• Title/Summary/Keyword: Node ratio

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The comparison of lesion localization methods in breast lymphoscintigraphy (Breast lymphoscintigraphy 검사 시 체표윤곽을 나타내는 방법의 비교)

  • Yeon, Joon ho;Hong, Gun chul;Kim, Soo yung;Choi, Sung wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.2
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    • pp.74-80
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    • 2015
  • Purpose Breast lymphoscintigraphy is an important technique to present for body surface precisely, which shows a lymph node metastasis of malignant tumors at an early stage and is performed before and after surgery in patients with breast cancer. In this study, we evaluated several methods of body outline imaging to present exact location of lesions, as well as compared respective exposure doses. Materials and Methods RANDO phantom and SYMBIA T-16 were used for obtaining imaging. A lesion and an injection site were created by inserting a point source of 0.11 MBq on the axillary sentinel lymph node and 37 MBq on the right breast, respectively. The first method for acquiring the image was used by drawing the body surface of phantom for 30 sec using $Na^{99m}TcO_4$ as a point source. The second, the image was acquired with $^{57}Co$ flood source for 30 seconds on the rear side and the left side of the phantom, the image as the third method was obtained using a syringe filled with 37 MBq of $Na^{99m}TcO_4$ in 10 ml of saline, and as the fourth, we used a photon energy and scatter energy of $^{99m}Tc$ emitting from phantom without any addition radiation exposure. Finally, the image was fused the scout image and the basal image of SPECT/CT using MATLAB$^{(R)}$ program. Anterior and lateral images were acquired for 3 min, and radiation exposure was measured by the personal exposure dosimeter. We conducted preference of 10 images from nuclear medicine doctors by the survey. Results TBR values of anterior and right image in the first to fifth method were 334.9 and 117.2 ($1^{st}$), 266.1 and 124.4 ($2^{nd}$), 117.4 and 99.6 ($3^{rd}$), 3.2 and 7.6 ($4^{th}$), and 565.6 and 141.8 ($5^{th}$). And also exposure doses of these method were 2, 2, 2, 0, and $30{\mu}Sv$, respectively. Among five methods, the fifth method showed the highest TBR value as well as exposure dose, where as the fourth method showed the lowest TBR value and exposure dose. As a result, the last method ($5^{th}$) is the best method and the fourth method is the worst method in this study. Conclusion Scout method of SPECT/CT can be useful that provides the best values of TBR and the best score of survey result. Even though personal exposure dose when patients take scout of SPECT/CT was higher than another scan, it was slight level comparison to 1 mSv as the dose limit to non-radiation workers. If the scout is possible to less than 80 kV, exposure dose can be reduced, and also useful lesion localization provided.

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A Ranking Algorithm for Semantic Web Resources: A Class-oriented Approach (시맨틱 웹 자원의 랭킹을 위한 알고리즘: 클래스중심 접근방법)

