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Results of Definitive Chemoradiotherapy for Unresectable Esophageal Cancer (절제 불가능한 식도암의 근치적 항암화학방사선치료의 성적)

  • Noh, O-Kyu;Je, Hyoung-Uk;Kim, Sung-Bae;Lee, Gin-Hyug;Park, Seung-Il;Lee, Sang-Wook;Song, Si-Yeol;Ahn, Seung-Do;Choi, Eun-Kyung;Kim, Jong-Hoon
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.195-203
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    • 2008
  • Purpose: To investigate the treatment outcome and failure patterns after definitive chemoradiation therapy in locally advanced, unresectable esophageal cancer. Materials and Methods: From February 1994 to December 2002, 168 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated by definitive chemoradiation therapy. External beam radiation therapy (EBRT) ($42{\sim}46\;Gy$) was delivered to the region encompassing the primary tumor and involved lymph nodes, while the supraclavicular fossa and celiac area were included in the treatment area as a function of disease location. The administered cone-down radiation dose to the gross tumor went up to $54{\sim}66\;Gy$, while the fraction size of the EBRT was 1.8-2.0 Gy/fraction qd or 1.2 Gy/fraction bid. An optional high dose rate (HDR) intraluminal brachytherapy (BT) boost was also administered (Ir-192, $9{\sim}12\;Gy/3{\sim}4\;fx$). Two cycles of concurrent FP chemotherapy (5-FU $1,000\;mg/m^2$/day, days $2{\sim}6$, $30{\sim}34$, cisplatin $60\;mg/m^2$/day, days 1, 29) were delivered during radiotherapy with the addition of two more cycles. Results: One hundred sixty patients were analyzable for this review [median follow-up time: 10 months (range $1{\sim}149$ months)). The number of patients within AJCC stages I, II, III, and IV was 5 (3.1%), 38 (23.8%), 68 (42.5%), and 49 (30.6%), respectively. A HDR intraluminal BT was performed in 26 patients. The 160 patients had a median EBRT radiation dose of 59.4 Gy (range $44.4{\sim}66$) and a total radiation dose, including BT, of 60 Gy (range $44.4{\sim}72$), while 144 patients received a dose higher than 40 Gy. Despite the treatment, the disease recurrence rate was 101/160 (63.1%). Of these, the patterns of recurrence were local in 20 patients (12.5%), persistent disease and local progression in 61 (38.1%), distant metastasis in 15 (9.4%), and concomitant local and distant failure in 5 (3.1%). The overall survival rate was 31.8% at 2 years and 14.2% at 5 years (median 11.1 months). Disease-free survival was 29.0% at 2 years and 22.7% at 5 years (median 10.4 months). The response to treatment and N-stage were significant factors affecting overall survival. In addition, total radiation dose (${\geq}50\;Gy$ vs. < 50 Gy), BT and fractionation scheme (qd. vs. bid.) were not significant factors for overall survival and disease-free survival. Conclusion: Survival outcome after definitive chemoradiation therapy in unresectable esophageal cancer was comparable to those of other series. The main failure pattern was local recurrence. Survival rate did not improve with increased radiation dose over 50 Gy or the use of brachytherapy or hyperfractionation.

Multiplication of Infectious Flacherie and Densonucleosis Viruses in the Silkworm, Bombyx mori (가잠의 전염성 연화병 및 농핵병 바이러스 증식에 관한 연구)

