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Treatment Outcome for Nasopharyngeal Carcinoma in University Malaya Medical Centre from 2004-2008

  • Ee Phua, Vincent Chee;Loo, Wei Hoong;Yusof, Mastura Md;Ishak, Wan Zamaniah Wan;Tho, Lye Mun;Ung, Ngie Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4567-4570
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    • 2013
  • Background: Nasopharyngeal carcinoma (NPC) is the commonest radiocurable cancer in Malaysia. This study aimed to determine the treatment outcomes and late effects of radiotherapy for NPC patients treated in University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with NPC referred for treatment to the Oncology unit at UMMC from 2004-2008 were retrospectively analyzed. Treatment outcomes were 5 years overall survival (OS), disease free survival (DFS), cause-specific survival (CSS), locoregional control (LRC) and radiotherapy-related late effects. The Kaplan-Meier method was used for survival analysis and differences in survival according to AJCC stage was compared using the log-rank test. Results: A total of 176 patients with newly diagnosed NPC were treated in UMMC during this period. Late presentation was common, with 33.5% presenting with T3-4 disease, 84.7% with N1-3 disease and 75.6% with AJCC stage 3-4 disease. Radical RT was given to 162 patients with 22.7% having RT alone and 69.3% having CCRT. The stipulated OTT was 7 weeks and 72.2% managed to complete their RT within this time period. Neoadjuvant chemotherapy was given to 14.8% while adjuvant chemotherapy was administered to 16.5%. The 5 years OS was 51.6% with a median follow up of 58 months. The 5 years OS according to stage were 81.8% for stage I, 77.9% for stage II, 47.4% for stage III and 25.9% for stage IV. The 5 years overall CSS, DFS and LRC were 54.4%, 48.4% and 70.6%, respectively. RT related late effects were documented in 80.2%. The commonest was xerostomia (66.7%). Other documented late effects were hearing deficit (17.3%), visual deficit (3.1%), neck stiffness (3.1%), dysphagia (3.4%), cranial nerve palsy (2.5%), pneumonitis (0.6%) and hypothyroidism (1.2%). Conclusions: The 5 years OS and LRC in this study are low compared to the latest studies especially those utilizing IMRT. Implementation of IMRT for NPC treatment should be strongly encouraged.

Application of tylosin antibiotics to olive flounder (Paralichthys olivaceus) infected with Streptococcus parauberis

  • Joo, Min-Soo;Hwang, Seong Don;Choi, Kwang-Min;Kim, Yoon-Jae;Hwang, Jee Youn;Kwon, Mun-Gyeong;Jeong, Ji-Min;Seo, Jung Soo;Lee, Ji Hoon;Lee, Hee-Chung;Park, Chan-Il
    • Fisheries and Aquatic Sciences
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    • v.23 no.8
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    • pp.20.1-20.18
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    • 2020
  • Background: Olive flounder, Paralichthys olivaceus, is an economically important aquaculture species in Korea. Olive flounders have been heavily damaged by streptococcal infections every year and are treated with antibiotics. However, antibiotic abuse is causing the emergence of resistant strains, and to overcome this, research has shown that new antibiotics must be applied. Tylosin is a relatively safe antibiotic and has good activity against Gram-positive bacteria and mycoplasma. We studied the therapeutic effects and side effects of tylosin on Streptococcus parauberis-infected olive flounder. Methods: After artificial infection of olive flounder with S. parauberis SPOF18J3, an appropriate dose of tylosin was confirmed by intramuscular injection (I.M.) at 2.5, 5, 10, and 15 mg/kg, and oral administration at 10 and 20 mg/kg. After I.M. and oral administration dosing of tylosin, side effects were confirmed by serological analysis, histopathological analysis, and median lethal dose (LD50) analysis at both an appropriate concentration and a high concentration. Statistical analysis was performed using one-way analysis of variance (ANOVA) and Tukey's test (p < 0.05). Results: The appropriate I.M. and oral administration concentration of tylosin administered to olive flounder infected with S. parauberis SPOF18J3 was found to be 10 mg/kg. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were showed not significantly different between the control group and the experimental groups. The histopathologic results showed mild inflammatory responses in muscle and tubular vacuolization and tubular atrophy appeared, but there were no significant differences between the groups. The LD50 was confirmed to be 461 mg/kg. Conclusion: In this study, an effective treatment method was provided by verifying the treatment effects and side effects of tylosin in olive flounder infected with S. parauberis, which can be applied directly to aquaculture sites. In addition, these results may be used as a reference for evaluation required upon request to obtain approval for tylosin antibiotics as fishery antibiotics in Korea. After approval, it is possible that a fishery disease manager will be able to prescribe and sell the antibiotic tylosin.