  • Rho, Sang-Kyu;Park, Hyun-Jung;Park, Jin-Soo
    • Asia pacific journal of information systems
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    • v.17 no.4
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    • pp.31-59
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    • 2007
  • We frequently use search engines to find relevant information in the Web but still end up with too much information. In order to solve this problem of information overload, ranking algorithms have been applied to various domains. As more information will be available in the future, effectively and efficiently ranking search results will become more critical. In this paper, we propose a ranking algorithm for the Semantic Web resources, specifically RDF resources. Traditionally, the importance of a particular Web page is estimated based on the number of key words found in the page, which is subject to manipulation. In contrast, link analysis methods such as Google's PageRank capitalize on the information which is inherent in the link structure of the Web graph. PageRank considers a certain page highly important if it is referred to by many other pages. The degree of the importance also increases if the importance of the referring pages is high. Kleinberg's algorithm is another link-structure based ranking algorithm for Web pages. Unlike PageRank, Kleinberg's algorithm utilizes two kinds of scores: the authority score and the hub score. If a page has a high authority score, it is an authority on a given topic and many pages refer to it. A page with a high hub score links to many authoritative pages. As mentioned above, the link-structure based ranking method has been playing an essential role in World Wide Web(WWW), and nowadays, many people recognize the effectiveness and efficiency of it. On the other hand, as Resource Description Framework(RDF) data model forms the foundation of the Semantic Web, any information in the Semantic Web can be expressed with RDF graph, making the ranking algorithm for RDF knowledge bases greatly important. The RDF graph consists of nodes and directional links similar to the Web graph. As a result, the link-structure based ranking method seems to be highly applicable to ranking the Semantic Web resources. However, the information space of the Semantic Web is more complex than that of WWW. For instance, WWW can be considered as one huge class, i.e., a collection of Web pages, which has only a recursive property, i.e., a 'refers to' property corresponding to the hyperlinks. However, the Semantic Web encompasses various kinds of classes and properties, and consequently, ranking methods used in WWW should be modified to reflect the complexity of the information space in the Semantic Web. Previous research addressed the ranking problem of query results retrieved from RDF knowledge bases. Mukherjea and Bamba modified Kleinberg's algorithm in order to apply their algorithm to rank the Semantic Web resources. They defined the objectivity score and the subjectivity score of a resource, which correspond to the authority score and the hub score of Kleinberg's, respectively. They concentrated on the diversity of properties and introduced property weights to control the influence of a resource on another resource depending on the characteristic of the property linking the two resources. A node with a high objectivity score becomes the object of many RDF triples, and a node with a high subjectivity score becomes the subject of many RDF triples. They developed several kinds of Semantic Web systems in order to validate their technique and showed some experimental results verifying the applicability of their method to the Semantic Web. Despite their efforts, however, there remained some limitations which they reported in their paper. First, their algorithm is useful only when a Semantic Web system represents most of the knowledge pertaining to a certain domain. In other words, the ratio of links to nodes should be high, or overall resources should be described in detail, to a certain degree for their algorithm to properly work. Second, a Tightly-Knit Community(TKC) effect, the phenomenon that pages which are less important but yet densely connected have higher scores than the ones that are more important but sparsely connected, remains as problematic. Third, a resource may have a high score, not because it is actually important, but simply because it is very common and as a consequence it has many links pointing to it. In this paper, we examine such ranking problems from a novel perspective and propose a new algorithm which can solve the problems under the previous studies. Our proposed method is based on a class-oriented approach. In contrast to the predicate-oriented approach entertained by the previous research, a user, under our approach, determines the weights of a property by comparing its relative significance to the other properties when evaluating the importance of resources in a specific class. This approach stems from the idea that most queries are supposed to find resources belonging to the same class in the Semantic Web, which consists of many heterogeneous classes in RDF Schema. This approach closely reflects the way that people, in the real world, evaluate something, and will turn out to be superior to the predicate-oriented approach for the Semantic Web. Our proposed algorithm can resolve the TKC(Tightly Knit Community) effect, and further can shed lights on other limitations posed by the previous research. In addition, we propose two ways to incorporate data-type properties which have not been employed even in the case when they have some significance on the resource importance. We designed an experiment to show the effectiveness of our proposed algorithm and the validity of ranking results, which was not tried ever in previous research. We also conducted a comprehensive mathematical analysis, which was overlooked in previous research. The mathematical analysis enabled us to simplify the calculation procedure. Finally, we summarize our experimental results and discuss further research issues.

The Behaviors of Phosphorus-32 and Ptoassium-42 under the Control of Thermoperiod and Potassium Level (가리(加里)와 온도주기성(溫度週期性)이 고구마 생육(生育) 및 인(燐)-32, 가리(加里)-42 동태(動態)에 미치는 영향(影響))

