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Postoperative Radiotherapy for Locally Advanced Gastric Cancer (국소적으로 진행된 위암의 수술후 방사선 치료성적)

  • Lee Myung Za;Chun Ha Chung;Kim Insoon;Chung Tejune
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.113-119
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    • 1997
  • Purpose : Radical gastrectomy is main treatment of gastric cancer. But the result is not satisfactory with surgery alone. Most of pattern of failure remain locoregional recurrence. To improve 5 year survival postoperative chemotherapy with or without radiotherapy has been used. We analyzed patients with stage III and IV stomach cancer who had radical operation and received postoperative radiation therapy combined with or without chemotherapy retrospectively. Material and Method : From March 1985 to June 1993, 68 patients treated with curative resection and received postoperative adiuvant radiotherapy with 36Gy or more were evaluated. Median age was 60 years(range 28-66 yrs) . Patients were followed from 3 to 133 months with median follow up of 48 months. Thirty seven patients had non signet ring adenocarcinoma, 29 signet ring cell, 2 other cell. Patients with stage IIIA, IIIB, IV disease were 19, 25 and 24 respectively Chemotherapy was given to all patients except two. Results : Five-year overall survival and disease-free survival rate were 36.6% and 33.6%, respectively. Prognostic factor affecting survival were assessed. High ratio of jnvolved/dissected Iymph node, signet ring histology showed Poor Prognosis with statistical significance. Presence of residual tumor after surgery, stageIV. split course of radiation therapy, age, number of involved Iymph node, number of Iymph node dissection and grade of tumor affected survival without statistical significance, Type of chemotherapy did not affect survival. Recurrence was documented in 34 patients. High recurrence was seen in omentum and peritoneum with 23.5%, and remnant stomach, anastomosis site, A-loop and I-loop had also high recurrence with 13.2%. In field locoregional recurrence was 20.7% and total distant metastases were 39.7%. Total intraabdominal failure was 47.1% and extraabdominal failure was 13.2%. Treatment toxicity was considered to be acceptable. 22.1% of patients had grade 3 and only 1 patient had grade 4 leukopenia. Six Patients(8.8%) had weigh loss more than 10%. Conclusion : Treatment toxicity was acceptable with combined treatment with chemotherapy and radiotherapy. Locoregional recurrence was relatively low compared to distant failure with addition of irradiation. Peritoneal and omental seeding was high Five-rear surival was increased with combined modality. Radiation may eradicate minimal residual disease and improve survival, To evaluate role of radiation Prospective randomized study employing chemotherapy alone and chemotherapy plus radiation is necessary. Futhermore to reduce intraabdominal failure, role of intraabdominal chemotherapy in addition to combined chemotherapy plus radiation has to be explored.

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Clinical Characteristics of the Intracordal Cysts (성대낭종의 임상적 특성)

  • Cho, Young-Ju;Yang, Yoon-Su;Yoon, Yong-Joo;Kwon, Sam-Hyun;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.1
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    • pp.47-51
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    • 2009
  • Background and Objectives: Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They may occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. With the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Methods: In the present study, 212 cases of the intracordal cysts were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 212 cases in the 4,20 I patients who underwent laryngeal microsurgery (5.04%). Ductal cysts were 156 cases and epidermoid cysts were 56 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the preoperative laryngoscopic examination, the intracordal cysts were mostly misdiagnosed as other disease of the vocal cord such as vocal polyps or nodules. And main cause of intracordal cysts was thought of vocal abuse. From view of the surgical approach, Ductal cysts was difficult to remove completely than epidermoid cyst without cystic wall rupture. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without rupture of the cystic wall or injury of the lamina propria. And marsupialization is meaningful to ductal cyst that cannot be enucleated completely.