Prognostic value of neutrophil-to-lymphocyte ratio in locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy

  • Park, Eun Young;Kim, Yeon-Sil;Choi, Kyu Hye;Song, Jin Ho;Lee, Hyo Chun;Hong, Sook-Hee;Kang, Jin-Hyoung
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.166-175
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    • 2019
  • Purpose: This study aimed to investigate neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic factors in patients with locally advanced non-small cell lung cancer (NSCLC) who received concurrent chemoradiotherapy (CCRT). Materials and Methods: We retrospectively analyzed 66 patients with locally advanced NSCLC treated with definitive CCRT. Among these patients, 95% received paclitaxel/carboplatin or docetaxel/cisplatin. The median radiation dose was 66 Gy in 33 fractions. The NLR and PLR before/after CCRT were evaluated. The maximally selected log-rank test was used to obtain the cutoff values related to the overall survival (OS). Results: Patients with high post-CCRT NLR (>3.12) showed worse OS, locoregional progression-free survival (LRPFS), and distant metastasis-free survival (DMFS) than those with low NLR (2-year OS: 25.8% vs. 68.2%, p < 0.001; 2-year LRPFS: 12.9% vs. 33.8%, p = 0.010; 2-year DMFS: 22.6% vs. 38.2%, p = 0.030). Patients with high post-CCRT PLR (>141) showed worse OS and LRPFS than those with low PLR (2-year OS: 37.5% vs. 71.1%, p = 0.004; 2-year LRPFS: 16.5% vs. 40.3%, p = 0.040). Patients with high NLR change (>1.61) showed worse OS and LRPFS than those with low NLR change (2-year OS: 26.0% vs. 59.0%, p < 0.001; 2-year LRPFS: 6.8% vs. 31.8%, p = 0.004). The planning target volume (hazard ration [HR] = 2.05, p = 0.028) and NLR change (HR = 3.17, p = 0.025) were the significant factors for OS in the multivariate analysis. Conclusion: NLR change after CCRT was associated with poor prognosis of survival in patients with locally advanced NSCLC. An elevated NLR after CCRT might be an indicator of an increased treatment failure risk.

The Role Of Tumor Marker CA 15-3 in Detection of Breast Cancer Relapse After Curative Mastectomy (유방암 환자에서 근치적 유방 절제술 후 재발 발견에 대한 CA 15-3의 역할)

  • Hyun, In-Young;Kim, In-Ho;Lee, Moon-Hee;Kim, Chul-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.4
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    • pp.311-317
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    • 2004
  • Purpose: The purpose of this study was to determine the utility of tumor marker CA 15-3 in the following: the diagnosis of breast cancer relapse after curative mastectomy, and the differentiation or the value of tumor marker by site of metastases. Materials and Methods: Two hundred two patients (median age 48 years) with breast cancer included in the follow-up after curative mastectomy. The tumor marker CA 15-3 was determined by IRMA (CIS BIO INTERNATIONAL, France). Test values > 30 U/ml were considered elevated (positive). Results: Among 202 patients, recurrent diseases were found in 16 patients. CA 15-3 was elevated in 5 of 16 patients with recurrences. There was no false-positive patient who had elevated CA 15-3. Sensitivity and specificity of CA 15-3 for detection of breast cancer recurrence were 31%, and 100%. CA 15-3 was elevated in all of the 4 patients with liver metastases. CA 15-3 was elevated in none of the patients who relapsed with metastasis to bone-only or contralateral breast-only. Conclusion: The tumor marker CA 15-3 in the detection of breast cancer relapse after curative mastectomy is specific, but not sensitive. However, it is useful to rule out liver metastases of breast cancer, which indicates bad prognosis.