  • Kim, Y.C.
    • Korean Journal of Soil Science and Fertilizer
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    • v.1 no.1
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    • pp.89-115
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    • 1968
  • 1. The experiment was carried out for investigating the interaction between potassium nutrition and thermoperiod (as an environment regulating factor) in relation to behaviors of several nutrients including phosphorus-32 and Potassium-42 in IPOMOEA BATAS. 2. To obtain same condition to trace the behaviors of phosphorus and potassum-42 they were simultaneously incorporated to roots. The determination of each CPM by counting twice with adequate interval and calculating true CPM of each isotope according to different half-life, was carried out with satisfactory. 3. Some specific symptoms i.e, chlorosis and withering of growing point under the condition of lower potassium level were found and was accelerated by the low night temperature. 4. A manganese shortage in growing point of the lower potassium level was found by activiation analysis and very low distribution ratio of phosphorus-32 and potassium-42 in the growing point of the lower potassium level was manifested, though the contents of nitrogen, phosphorus, potassium, sodium and magnesium were not in great difference. 5. In addition to the low water content with appearence of "hard", shorterning internode and lower ratio of roots to shoot as well as the symptoms of potassium deficiency such as brown spot in leaf blade and necrosis of leaf margin were appeared at later stage of experiment at the lower potassium level. 6. Very stimulating vegetative growth, e.g, large plant length, leaf expansion, increasing node number and fresh weight as well as high ratio of roots to shoot, high water content was resulted in the condition of higher potassium level. 7. A specific interaction between higher potassium level and thermoperiod was found, that is, the largest tuber production and the largest ratio of roots to shoot were resulted in the combined condition of higher potassium level and constant temperature while the largest plant length, fresh weight etc. i.e. the most stimulative vegetative growth was resulted in the combined condition of higher potassium level and low night temperature. 8. Comparatively low water content in the former condition of stimulative tuber production was resulted(especially at the tuber thickening stage), while high water content in the latter condition of stimulative vegetation was resulted though the higher potassium level made generally high water contents. 9. The nitrogen contents of soluble and insoluble did not make distinct difference between the lower and higher potassium level. 10. Though the phosphorus contents were not distinctly different by the potassium level, the lower potassium level made the percentage of phosphorus increased at tuber forming stage accumulating more phosphorus in roots, while the higher potassium level decreased percentage of phosphorus at that stage. 11. The higher potassium level made distinctly high potassium contents than the lower potassium level and increased contents at the tuber forming stage through both conditions. 12. The sodium contents were low in the condition of higher potassium level than the lower potassium level and decreased at tuber forming stage in both conditions, on the contary of potassium. 13. Except the noticeable deficeney of manganese in the growing point of the lower potassium level, mangense and magnesium contents in other organs did not make distinct difference according to the potassium level. 14. Generally more uptake and large absorption rate of phosphorus-32 and potassium-42 were resulted at the higher potassium level, and the most uptake, and the largest absorption rate of phosphorus and potassium-42 (especially potassium-42 at tuber forming stage) were resulted in the condition of higher potassium level and constant temperature which made the highest tuber production. 15. The higher potassium level stimulated the translocation of phoshorus-32 and potassium-42 from roots to shoots while the lower potassium level suppressed or blocked the translocation. 16. Therefore, very large distribution rate of $p^{32}$, $K^{42}$ in shoot, especially, in growing point, compared with roots was resulted in the higher potassium level. 17. The lower potassium level suppressed the translocation of phosporus-32 from roots to shoot more than that of potassium-42. 18. The uptake of potassium-42 and translocation in IPOMOEA BATATAS were more vivid than phosphorus-32. 19. A specific interaction between potassium nutrition and thermoperiod which resulted the largest tuber production etc. was discussed in relation to behaviors of minerals and potasium-42 etc. 20. Also, the specific effect of the lower and higher potassium level on the growth pattern of IPOMOEA BATATAS were discussed in relation to behaviors of minerals and isotopes. 21. An emphasize on the significance of the higher potassium level as well as the interaction with the regulating factor and problem of potassium level (gradient) for crops product ion were discussed from the point of dynamical and variable function of potassium.

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Economic Value of the Sirolimus Eluting Stent($CYPHER^{TM}$) in Treating Acute Coronary Heart Disease (관상동맥질환 치료를 위한 시롤리무스 방출 스텐트 ($CYPHER^{TM}$)의 경제성 분석)

  • Lee, Hoo-Yeon;Park, Eun-Cheol;Park, Ki-Dong;Park, Ji-Eun;Kim, Young;Lee, Sang-Soo;Kang, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.339-348
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    • 2003
  • Objective : To quantify the economic value of the Sirolimus fluting Stent ($CYPHER^{TM}$) in treating acute coronary heart disease (CMD), and to assist in determining an adequate level of reimbursement for $CYPHER^{TM}$ in Korea. Methods : A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of $CYPHER^{TM}$ versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization, The follow-vp costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Defending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were peformed for discount rates of 3, 5 and 7%. Since the major clinical advantage of $CYPHER^{TM}$ over conventional stenting was the reduction in the revascularization rates, the economic value of $CYPHER^{TM}$, in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of $CYPHER^{TM}$ per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, $CYPHER^{TM}$ would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of $CYPHER^{TM}$ making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. Results : The average weighted initial insurance covered and total medical costs of conventional stenting were about 6,275,000 and 8,058,000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13,659,000 and 17,353,000 Won, respectively. The estimated maximum level of reimbursement price of $CYPHER^{TM}$ from the perspectives of the insurer and society were $4,126,897{\sim}4,325,161$ and $4,939,939{\sim}5,078,181$ Won, respectively. Conclusion : By evaluating the economic value of $CYPHER^{TM}$, as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for $CYPHER^{TM}$.