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Performance Measurements of Positron Emission Tomography: An Investigation Using General Electric $Advance^{TM}$ (양전자방출단층촬영기의 표준 성능평가 방법: GE $Advance^{TM}$에 적용한 예)

  • Lee, J.R.;Choi, Y.;Choe, Y.S.;Lee, K.H.;Kim, S.E.;Shin, S.A.;Kim, B.T.
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.548-559
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    • 1996
  • A series of performance measurements of positron emission tomography (PET) were performed following the recommendations of the Computer and Instrumentation Council of the Society of Nuclear Medicine and the National Electrical Manufacturers Association. We investigated the performance of the General Electric $Advance^{TM}$ PET. The measurements include the basic intrinsic tests of spatial resolution, scatter fraction, sensitivity, and count rate losses and randoms. They also include the tests of the accuracy of corrections: count rate linearity correction, uniformity correction, scatter correction and attenuation correction. GE $Advance^{TM}$ PET has bismuth germanate oxide crystals (4.0mm transaxial ${\times}$ 8.1mm axial ${\times}$ 30.0mm radial) in 18 rings, which form 35 imaging planes spaced by 4.25mm. The system has retractable tungsten septa 1mm thick and 12cm long. Transaxial resolution was 4.92mm FWHM in 2D and 5.14mm FWHM in 3D at the center. Average axial resolution in 2D decreased from 3.91mm FWHM at the center to 6.49mm FWHM at R=20cm. Average scatter fraction of direct and cross slices was 9.57%. Dead-time losses of 50% corresponded to a radioactivity concentration of $4.86{\mu}Ci/cc$ and a true count rate of 519 kcps in 2D. The accuracy of count rate linearity correction was 1.84% at the activity of $4.50{\mu}Ci/cc$. Non-uniformity was 2.06% in 2D and 2.93% in 3D. Remnant errors after scatter correction were 0.55% in 2D and 4.12% in 3D. The errors of attenuation correction were 6.21% (air), 0.20% (water), -6.32% (teflon) in 2D and 5.00% (air), 6.94% (water), 3.01% (teflon) in 3D. The results indicate the performance of GE $Advance^{TM}$ PET scanner to be well suited for clinical and research applications.

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THE EFFECTS OF SURFACE CONTAMINATION BY HEMOSTATIC AGENTS ON THE SHEAR BOND STRENGTH OF COMPOMER (지혈제 오염이 콤포머의 전단결합강도에 미치는 영향)

  • Heo, Jeong-Moo;Kwak, Ju-Seog;Lee, Hwang;Lee, Su-Jong;Im, Mi-Kyung
    • Restorative Dentistry and Endodontics
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    • v.27 no.2
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    • pp.150-157
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    • 2002
  • One of the latest concepts in bonding are "total etch", in which both enamel and dentin are etched with an acid to remove the smear layers, and "wet dentin" in which the dentin is not dry but left moist before application of the bonding primer Ideally the application of a bonding agent to tooth structure should be insensitive to minor contamination from oral fluids. Clinically, contaminations such as saliva, gingival fluid, blood and handpiece lubricant are often encountered by dentists during cavity preparation. The aim of this study was to evaluate the effect of contamination by hemostatic agents on shear bond strength of compomer restorations. One hundred and ten extracted human maxillary and mandibular molar teeth were collected. The teeth were removed soft tissue remnant and debris and stored in physiologic solution until they were used. Small flat area on dentin of the buccal surface were wet ground serially with 400, 800 and 1200 abrasive papers on automatic polishing machine. The teeth were randomly divided into 11 groups. Each group was conditioned as follows : Group 1: Dentin surface was not etched and not contaminated by hemostatic agents. Group 2: Dentin surface was not etched but was contaminated by Astringedent$^{\circledR}$(Ultradent product Inc., Utah, U.S.A.) Group 3: Dentin surface was not etched but was contaminated by Bosmin$^{\circledR}$(Jeil Pharm, Korea.). Group 4: Dentin surface was not etched but was contaminated by Epri-dent$^{\circledR}$(Epr Industries, NJ, U.S.A.). Group 5: Dentin surface was etched and not contaminated by hemostatic agents. Group 6: Dentin sorface was etched and contaminated by Astringedent$^{\circledR}$. Group 7 : Dentin surface was etched and contaminated by Bosmin$^{\circledR}$. Group 8: Dentin surface was etched and contaminated by Epri-dent$^{\circledR}$. Group 9: Dentin surface was contaminated by Astringedent$^{\circledR}$. The contaminated surface was rinsed by water and dried by compressed air. Group 10: Dentin surface was contaminated by Bosmin$^{\circledR}$. The contaminated surface was rinsed by water and dried by compressed air. Group 11 : Dentin surface was contaminated by Epri-dent$^{\circledR}$. The contaminated surface was rinsed by water and dried by compressed air. After surface conditioning, F2000$^{\circledR}$ was applicated on the conditoned dentin surface The teeth were thermocycled in distilled water at 5$^{\circ}C$ and 55$^{\circ}C$ for 1,000 cycles. The samples were placed on the binder with the bonded compomer-dentin interface parallel to the knife-edge shearing rod of the Universal Testing Machine(Zwick Z020, Zwick Co., Germany) running at a cross head speed or 1.0 mm/min. Group 2 showed significant decrease in shear bond strength compared with group 1 and group 6 showed significant decrease in shear bond strength compared with group 5. There were no significant differences in shear bond strength between group 5 and group 9, 10 and 11.