Carpal Tunnel Syndrome among Packing Workers in A Rayon Manufacturing Factory (모 사업장 포장부서 근로자들에서 발생한 수근터널증후군에 대한 조사연구)

  • Lee, Won-Jin;Lee, Eun-Il;Cha, Chul-Whan
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.26-33
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    • 1992
  • The carpal tunnel syndrome is one of the most common peripheral nerve entrapment syndromes. The typical symptoms are pain, numbness and paresthesia in the median nerve territory of the hand. Recently, it is widely recognized that occupational factor is regarded as the important cause of the carpal tunnel syndrome. Clinical study is performed in the 42 female workers who is repetitively working at packing department in a rayon manufacturing factory from November 1991 till March 1992. The study included a questionnaire, physical examinations, and the neurophysiological test. The summary of the results obtained was as follows : 1. Among 42 packing workers, 9 workers(21.4%) were diagnosed as carpal tunnel syndrome by electromyography. The affected side was bilateral in 4 workers(9.5%), right in 4 workers(9.5%), and left in one worker(2.4%). 2. Among 42 subjects, 28 workers(66.7%) complained the clinical symptoms related to carpal tunnel syndrome, 11 workers(26.2%) showed positive Phalen sign, and 7 workers(16.7%) showed positive Tinel sign. 3. Researchers regard electromyographic finding as the gold standard for diagnosis of carpal tunnel syndrome. The sensitivity and specificity of the clinical symptoms to diagnose the carpal tunnel syndrome were 0.89, 0.39 respectively. If the carpal tunnel syndrome is diagnosed by the combination of the positive findings of the symptoms and the physical examinations, either Tinel or Phalen sign, the sensitivity and specificity were 0.67 and 0.76 respectively. Considering above results, though this small number of workers is not adequate for epidemiologic conclusions, carpal tunnel syndrome seems to be an important occupational disorder among packing workers in a rayon manufacturing factory.

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The Local Myocardial Perfusion Rates of Right Atrial Cardioplegia in Hearts with Coronary Arterial Obstruction (관상동맥 협착을 동반한 심장에서 심근보호액 우심방 관류법의 심근 국소관류량)

  • Lee, Jae-Won;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.1-16
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    • 1992
  • The quantitatively measured local myocardial perfusion rates with microspheres are used as an objective indicator of even distribution of cardioplegic solution, and the efficacy of the retrograde right atrial route of cardioplegia is evaluated in hearts with various levels of coronary arterial obstruction. After initial antegrade cardioplegia under the median sternotomy and aortic cannulation, 60 hearts from anesthetized New Zealand white rabbits are divided in random order as normal group [ligated left main coronary artery ; MA, MR] and diagonal group [ligated proximal diagonal artery ; LA, LR]. Half of each group [N=10] are perfused with antegrade cardioplegia[A] under the pressure of 100 cmH2O and the other half with retrograde right atrial route[R] under the pressure of 60 cmH2O[St. Thomas cardioplegic solution mixed with measured amount of microspheres]. The myocardium is subdivided into segments as A[atria], RV[right ventricle]. S[septum], LV[normally perfused left ventricular free wall], ROI[ischemic myocardium of left ventricular free wall]. LV and RQI are further divided into N[subendocardium] and P[subepicardium]. The resulting local myocardial perfusion rates and N /P of each group are compared with Wilcoxon rank sum test. The weight of the hearts is 5.94$\pm$0.66g, and there are no statistically significant dif-ferences[p>0.05, ANOVA] between six compared group. The mean flow rate[F: ml /g / min] of MR group is comparable with MA group[p>0.05], but in N and L group, there are significantly depressed F with right atrial route of cardioplegia, which means elevated perfusion resistance with this route. In spite of no significant differences in delivered doses of microsphere[DEL] between compared groups[p>0.05, ANOVA], there are significantly depressed REC and NF in hearts with right atrial cardioplegia which suggests increased requirement of cardioplegic solution with this route. The interventricular septum shows poor perfusion with right atrial route of cardioplegia without obstruction of supplying coronary arteries. But, with obstruction of coronary artery supplying septum as in M group, the flow rate is superior with right atrial route of infusion. The left ventricular free wall perfusion rates of every RQI with R route are superior to that of A route[p<0.05]. But, in LV segments, there are unfavorable effects of right atrial cardioplegia in L group, although the subendocardial perfusion is well maintained in N group. The LV free wall of left main group shows depressed perfusion rates with antegrade route as compared with RQI segments of diagonal group. But, by contraries, there are increased perfusion rates and superior N /P ratio with retrograde right atrial route. It implies more effective perfusion with right atrial route of cardioplegia in more proximal coronary arterial obstruction[i.e., M group as compared with L group]. As a conclusion, all region of ischemia have superior perfusion rates with right atrial car-dioplegia as compared with antegrade route, and especially excellent results can be obtained in hearts with more proximal obstruction of coronary arteries which would otherwise result in more severe ischemic damage. But, the depressed perfusion rates of the segments with normal coronary artery in hearts with coronary arterial obstruction may be a problem of concern with right atrial cardioplegia and needs solution.