  • 김근영;강석권
    • Journal of Sericultural and Entomological Science
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    • v.25 no.2
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    • pp.1-31
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    • 1984
  • Flacherie, as one of the most prevalent silkworm diseases, causes severe economic damage to sericultural industry and its pathogens have been proved to be flacherie virus (FV) and densonucleosis virus (DNV). Multiplications of the viruses in the larvae of the silkworm, Bombyx mori, were studied by the sucrose density gradient centrifugation and electron microscopy. The quantitative and qualitative changes of nucleic acids and proteins were investigated from the midgut and hemolymph in the silkworm larvae infected separately with FV and DNV. The histopathological changes of epithelial cells of infected midgut also were examined by an electron microscope. 1. Purified fractions of FV or DNV in a sucrose density gradient centrifugation yielded one homogenous and sharp peak without a shoulder, suggesting no heterogenous materials in the preparation. Electron microscopy also revealed that FV and DNV were spherical particles, 27nm and 21nm in diameter, respectively. 2. Silkworm larvae showed a decrease in body weight on the 6th day and in midgut weight on the 3rd day after inoculation with FV or DNV. 3. DNA content was higher in the midgut when infected with FV or DNV, but the hemolymph of the infected larvae showed no difference during first 6 days after inoculation, after which DNA concentration declined rapidly. 4. RNA synthesis of silkworm larvae infected separately with FV and DNV was stimulated in the midgut, but RNA content was reduced in the hemolymph at the early stage of virus multiplication. At the late stage of virus multiplication, however, it was extremely reduced in both midgut and hemolymph. 5. The concentration of protein in the midgut and hemolymph of silkworm larvae infected separately with FV and DNV showed no difference from that of the healthy larvae at the early stage of virus multiplication, but it was significantly reduced at the late stage of virus multiplication. 6. There was no difference in the electrophoretic patterns of RNAs extracted from the midgut of healthy or virus-infected larvae. 7. The electrophoresis of proteins extracted from the midgut infected with FV or DNV, when carried out on the 1st and 5th day after virus inoculation, showed no difference from that of the healthy larvae. But, there was an additional band with medium motility in the proteins on the 8th day after virus inoculation, while a band with low mobility shown in the proteins of healthy larvae disappeared in the infected larvae. However, a band with high mobility in the healthy larvae was separated into two fractions in the infected larvae. 8. The electrophoretic pattern of hemolymph proteins of the silkworm larvae infected separately with FV and DNV was similar to that of the healthy larvae, but the concentration of hemolymph proteins in the infected larvae was lower than that of the healthy larvae at the late stage. 9. Two types of inclusion bodies were shown by the double staining of pyronin-methyl green in the columnar cell of the midgut on the 8th day after FV inoculation. 10. Electron microscopy of the infected midgut revealed that the 'cytoplasmic wall' of the goblet cell thickened on the 5th day after FV inoculation and several types of the cytopathogenic structures, such as virus$.$specific vesicles, virus particles, linear structures, tubular structures, and high electron-dense matrices were observed in the cytoplasm of the goblet cell. The virus particles were also observed in the microvilli and the structures similar to spherical virus particles were observed around the virus-specific vesicles, suggesting the virus assembly in the cytoplasm. 11. Fluorescence micrograph of the infected midgut stained with acridine orange showed that the nucleus, the site of DNV multiplication in the columnar cell, enlarged on the 5th day after virus inoculation. 12. Electron microscopic examination of DNV infected midgut revealed that the nucleolus of the columnar cell was broken into granules and those granules dispersed into apical region of the nucleus on the 5th day after virus inoculation. On the 8th day after inoculation, it was also observed that the nucleus of the columnar cell was full with the high electron-dense virogenic stroma which were similar to virus particles. These facts suggest that the virogenic stroma were the sites of virus assembly in the process of DNV multiplication.

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Agronomical studies on the major environmental factors of rice culture in Korea (수도재배의 주요환경요인에 관한 해석적 조사연구)

