loam than in Clay loam soil. Potato yields were also higher in soils where the exchangeable potassium content was high even in the same soil texture. However, the response to applied potassium was higher in Clay loam soils than in Sandy loam soils and in paddy soil than in upland soil. 18. The requirement for nitrogen and phosphorus by sweet potato was relatively low. The sweet potato yield is relatively high even under unfavorable soil conditions. A characteristics of sweet potatoes is to require higher level of potassium and to show significant responses to potassium. 19. The response of sweet potato to potassium varied according to soil texture. Higher yields were obtained in Sandy soil, which has a low exchangeable potassium content, by applying sufficient potassium. 20. When the optimum rate of potassium was applied, the yields of sweet potato in newly reclaimed soil were comparable to that in older upland soils.