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Spatial-temporal Variations of Nitrate Levels in Groundwater of Jeju Island, Korea: Evaluation of Long-term (1993-2015) Monitoring Data (제주도 지하수질산염 농도의 시·공간적변화 특성: 장기(1993-2015) 모니터링 자료의 평가)

  • Kim, Ho-Rim;Oh, Junseop;Do, Hyun-Kwon;Lee, Kyung-Jin;Hyun, Ik-Hyun;Oh, Sang-Sil;Kam, Sang-Kyu;Yun, Seong-Taek
    • Economic and Environmental Geology
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    • v.51 no.1
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    • pp.15-26
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    • 2018
  • The spatio-temporal variations of nitrate concentrations in groundwater of Jeju Island were evaluated by an analysis of time series groundwater quality data (N = 21,568) that were collected from regional groundwater monitoring (number of wells = 4,835) for up to 20 years between 1993 and 2015. The median concentration of $NO_3-N$ is 2.5 mg/L, which is slightly higher than those reported from regional surveys in other countries. Nitrate concentrations of groundwater in wells tend to significantly vary according to different water usage (of the well), administrative districts, and topographic elevations: nitrate level is higher in low-lying agricultural and residential areas than those in high mountainous areas. The Mann-Kendall trend test and Sen's slope analysis show that nitrate concentration in mid-mountainous areas tends to increase, possibly due to the expansion of agricultural areas toward highland. On the other hand, nitrate concentrations in the Specially Designated Groundwater Quality Protection Zones show the temporally decreasing trend, which implies the efficiency of groundwater management actions in Jeju. Proper measures for sustainable groundwater quality management are suggested in this study.

Urachal Anomalies in Children (소아 요막관 기형)

  • Kang, Eun-Young;Lee, Cheol-Koo;Park, Kwan-Hyeon;Seo, Jeong-Meen;Lee, Suk-Koo
    • Advances in pediatric surgery
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    • v.11 no.2
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    • pp.150-156
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    • 2005
  • Failure of the urachus to regress completely results in anomalies that may be classified as patent urachus, urachal sinus, urachal cyst and bladder diverticula. The presenting symptoms of children with urachal anomalies are variable and uniform guidelines for diagnosis and treatment are lacking. The purpose of this study was to analyze our experience and develop conclusions regarding the presentation, diagnosis and treatment of urachal anomalies. We retrospectively analyzed the records of 32 patients who were admitted for urachal anomalies from March 1995 to February 2005. The age distribution of these patients at presentation ranged from 1 day to 14 years old (median age 1 month). There were 20 boys and 12 girls. The 32 cases comprised 13 cases of urachal sinus (40.6 %), 10 urachal cyst (31.3 %), and 9 patent urchus (28.1 %). In 30 patients ultrasonography was used for diagnosis and 2 patients with patent urachus were explored without using a diagnostic method. Twenty-three patients were confirmed by ultrasonography alone and 7 patients were examined using additional modalities, namely, computed tomography for 2 patients with an urachal cyst, magnetic resonance imaging for 1 patient with an urachal cyst, and fistulography for 3 patients with an urachal sinus. The presenting symptoms were umbilical discharge (14 patients), umbilical granuloma (8), abdominal pain and fever (3), fever (3), abdominal pain (2), and a low abdominal mass (2). Excision was performed in 29 patients, and 3 patients were conservatively managed. Urachal anomalies in children most frequently presented in neonates, and the most common complaint was umbilical discharge with infection. Urachal anomalies can be diagnosed by a physical examination and an appropriate radiographic test. Ultrasound was the most useful diagnostic method. Complete surgical excision of an urachal anomaly is recommended to avoid recurrence, and the rare development of carcinoma.