APPLICATION OF ACIDIC PRIMER FOR ORTHODONTIC ADHESIVE SYSTEM (Acidic primer를 이용한 교정용 브라켓 접착의 전단결합강도)

  • Kim, Jin-Hee;Jin, Hun-Hee;Oh, Jang-Kyun
    • The korean journal of orthodontics
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    • v.31 no.1 s.84
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    • pp.137-147
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    • 2001
  • Acidic primer is the bonding agent which combines the conditioning and priming agent into the single solution and was originally developed for the dentin bonding system. It is less harmful to the tooth structure and more convenient to manipulate than the traditional etching procedure. The Purpose of this study is to evaluate the shear bond strength of various bonding materials when the enamel is treated with acidic primer for the bracket bonding procedure. Fifty recently extracted human premolars were randomly separated into five groups -Group I using Clearfil Liner Bond 2 adhesive system to the enamel treated with acidic primer, Group II using Transbond XT adhesive system to the enamel treated with acidic primer, Group III using panavia 21 adhesive system to the enamel treated with acidic primer, Group IV using Fuji-Ortho LC adhesive system to the enamel treated with acidic primer, Group V using Transbond XT adhesive system to the enamel treated with 37$\%$ phosphoric acid. The shear bond strength was measured with Instron universal testing machine after storing in $37^{\circ}C$ water bath for 48 hours. After debonding, the teeth and brackets were examined under scanning electron microscope (SEM) and assessed with the adhesive remnant index (ARI). The results were as follows : 1. There were no significant differences in shear bond strength between group III ($8.69{\pm}2.72MPa$), group IV (9.7 ± 3.16 MPa), and group V ($10.48{\pm}2.60MPa$) (p>0.05). 2. The shear bond strength of group III and group IV was significantly higher than that of group I ($1.09{\pm}0.53MPa$), and Group II ($2.70{\pm}1.46MPa$) (p<0.05). 3. The ARI of group IV ($2.1{\pm}1.1$) and group V ($2.9{\pm}0.3$) was significantly higher than that of group I ($0.2{\pm}0.4$), group II ($0.3{\pm}0.9$) and group III ($0.2{\pm}0.4$) (p<0.05). 4. There were no significant difference between the ARI of group IV and group V (p>0.05). This result suggests that the combination of acidic primer and some bonding adhesive can provide sufficient shear bond strength for clinical orthodontics.

