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Conventional Radiotherapy with Concurrent Weekly Cisplatin in Locally Advanced Head and Neck Cancers of Squamous Cell Origin - a Single Institution Experience

  • Dimri, Kislay;Pandey, Awadhesh Kumar;Trehan, Romeeta;Rai, Bhavana;Kumar, Anup
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6883-6888
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    • 2013
  • Background: Platinum based concurrent chemo-radiation is the de-facto standard of care in the non-surgical management of locally-advanced head and neck cancer of squamous origin. Three-weekly single agent cisplatin at 100 $mg/m^2$ concurrent with radical radiotherapy has demonstrated consistent improvement in loco-regional control and survival. This improvement is however at the cost of considerable hematologic toxicity and poor overall compliance. The routine use of this regime is improbable in developing countries with limited resources. We therefore aimed to determine the safety and efficacy of an alternative regime of weekly cisplatin and concurrent radiotherapy in such patients. Materials and Methods: January-05 and April-12, 188 patients of locally-advanced head and neck cancer of squamous origin were treated with concurrent weekly-cisplatin at $35mg/m^2$ and conventional radiotherapy 60-66Gy/30-33 fractions/5days per week. Results: Overall, 95% patients received planned doses of RT while 74% completed within the stipulated overall treatment time of <50 days. Eighty-two percent received at-least 5 weekly cycles. Grade-III/IV mucositis was seen in 58%/9% respectively, which resulted in mean weight loss of 9.2% from a pre-treatment mean of 54.5 kg. Grade-III hematologic toxicity-0.5%; grade II nephrotoxicity-2.5% and grade III emesis-3% were also seen. Grade-III/IV subcutaneous toxicity-10%/1% and grade-III/IV xerostomia-10%/0% were observed. Complete responses at the primary site, regional nodes and overall disease were seen in 86%, 89% and 83% patients respectively. The median and 5-years disease-free survival were 26 months and 39.4% respectively, while the median and overall survival were 27 months and 41.8% respectively. Conclusions: Weekly-cisplatin at 35 $mg/m^2$ when delivered concurrently with conventional radical RT (at-least 66y/33 fractions) in locally-advanced head and neck cancer is well tolerated with minimal hematologic and neprologic toxicity and can be routinely delivered on an out-patient basis. It is an effective alternative to the standard 3-weekly cisplatin especially in the context of developing countries.

Resource Allocation Scheme for Multiple Device-to-Device Communications in a Multicell Network (다중 셀 네트워크에서 다중 D2D 통신 자원할당 기법)

  • Kim, Hyeon-Min;Kang, Gil-Mo;Shin, Oh-Soon
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.9
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    • pp.18-25
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    • 2016
  • In D2D communications underlaying a multicell network, it is of primary importance to ensure coexistence of cellular links and D2D links with minimal interference. Therefore, resource allocation scheme for D2D links should be designed to limit the interference between cellular links and D2D links. In this paper, we propose an effective resource allocation scheme for multiple D2D links which share the uplink spectrum resource with cellular users in a multicell network. Under the assumption that the locations of users are known to the base station, the proposed scheme allocates cellular resources to D2D links, such that the interference between a cellular link and multiple D2D links is minimized. In particular, we compute two constants from the path loss model and then use the constants to protect both cellular and D2D links. Simulation results are provided to verify the performance of the proposed scheme.

Effects of Infulence of Working Environment and Recognition on the Exam-Promotion Stress (경찰공무원의 근무여건 인식이 시험승진 스트레스에 미치는 영향)

  • Lee, Hyo-Min;Kim, Jong-Soo
    • The Journal of the Korea Contents Association
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    • v.9 no.3
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    • pp.256-261
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    • 2009
  • This research started with the objective to clarify how policemen are affected by promotion by test among promotion system of police which is one of the very important factors deciding the efficiency of organization through morale of policemen and which is mentioned as a factor that raises morale of policeman. The job of police is the ground of life for policemen and the place of opportunity where they can find and develop the ego. Though it is difficult to perfectly realize diverse values and desires of individuals in the organizational society which is ruled by plural values, the organization is still responsible for grasping the desire and value of individual for organization and satisfying them to the minimal level. Nobody is free from stress in the past, present and future. That is, stress can be seen as a phenomenon that inevitably occurs in any occupation and environment. The stress factor of policeman in the organization that has been discussed all the time is the deficient opportunities of promotion. Thus, it is most important to manage the stress of members in the organization so as to efficiently operate police organization. If the factor of stress perceived by the members can be grasped and diminished, the efficiency of business will be increased. The objective of this research is to reduce the stress of policemen suffering in the test promotion system by analyzing the recognition of members, to find the method reducing stress by performing empirical research and to prepare alternatives in policy in the aspect of human resources in police and management of organization.