Decision Making on the Non surgical, Surgical Treatment on Chronic Adult Periodontitis (만성 성인성 치주염 치료시 비외과적, 외과적 방법에 대한 의사결정)

  • Song, Si-Eun;Li, Seung-Won;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.28 no.4
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    • pp.645-660
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    • 1998
  • The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.

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Clinical Significance of Gastrointestinal Symptoms and Abdominal Ultrasonographic Findings in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 복부 증상의 임상적 의의와 복부 초음파 소견)

  • Choi, Eun Jung;Lee, Chang Woo;Choi, Du Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.63-67
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    • 2005
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

Changes in the expression of cytokines and apoptosis-related genes in children with infectious mononucleosis (소아의 전염성 단핵구증에서 사이토카인과 세포자멸사 연관 유전자의 발현의 변화)

  • Jo, Dae Sun;Han, Ji Hye;Kim, Sun Young;Kim, Min Sun;Yi, Ho Keun;Lee, Dae-Yeol;Hwang, Pyoung Han
    • Clinical and Experimental Pediatrics
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    • v.52 no.12
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    • pp.1348-1357
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    • 2009
  • Purpose:The aims of this study were to identify the clinical characteristics and determine the changes in the expression of cytokines and apoptosis-related genes in children with infectious mononucleosis. Methods:Serological examinations of 15 pediatric patients diagnosed with infectious mononucleosis were performed prospectively. Peripheral blood from the patients was used to compare the composition of T cell subsets, cytokines, Epstein-Barr virus (EBV) DNA, and the expression of apoptosis-related genes with those in 10 healthy children. Results:Mean age of the patient group was $5.7{\pm}3.4$ (range, 3-9) years, and the male-to-female ratio was 1.5:1. Fever, sore throat, pharyngitis/tonsillitis, and cervical lymph node enlargement were the most common symptoms and signs. The proportions of CD3+ T cells, CD8+ suppressor cells, and CD56+ natural killer (NK) cells were higher in the patient group than in the control group (P<0.01). The IL-2, IL-6, and interferon $(INF)-{\gamma}$ levels were higher in the early symptomatic period (P<0.01). Mean amount of EBV DNA in the patients was $10^{2.38}copies/{\mu}g$, and the amount was the highest at the beginning of the symptomatic period and normalized during the convalescent phase. Bcl-2 expression increased during the initial phase, while Bax expression increased during the convalescent phase. Further, FasL expression increased 1 week after symptom presentation and decreased during the convalescent phase. There was no significant change in Fas expression. Conclusion:We analyzed the clinical characteristics and changes in the expression ofcytokines and apoptosis-related genes in the patients with infectious mononucleosis.

Clinical observations of juvenile rheumatoid arthritis (연소성 류마티스 관절염의 임상적 고찰)

  • Lee, Joo Hoon;Ryu, Jeong Min;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.424-430
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    • 2006
  • Purpose : Juvenile rheumatoid arthritis(JRA) is one of the most common rheumatic diseases of childhood and is an important cause of short- and long-term disability. The purpose of this study was to determine the disease course and outcome in childhood patients with JRA. Methods : Fifty nine patients with JRA who were diagnosed and treated in the Department of Pediatrics, Asan Medical Center from August 1990 to November 2004 were enrolled in this study. Sex, age, type, affected joints, extra-articular manifestations, laboratory and radiologic findings, treatments, and outcomes of JRA patients were reviewed retrospectively. Results : Among JRA patients, 32.2 percent had pauciarticular type, 30.5 percent had polyarticular type and 37.3 percent had systemic type. The ratio of boys to girls was 1.7 : 1 and the mean age at onset was $9.3{\pm}3.7$(1.3-15.9) years. The most commonly affected joints were knee, ankle and wrist. The extra-articular manifestations observed were fever, rash, myalgia and lymph node enlargement, etc. The main laboratory findings observed were leukocytosis, anemia, thrombocytosis, elevated ESR, and elevated CRP. Rheumatoid factor and antinuclear antibody(ANA) were positive in 5.3 percent and 18.0 percent. Nonsteroid anti-inflammatory drugs(NSAID) were used most frequently and methotrexate with or without steroids was added in 27.1 percent of patients unresponsive to NSAID. 88.1 percent of patients were cured without functional disability and only one patient was in functional status IV. One patient, who had pulmonary involvement, died. Conclusion : Our results showed an even distribution in type of onset, male predominance, older age of onset, low incidence of iridocyclitis, and low positivity of ANA in JRA patients; this differs from occidental data. This study may suggest regional differences and variability in disease groups of JRA among different racies, but further multi-center trials and large scale epidemiological studies are needed to confirm our conclusion.