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Subjective and Functional Results after a Proximal Gastrectomy: Prospective Study for Comparison of Reconstruction Procedures (근위부 위절제술 후 재건 술식에 따른 경과 관찰)

  • Kim, Ji-Hoon;Yook, Jeong-Hwan;Kim, Byung-Sik;Oh, Sung-Tae
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.1-5
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    • 2006
  • Purpose: A proximal gastrectomy is performed for gastric cancer in the upper part of the stomach to preserve the function of the stomach after surgery. An esophagogastrostomy is one of the common reconstruction methods for a proximal gastrectomy, but this method results in a high incidence of reflux esophagitis. This study was undertaken to compare subjective and functional results between esophagogastrostomy and jejunal interposition reconstructions. Materials and Methods: From June 1998 to December 2002, proximal gastrectomies were performed in 33 patients with tumors in the upper third of the stomach; 8 had reconstruction using jejunal interposition between the esophagus and the remnant stomach (JI group) while 25 had reconstruction using esophagogastrostomy (EG group). The postroperative courses of the patients were reviewed in terms of symptoms, weight changes, and endoscopic findings. Results: The mean age of the patients was 59 years; 26 were men and 7 were women. There were no significant differences in general complications, operating times, or histologic features between the two groups. Fifty-two percent (52%) of the EG group complained of dysphagia, and 16% them experienced heartburn and acid belching. Twelve percent (12%) of the JI group complained of dysphagia, but heartburn and acid belching did not occur. Incidences of reflux esphagitis (36%) and balloon dilatation for anastomotic stricture (16%) were more common in the EG group than in the JI group (0% and 12%). Conclusion: To prevent or minimize complications, such as reflux esophagitis and postoperative symptoms, a proximal gastrectomy with a jejunal interposition is an alternative method as an organ-preserving surgical strategy to improve quality of life for patients. (J Korean Gastric Cancer Assoc 2006;6:1-5)

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Devonian Strata in Imjingang Belt of the Central Korean Peninsula: Imjin System (임진강대의 중부 고생대층: 임진계)

  • Choi, Yong-Mi;Choh, Suk-Joo;Lee, Jeong-Hyun;Lee, Dong-Chan;Lee, Jeong-Gu;Kwon, Yi-Kyun;Cao, Lin;Lee, Dong-Jin
    • The Journal of the Petrological Society of Korea
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    • v.24 no.2
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    • pp.107-124
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    • 2015
  • The 'Imjin System' (or Rimjin System) was established in 1962 as a new stratigraphic unit separated from the Upper Paleozoic Pyeongan System based on the discovery of brachiopods and echinoderms of possible Devonian age. Subsequent discoveries of the Middle Devonian charophytes confirmed the Devonian age of the system. The Imjin System is distributed in the Imjingang Belt between the Pyongnam Basin and the Gyeonggi Massif, spans from the eastern areas including Cholwon-gun of the Gangwon Province, Gumchon-gun, Phanmun-gun, and Tosan-gun of the Hwanghaebuk Province, to the western areas of Gangryong-gun and Ongjin-gun of the Hwanghaenam Province, and includes the Yeoncheon Group (metamorphic complex) to the south. Unlike the lower Paleozoic strata in the Pyongnam Basin which solely produce marine invertebrate fossils, the Imjin System yields diverse non-marine plant and algal fossils. Brachiopods of the system are similar to those from the Devonian of the South China Block and include taxa endemic to the platform, implying a close paleogeographic affinity to the South China Block. The Imjin System is generally considered as of Middle to Late Devonian in age, although there have been suggestions that the system is of the Middle Devonian to Carboniferous in age. North Korean workers postulated that the Imjin System was deposited in the current geographic position, where the "Imjin Sea" (an extension of the South China Platform) was located during the Devonian. The Imjin System displays strong local variations in stratigraphy and its thickness. It has recently been reported that the strata are repeated and overturned by thrust faults in many exposures. The Yeoncheon Group a southward extension of the Imjin System, also experienced intense tight folding and contractional deformation. Northward decrease in metamorphic grade within the system suggests that the northern part of the Gyeonggi Massif and the Imjingang Belt are probably an extension of the Dabie-Sulu Belt between the South China and Sino-Korean blocks, and the Imjin System is an remnant of accretion resulted from the collision between the two blocks. In order to understand tectonic evolution and Paleozoic paleogeography of eastern Asia, further studies on stratigraphic, sedimentologic and tectonic evolution of the Imjin System involving scientists from the two Koreas are urgently needed.