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Evaluation of marginal fidelity of copy-milled and CAD/CAM all ceramic crowns

  • Jeong Seung-Mi;Kang Dong-Wan;Wolf Christoph
    • The Journal of Korean Academy of Prosthodontics
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    • v.39 no.3
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    • pp.243-249
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    • 2001
  • Statement of the problem. The interest in all-ceramic restorations has increased as more techniques have become available. With the introduction of machinable dental ceramics and CAD/CAM systems or Copy-milling systems there is a need for evaluating the quality levels of these new fabrication techniques. Purpose. This study was to evaluate the fitting accuracy of machined all-ceramic crowns made out of an industrially prefabricated feldspathic porcelain. Material and Methods. Three master models with different cutting depth (0.8mm/1.0mm/1.2mm)were produced using a palladium-silver alloy. A total of 36 working dies, 12 of each form, was used for the modellation of prototype resin copings and 36 additional crowns, 12 of each cutting depth, were produced by using the $CEREC^{(R)}2$ system for all crowns. The maginal fit of all 72 crowns was then evaluated on their respective master die at 54 circularly staggered points of measurement per crown under a fixation pressure of 30 N by using a computerized video image system. Results. The medians of the copy-milled $CELAY^{(R)}$ crowns ranged from 29 to $36{\mu}m$. The highest value for the marginal gap was found in group B (cutting depth 1.0mm) at $107{\mu}m$. The median for the $CEREC^{(R)}2$ crowns was found between 43.5 and $70{\mu}m$. The maximum values for all three groups ranged from $181{\mu}m$ to $286{\mu}m$. With $286{\mu}m$ the highest value for marginal gap was found in group C. the Kruskal-Wallis test and multiple comparisons analysis procedure revealed a significant influence of the production technique on the marginal fit in all three groups (p<0,02). Conclusion. 1. The $CELAY^{(R)}$ system is capable to produce all-ceramic crowns with a significantly better marginal fit than the $CEREC^{(R)}2$ system. 2. As far as premolar crowns produced with the $CEREC^{(R)}2$ system are concerned, the cutting depth has a significant influence on fitting accuracy. 3. The production of crowns with an acceptable marginal fit is possible with both systems. However, adhesive luting is recommended for milled feldspathic porcelain crowns.

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Development of a Load Measurement System for Vehicles using Tire Pressure System Technology (타이어 공기압 시스템 기술을 사용한 차량의 적재중량 측정 시스템 개발)

  • Park, Jae-Hyun;Lee, Seung-Ho
    • Journal of IKEEE
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    • v.24 no.1
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    • pp.33-39
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    • 2020
  • In this paper, we propose the design technique of the vehicle's load weight measuring system using tire pressure, which is one of the physical elements of tires. The proposed technique consists of four processes: noise correction by load and vibration, gas flow correction, data mixer and weight conversion. Noise correction by load and vibration eliminates noise that increases the tire's internal pressure due to external shocks and vibrations produced by the vehicle while it is in motion. In the gas flow correction process, the noise of the internal pressure of the tire is increased due to the temperature rise of the ground with respect to the data obtained through the noise correction process due to the load and vibration. In the data mixer process, the load and pressure on the tolerances the empty, median and the full load are classified according to the change in pressure of the tire that is delivered perpendicular to the tire in the event of cargo. In the weight conversion process, weight is expressed by weight through weight conversion algorithms using noise correction results by load and vibration and gas flow correction. The weight conversion algorithm calculates the weight conversion factor, which is the slope of the linear function with respect to the load and pressure change, and converts the weight. In order to evaluate the accuracy of the loading weight measurement system of the vehicle using the tire pneumatic system technique proposed in this paper, we propose the design technique of the vehicle's load weight measuring system using tire pressure, which is one of the physical elements of tires.. Noise correction results by load and vibration and gas flow data correction results showed reliable results. In addition, repeated weight precision test showed better weight accuracy than the standard value of 90% of domestic companies.