High Frequency Plant Regeneration from Leaf Explant Cultures of Domestic Cultivated Strawberry (Fragaria x ananassa Duch) (국내 딸기 재배품종의 잎절편 배양으로부터 고빈도 식물체 재생)

  • Cho Mi-Ae;Choi Kyu-Myeong;Ko Suck-Min;Min Sung-Ran;Chung Hwa-Ji;Liu Jang-Ryol;Choi Pil-Son
    • Journal of Plant Biotechnology
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    • v.32 no.3
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    • pp.175-179
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    • 2005
  • To develop a high efficiency plant regeneration system from in vitro cultures of strawberry, cv. Yeobong, petiole and leaf explants were cultured on MS basal medium containing a combination of 0.5 mg/L IBA and 3.2 mg/L kinetin or zeatin or benzyl amino purine (BAP) for 6 weeks, and leaf explants with dark pretreatment for a week ($T_1$), 2 weeks ($T_2$), and 4 weeks ($T_3$) were cultured on medium supplemented with 0.5 mg/L IBA and 3.2 mg/L zeatin under 16 hr photoperiod for 6 weeks. Shoot organogenesis was observed from the greenish calli containing minimal anthocyanin formed at proximal cutting edges of the leaf explant (57%) when cultured adaxial side on the medium, whereas was directly formed from a cutting edges of petiole explant (6.3%). Frequency of callus formation and shoot organogenesis at large size of leaf explant ($1.0{\sim}1.5\;cm^2$) was higher than small size ($0.5{\sim}1.0\;cm^2$), and dark pretreatment significantly improved the frequency of leaf explants that produced calli and shoots. The maximum frequency (87%) for shoot organogenesis was obtained from the leaf explants that transferred to a 16 hr photoperiod condition after the initial 4 weeks dark period. The improved frequency (87%) in comparision with control without dark pretreatment (27%). When the shoots were transferred to 1/2 MS basal medium, formed roots with 20 d of culture. The rooted plants were subsequently transferred to the pots and to the field.

A Study on the Threat of Biological Terrorism in modern society (현대사회의 환경변화에 따른 Bio-Terror의 위협요인 연구)

  • Kang, young-sook;Kim, Tae-hwan
    • Journal of the Society of Disaster Information
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    • v.1 no.1
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    • pp.3-26
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    • 2005
  • In recent years, there is growing concern about the potential use of biological agents in war or acts of terrorism accompanied an increased realization that rapid preparedness and response are needed to prevent or treat the human damage that can be caused by these agents. The threat is indeed serious, and the potential for devastating numbers of casualties is high. The use of agents as weapons, even on a small scale, has the potential for huge social and economic disruption and massive diversion of regional and national resources to combat the threat, to treat primary disease, and to clean up environmental contamination. Biological weapons are one of weapons of mass destruction (or mass casualty weapons, to be precise. since they do not damage non-living entities) that are based on bacteria, viruses, rickettsia, fungi or toxins produced by these organisms. Biological weapons are known to be easy and cheap to produce and can be used to selectively target humans, animals, or plants. Theses agents can cause large numbers of casualties with minimal logistical requirements (in wide area). The spread of disease cannot be controlled until there is awareness of the signs of infection followed by identification of agents; and if the organism is easily spread from person to person, as in the case of smallpox, the number of casualties could run into the tens of thousands. Biological weapons could be used covertly, there can be a lot of different deployment scenarios. A lot of different agents could be used in biological weapons. And, there are a lot of different techniques to manufacture biological weapons. Terrorist acts that make use of Biological Agents differ in a number of ways from those involving chemicals. The distinction between terrorist and military use of Biological Weapon is increasingly problematic. The stealthy qualities of biological weapons further complicate the distinction between terrorism and war. In reality, all biological attacks are likely to require an integrated response involving both military and civilian communities. The basic considerations when public health agencies establish national defence plan against bioterrorism must be 1) arraying various laws and regulations to meet the realistic needs, 2)education for public health personnels and support of concerned academic society, 3)information collection and cooperative project with other countries, 4)Detection and surveillance(Early detection is essential for ensuring a prompt response to biological or chemical attack, including the provision of prophylactic medicines, chemical antidotes, or vaccines) and 5) Response(A comprehensive public health response to a biological or chemical terrorist event involves epidemiologic investigation, medical treatment and prophylaxis for affacted persons, and the initiation of disease prevention or environmental decontamination measures). The purpose of this paper is providing basic material of preparedness and response for biological terrorism in modern society.