The Effect of Temporary Cement Cleaning Methods on the Retentive Strength of Cementation Type Implant Prostheses (임시 시멘트 제거방법이 시멘트 유지형 임플란트 보철물의 유지력에 미치는 영향)

  • Shin, Hwang-Kyu;Song, Young-Gyun;Shin, Soo-Yeon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.125-140
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    • 2011
  • The remnant of temporary cement on the intaglio surface of cast restoration may have a negative effect on the retentive strength of permanent cement. This study was to evaluate the effect of temporary cement cleaning methods on the retentive strength of cementation type implant prostheses. Prefabricated implant abutments - height 5.5mm, diameter 4.5mm, 6 degree axial wall taper with chamfer margins were used. Forty copings-abutment specimens were divided into four groups(each n=10) according to the cleaning methods for temporary cement(Temp-$Bond^{(R)}$) as follows : no temporary cementation(the control group), orange solvent, ultrasonic cleaning, air borne-particle abrasion. After the application of temporary cement and the separation, the cleaning procedure was performed according to the protocol of each group. The specimens were cemented with $Premier^{(R)}$ Implant $Cement^{TM}$. After the permanent cementation, the specimens were subjected to thermocycling and pulled out from the specimens with a universal testing machine at a cross-head speed of 0.5mm/min. After the retentive strength test, all the specimens were cleaned using ultrasonic cleaning, abraded with air borne-particles, and steam-cleaned. Likewise, the specimens were temporarily cemented(Temp-$Bond^{(R)}$ NE), cleaned according to the protocol of each group, cemented with $Premier^{(R)}$ Implant $Cement^{TM}$ and subjected to thermocycling and measurement of their retentive strength. The mean of group with orange solvent were significantly lower than those of other groups(p<0.05). There was no significance between group with ultrasonic cleaning and group with air borne-particle abrasion. Group with ultrasonic cleaning and group with air-particle abrasion were no significance at control group. There was no significance between group cemented with Temp-$Bond^{(R)}$ and group cemented with Temp-$Bond^{(R)}$ NE. Within the limitation of this study, it can be concluded that the temporary cement cleaning method with only orange solvent may have a negative effect on the retentive strength of permanent cement. Ultrasonic cleaning and air borne-particle abrasion methods are recommended for the temporary cement cleaning method on cementation type implant prostheses.

A Simple Isolating Method of Preantral Follicles from Mouse Ovaries (생쥐 난소에서 Preantral Follice의 단순 분리법)