  • Yung-Sup Kim
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.3
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    • pp.49-82
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    • 1965
  • For the stable and high yields of low-land rice in Korea, the characteristics of rice plant for the vegetative and physiological responses, plant type formation, and yield components have been studied in order to obtain the fundamental data for the improvement of cultural practices, especially for the ideal fertilizer application. Furthermore the environmental conditions in Korea including temperatures, light, precipitation, and soil conditions have been compared in the broad sense with those in Japan, and the application of nitrogen, phosphorus, potassium, silicate and other micro-nutrients were described in relation to the characteristics of environmental conditions for the improvement of fertilizer application. 1. The average yield of polished-rice per 10 are in Korea is about 204 kg and this values are much less than those in Japan and Taiwan where they produce 77% to 13% more than in Korea. The rate of yield increase a year in Korea is 4.2 kg, but in Japan and Taiwan the rates of yield increase a year are 81 % and 62%, respectively. It was also found that the coefficient of variation of yield is 7.7% in Korea, 6.7% in Japan and 2.5% in Taiwan. This means that the stability of producing rice in Korea is very low when compared with those in Japan and Taiwan. 2. It was learned from the results obtained from the 'annual yield estimation experiment' that there are big differences in the respect of plant type formations between rice crops grown in Japan and Korea. The important differences found were as follows: (1) The numbers of spikelets per 3.3 square meters are 891 in Korea and 1, 007 in Japan(13% more than in Korea). (2) The numbers of tillers per 3.3 square meters at the stage of maximum tillering are 1, 150 in Korea, but in Japan they showed 19% more than in Korea. (3) The ratio of effective tillers to total tillers is 77.5% in Korea and 74.7% in Japan, which seems to be higher in Korea than in Japan. But the ratio in Korea is very low when considered the numbers of total tillers in both countries. (4) The ratio of grain to straw is 85.4% in Korea and 96.3% in Japan. 3. The average temperatures during the growing season at the area of Suwon, Kwangjoo and Taegu are almost same as those in the district of Jookokoo(Fookoo yama) in Japan, i.e., the temperatures during the rice-growing season in Korea are similar to those in the southern-warm regions of Japan. 4. Considering the minimum temperatures at the stage of limiting transplanting, 13$^{\circ}C$, the time of transplanting might be 30 to 40 days earlier than presently practicing transplanting time, which comes around June 10. 5. The temperatures during the vegetative growth in Korea were higher than those temperatures that needed in the protein synthesis which ate the main metabolism during this stage. However, the temperatures at the time of reproductive growth was lower than the temperatures that needed in the sugar assimilation which is main metabolism in this stage. In this point of view, it might be considered that the proper time of growing rice plant in Korea would be rather earlier. 6. The temperatures and the day light conditions at the time of first tillering stage of rice plant, when planted as presenting transplanting practices, are very satisfactory, but the poor day light length, high temperatures and too wet conditions in the time of last-tillering stage(mid or last July) might cause the occurrence of disease such as blast. 7. The heading stage of rice plants at each region through nations when planted as presently practicing method comes when the day light length is short. 8. It was shown that the accumulated average air-temperature at the time of maturing stage was not enough and the heading time was too late, when considered the annual deviations of mean temperatures and low minimum temperatures. 9. The nitrogen content of each plant part at the each growing stage was very high at the stage of vegetative growth when compared with the nitrogen content at the stage of reproductive growth after heading. In this respect it was believed to be important to prevent the nutrient shortages at the reproductive stages, especially after the heading. 10. The area of unsatisfactory irrigation paddy fields and natural rain-fed paddy fields are getting reduced in Korea. The correlation between the rate of reducing unsatisfactory irrigation and natural rain-fed paddy fields and the rate of yield increase were computed. The correlation coefficients(r) between the area of unsatisfactory irrigation paddy fields and yield increase were +0.525, and between the natural rain-fed paddy fields and yield increase, +0.832 and between the unsatisfactory irrigation plus natural rain-fed paddy fields and yield increase, +0.84. And there were. highly significant positive correlations between natural rain-fed paddy fields and yield increases indicating that the less the area of natural rain-fed paddy fields, the greater the yields per unit area. 11. The results obtained from the fertilizer experiments (yield performance trials) conducted in both Korea and Japan showed that the yield of non-fertilized plots per 10 are was 231 kg in Korea and 360 kg in Japan. On the basis of this it might be concluded that the fertility of soil in Korea is lower than that in Japan. Furthermore it was. also found that the yields of non-nitrogen applied plots per 10 are were 236 kg in Korea and 383 kg in Japan. This also indicates that the yields of rice in Korea are largely depending on the nitrogen content in the soil. 12. The followings were obtained when the chemical natures of soils in both Korea and Japan were compared. (1) The content of organic matter, total nitrogen, exchangeable calcium, and magnesium in Korea were no more than the half those in Japan. (2) The content of N/2 chloride and soluble silicate in low-land soil were on the average lower in Korea. (3) The exchange capacity of bases in Korea was no more than half that in Japan. 13. It was also observed by comparing the soil nature of the soil with high yielding capacity with the soil with low yielding capacity that the exchange capacity of bases, exchangeable calcium and magnesium, potassium, phosphorus, manganese, silicate and iron were low in the soil with low yielding capacity. 14. The depth of furrow slice was always deeper in the soil with high yielding capacity, and the depth of furrow slice in Korea was also shallower than that in Japan. 15. Summarizing the various conditions mentioned previously and considering the effects of silicate and trace elements such as manganese and iron besides three elements on the physiological and plant type formation of rice crops, more realistic and more ideal fertilizing practices were proposed. proposed.

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