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Application of Cyber Physical System (CPS) for Risk Management of a CO2 Storage Site (이산화탄소 저장부지 위해성 관리를 위한 가상물리시스템 적용성 평가)

  • Jeong, Jina;Park, Eungyu;Jun, Seong-Chun;Kim, Hyun-Jun;Yun, Seong-Taek
    • Economic and Environmental Geology
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    • v.50 no.5
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    • pp.363-373
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    • 2017
  • In the present study, adaptability of cyber-physical system (CPS) for risk management of $CO_2$ storage site is examined and the subagging regression (SBR) method is proposed as a key component of the cyber-twin to estimate the risk due to potential $CO_2$ leakage. For these purposes, $CO_2$ concentration data monitored from a controlled $CO_2$ release field experiment is employed to validate the potentialities of the SBR method. From the validation study, it is found that the SBR method has robust estimation capability by showing minimal influence from anomalous measurements, and makes stable and sound predictions for the forthcoming $CO_2$ concentration trend. In addition, the method is found to be well suited as a tool of operational risk assessment based on real-time monitoring data due to the computational efficiency. The overall results suggest that the SBR method has potential to be an important component comprising the cyber twin of CPS for risk management of $CO_2$ storage site.

Occurrence and antibiotic susceptibility of fish bacteria isolated from Oreochromis niloticus (Nile tilapia) and Clarias gariepinus (African catfish) in Uganda

  • Wamala, S.P.;Mugimba, K.K.;Mutoloki, S.;Evensen, O.;Mdegela, R.;Byarugaba, D.K.;Sorum, H.
    • Fisheries and Aquatic Sciences
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    • v.21 no.2
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    • pp.6.1-6.10
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    • 2018
  • The intention of this study was to identify the bacterial pathogens infecting Oreochromis niloticus (Nile tilapia) and Clarias gariepinus (African catfish), and to establish the antibiotic susceptibility of fish bacteria in Uganda. A total of 288 fish samples from 40 fish farms (ponds, cages, and tanks) and 8 wild water sites were aseptically collected and bacteria isolated from the head kidney, liver, brain and spleen. The isolates were identified by their morphological characteristics, conventional biochemical tests and Analytical Profile Index test kits. Antibiotic susceptibility of selected bacteria was determined by the Kirby-Bauer disc diffusion method. The following well-known fish pathogens were identified at a farm prevalence of; Aeromonas hydrophila (43.8%), Aeromonas sobria (20.8%), Edwardsiella tarda (8.3%), Flavobacterium spp. (4.2%) and Streptococcus spp. (6.3%). Other bacteria with varying significance as fish pathogens were also identified including Plesiomonas shigelloides (25.0%), Chryseobacterium indoligenes (12.5%), Pseudomonas fluorescens (10.4%), Pseudomonas aeruginosa (4.2%), Pseudomonas stutzeri (2.1%), Vibrio cholerae (10.4%), Proteus spp. (6.3%), Citrobacter spp. (4.2%), Klebsiella spp. (4.2%) Serratia marcescens (4.2%), Burkholderia cepacia (2.1%), Comamonas testosteroni (8.3%) and Ralstonia picketti (2.1%). Aeromonas spp., Edwardsiella tarda and Streptococcus spp. were commonly isolated from diseased fish. Aeromonas spp. (n = 82) and Plesiomonas shigelloides (n = 73) were evaluated for antibiotic susceptibility. All isolates tested were susceptible to at-least ten (10) of the fourteen antibiotics evaluated. High levels of resistance were however expressed by all isolates to penicillin, oxacillin and ampicillin. This observed resistance is most probably intrinsic to those bacteria, suggesting minimal levels of acquired antibiotic resistance in fish bacteria from the study area. To our knowledge, this is the first study to establish the occurrence of several bacteria species infecting fish; and to determine antibiotic susceptibility of fish bacteria in Uganda. The current study provides baseline information for future reference and fish disease management in the country.