  • Kim, Ju-Hwan;Park, Kee-Sang;Song, Hai-Bum;Chun, Sang-Sik
    • Clinical and Experimental Reproductive Medicine
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    • v.27 no.3
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    • pp.235-243
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    • 2000
  • Objective: Our present studies were conducted to examine more effective isolating method of preantral follicles from mouse ovaries. Methods: ICR mice (3-6 weeks old) were sacrificed through cervical dislocation and their ovaries were removed and put into watch glasses containing Hams F-10 supplemented with 10% fetal bovine serum (FBS). Preantral follicles were isolated by three different methods; 1) enzymatical method and 2) mincing method, and 3) scraping method. Enzymatical method was carried out as following. Ovaries were bisected with a pair of fine 30G needles. Bisected ovaries were incubated at $37^{\circ}C$ and 5% $CO_2$ incubator in 2-well dish containing Hams F-10 supplemented with collagenase 600 lU/ml and DNAse 20 lU/ml. After 20 min., follicles were isolated by repeated pipetting. Isolated preantral follicles were collected, and the remnant of tissues was placed in incubator and previous procedure was repeated. Mincing method was carried out with a pair of fine 30G needles attached to 1 ml syringes and minced ovary. Scraping method was carried out with a pair of fine 30G needles and scratched to surface of ovary. The differences between isolating methods were analyzed using Student's t-test and Chi-square. Results were considered statistically significant when ${\rho}$ value was less than 0.05. Results: In handling time, mincing or scraping method ($28{\pm}3.42$ min or $16{\pm}1.58$ min) were significantly (p<0.00001) shorter than enzymatical method ($72{\pm}1.69$ min), and scraping method was significantly (p<0.01) shorter than mincing method. Total number of isolated follicles was significantly (p<0.0001) higher in enzymatical method ($49.8{\pm}3.91$) than in mincing or scraping method ($25.3{\pm}2.33$ or $20.5{\pm}1.75$). Isolated follicles in ${\leq}$90${\mu}m$ were significantly (p<0.005) higher in enzymatical method ($15{\pm}1.71$) than in mincing or scraping method ($7.8{\pm}0.98$ or $8.1{\pm}1.31$). In 91~130 ${\mu}m$, isolated follicles were significantly (p<0.0005) higher in enzymatical method ($33{\pm}3.27$) than in mincing or scraping method ($16.3{\pm}1.82$ or $10.7{\pm}1.38$). In ${\geq}$ 131 ${\mu}m$, isolated follicles were not significantly differences between all groups. In equal sizes, the rate of isolated follicles in ${\leq}$ 90 ${\mu}m$ was highest in scraping method (39.6% vs. enzymatical method: 30.1%, p<0.05; mincing method: 30.9%, p=0.11719, NS). Rate of follicles in $91{\sim}130$ ${\mu}m$ was significantly (p<0.05) lower in scraping method (52.7%) than in enzymatical or mincing method (66.3% or 64.5%). Rate of follicles in ${\geq}$131 ${\mu}m$ was highest in scraping method (8.3% vs. enzymatical or scraping method: 3.6%, p<0.05 or 4.6%, p=0.19053, NS). Conclusions: This study suggests that scraping method is simple and useful for isolation of preantral follicles, because this method reduced handling time and recovered enough follicles. The recovered rate of isolated follicles in diameter of 91 ~ 130 ${\mu}m$ was highest in all methods.

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Thyroglossal Duct Cyst and Fistula (갑상설관 낭포 및 루)

  • 최종욱;김한상;안문성;김춘길;주양자
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.10-10
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    • 1981
  • The thyroglossal duct cyst is relatively rare disease that derived congenitally from the remnant of thyroglossal duct and that was found anywhere from the foramen cecum to pyramidal lobe of thyroid. We studied the 62 cases of above disease who admitted and operated at E.N.T. dept. of N.M.C. for 20 years since 1961 to 1980 on the clinical and histopathological aspect, and we concluded following results. 1. In the age distribution, 45 cases(72.6%) were under 20 years, and in the age distribution of the known on-set of symptoms, 26 cases(58.0%) were under 10 years. In the duration, 23 cases(37.0%) were under 1 year. The sex ratio of male to female revealed 1.2:1. 2. The palpable mass were complained at 48 cases(77.4%) and 14 cases(22.6%) complained of the discharge from sinus tracts and the other complaints were dysphagia and odynophagia, etc. 3. In location 55 cases (88.7%) were at midline, 1 case(1.6%) was at right and 6 cases(9.7%) were left sided. And 47 cases(75.8%) were situated at infrahyoid region, 11 cases(17.7%) at suprahyoid, 3 cases(4.8%) at suprasternal, only 1 case(1.6%) at intralingual region. 4. In 27 cases formed fistulae, spontaneous occurrance were 7 cases and artificial occurrance were 20 cases. 5. In histopathologically among 41 cases preserving available slides, 5 cases(12.2%) had single duct and 20 cases(48.8%) had multiple accessory ducts, but 16 cases were impossible to detect the ducts. The lining epithelium composed of chiefly respiratory and squamous epithelium. 15 cases had inflammatory reaction at periductal area and 7 cases had around the cysts. The ectopic thyroid tissue was found on 6 cases(14.6%) and 1 case had the follicular adenoma. 6. In the recurrance rate among 43 cases performed sistrunk type operation, 2 cases (4.6%) recurred, and among 19 cases performed simple removal of cysts, 4 cases (21.1%) recurred.

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