Clinical and Epidemiologic Study of Kawasaki Disease in Children 8 Years of Age and Older (8세 이상 소아에서의 가와사끼병의 임상 역학적 연구)

  • Park, Yong Won;Han, Ji Whan;Park, In Sook;Kim, Chang Hwi;Cha, Sung Ho;Ma, Jae Sook;Kwon, Tae Chan;Lee, Sang Bum;Kim, Chul Ho;Lee, Heung Jae;Yun, Yong Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1139-1142
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    • 2005
  • Purpose : The aim of this study was to investigate the epidemiologic and clinical profiles of Kawasaki disease(KD) in children 8 years of age and older. Methods : For the epidemiologic study of KD in Korea, data of total 15,692 KD patients were collected from 1994 to 2002 on a 3 year basis, by the retrospective survey. Among them, data of 211 KD patients 8 years of age and older were analyzed and compared with those of the KD patients less than 8 years of age. Results : 211 patients 8 years of age and older(1.3% of total KD patients) with the mean age of 9.8 years, included 142 cases aged 8-10 years, 42 cases aged 10-12 years, and 27 cases aged 12 years and older. The male-to-female ratio was 1.9 : 1, the recurrence rate was 3.8%, and the prevalence of cases in sibling was zero. Coronary arterial(CA) abnormalities were detected by echocardiography in 25.4% of the cases, including 7.6% of CA aneurysm cases. There was 1 case complicated by myocardial infarction. Conclusion : Comparing with the data of the KD patients less than 8 years of age, data of 211 patients 8 years of age and older showed significantly higher incidences of CA abnormalities(25.4% : 19.8%) and CA aneurysms(7.6% : 4.0%).

Treatment Outcome of Postoperative Radiotherapy in Extrahepatic Bile Duct Cancer (간외담관암의 수술 후 방사선치료 성적)

  • Choi, Young-Min;Cho, Heung-Lae
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.27-34
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    • 2003
  • Purpose : To evaluate the efficacy of radiotherapy, and the factors affecting survival in patients of extrahepatic bile duct cancer, by analyzing the results of postoperative radiotherapy Materials and Methods : Between October 1991 and July 2001, 21 patients with extrahepatic bile duct cancer, who received radiotherapy after a radical resection, were retrospectively reviewed. The patients' ages ranged from 39 to 75 years, with a median of 61 years, and a male to female ratio of 16 to 5. The numbers of patients with proximal and distal bile duct cancer were 14 and 7, respectively. From the postoperative pathological examination, 19 of the patients were found to have microscopic residues, and 7 to be lymph node positive. Patients with AJCC stages I, II and III were 10, 10 and 1, respectively. The total radiation dose administered was 4,500$\~$6,300 cGy, with a median dose of 5,040 cGy. The follow up period was 20$\~$81 months, with a median of 57.5 months. Results : The overall and disease free survival rates at 3 and 5 years were 41.0 and 29.3$\%$, and 41.6 and 29.7$\%$, respectively. The influences of age, sex, tumor location, differentiation, microscopic residue, neural invasion, 7 and N stage, the stage itself, the dose of radiation and chemotherapy, on survival were evaluated. The T stage and the stage itself were found to be significant from a univariate analysis (p<0.05), but the degree of significance was limited by the small number of patients. A recurrence occurred in 12 patients (57.1$\%$), 5 in locoregional sites, 4 in distant sites and 3 in a combination of locoregional and distant sites, and the sites of distant metastasis were the liver, 6, and the bone, 1 Grade 2 or 3 acute leucopenias occurred in 2 patients and grade 2 chronic peptic ulcers occurred in 4, who were all recovered by conservative management. Conclusion : Postoperative radiotherapy is feasigbls in extrah데atic bile duct cancer, with tolerable toxicity, but prospective studies, with a large patient enrollment, are needed for the evaluation of the effects of postoperative radiotherapy and the related prognostic factors.