Formation Characteristics and Control of Disinfection Byproducts in a Drinking Water Treatment Plant Using Lake Water (호소수를 원수로 사용하는 정수장의 소독부산물 생성 특성 및 제어 방안)

  • Lee, Kichang;Gegal, Bongchang;Choi, Ilhwan;Lee, Wontae
    • Journal of Korean Society of Environmental Engineers
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    • v.37 no.5
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    • pp.269-276
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    • 2015
  • This study investigated the influence of characteristics of natural organic matter (NOM) on the formation of disinfection by-products (DBPs), and proposed the control strategies of DBPs formation in a drinking water treatment plant using lake water in Gyeongsangbuk-do. The fluorescence excitation-emission matrix analysis results revealed that the origins of NOM in raw waters to the plant were a mixture of terrestrial and microbial sources. Molecular size distributions and removals of NOM fractions were evaluated with a liquid chromatography-organic carbon detector (LC-OCD) analysis. Humic substances and low molecular weight organics were dominant fractions of NOM in the raw water. High molecular weight organics were relatively easier to remove through coagulation/precipitation than low molecular weight organics. The concentrations of DBPs formed by pre-chlorination increased through the treatment processes in regular sequence due to longer reaction time. Chloroform (74%) accounts for the largest part of trihalomethanes, followed by bromodichloromethane (22%) and dibromochloromethane (4%). Dichloroacetic acid (50%) and trichloroacetic acid (48%) were dominant species of haloacetic acids, and brominated species such as dibromoacetic acid (2%) were minimal or none. Dichloroacetonitrile (60%) accounts for the largest part of haloacetonitriles, followed by bromochloroacetonitrile (30%) and dibromoacetonitrile (10%). The formation of DBPs were reduced by 16~44% as dosages of pre-chlorine decreased. Dosages of pre-chlorine was more contributing to DBPs formation than variations of dissolved organic contents or water temperature.

On the Street System of Natural Villages in Seogwipo, Jeju (서귀포시 자연취락지의 도시가로망 구성)

  • 전명택;양성기
    • Journal of Environmental Science International
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    • v.11 no.3
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    • pp.139-148
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    • 2002
  • When the natural villages in Jeju province are incorporated into the district of city planning, they are considered to be a small-scale residential districts. Therefore, a garden city should be planned that considers the characteristics of the villages to implement an appropriate street system, to use the area effectively, and to harmonize the villages with the surrounding communities. There have been an especially large number of problems with the street system in the city of Seogwipo, which was notified as the area of natural settlement. This study analyzes the problems inherent in street planning and the present condition of roads whose construction has been postponed for a long time due to several problems including an inappropriately planned street system. Based on the research of various documents, a practical street system has been investigated. Most of the residents in natural settlement units demand use of the continued the existing roads as well as the implementation of an effective street system. They ask for street planning under which the involved construction would take only a short period of time and would result in only minimal damage to their existing properties. Therefore, the street system should be planned so as to preserve the nature-friendly features of natural settlements, their surroundings and tourism resources. Even after streets hwve been planned and their completion you has been established, the plan should be continuously evaluated, analyzed and compared with other alternatives. The street plan should continuously incorporate improvement measures which would satisfy various aspects of the street system including land use, traffic demand, and future population demands. Both the amount of money to be invested and economical efficiency should be considered for street planning since the street system has a great impact on many industries. Unnecessary costs related to excessive road construction should be avoided. The street network plan should also include the complete evaluation of the natural topography as well as the surrounding. Considering these views, the data concerning the current condition of the city and the related investigation play an important role in establishing a street plan. However, the investigation of future construction plans by the city is as of yet at a very early stage. Therefore, there is an urgent need for the investigational study of the current city development plans. The street system for the natural settlement area should be established only after the thorough investigation of all aspects of street planning. In addition, the plan should be flexible enough to consider the characteristics of Jeju.

Pulsed Electric Fields: An Emerging Food Processing Technology-An Overview (PEF 처리에 의한 식품의 가공)

  • Jayaprakasha, H.M.;Yoon, Y.C.;Lee, S.K.
    • Journal of Animal Science and Technology
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    • v.46 no.5
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    • pp.871-878
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    • 2004
  • Pulsed electric fields(PEF) technology is one of the latest nonthermal methods of food processing for obtaining safe and minimally processed foods. This technology can be effectively explored for obtaining safe food with minimum effect on nutritional, flavor, rheological and sensory qualities of food products. The process involves the application of high voltage(typically 20 ${\sim}$ 80 kv/cm) to foods placed between two electrodes. The mode of inactivation of microorganism; by PEP processing has been postulated in term; of electric breakdown and electroporation. The extent of destruction of microorganisms in PEF processing depends mainly on the electric field strength of the pulses and treatment time. For each cell types, a specific critical electric field strength and specific critical treatment time are required depending on the cell characteristics and the type and strength of the medium where they have been present. The effect also depends on the types of microorganisms and their phase of growth. A careful combination of processing parameters has to be selected for effective processing. The potential applications of PEF technology are numerous ranging from biotechnology to food preservation. With respect to food processing, it has already been established that, the technology is non-thermal in nature, economical and energy efficient, besides providing minimally processed foods. This article gives a brief overview of this technology for food processing applications.