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Validation of Electronic Foot Function Index in Patients with Foot and Ankle Disease: A Randomized, Prospective Multicenter Study (족부 족관절 질환 환자에서 전자식 족부 기능 지수의 인증: 임의 배정, 전향적, 다기관 연구)

  • Lee, Dong Yeon;Kim, Yu Mi;Lee, Jun Hyung;Kim, Jin;Kim, Ji-Beom;Kim, Bom Soo;Choi, Gi Won;Seo, Sang Gyo;Kim, Jun Beom;Park, Se-Jin;Kim, Yoon-Chung;Choi, Young Rak;Lee, Dong-Oh;Cho, Jae-Ho;Chun, Dong-Il;Kim, Hyong Nyun;Park, Jae-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.24-30
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    • 2019
  • Purpose: To evaluate the efficiency of the electronic foot function index (eFFI) through a prospective, random based, multi-institutional study. Materials and Methods: The study included 227 patients ranging in age from 20 to 79 years, visited for surgery in different 15 institutes, and agreed to volunteer. The patients were assigned randomly into a paper-based evaluated group (n=113) and tablet-based evaluated group (n=114). The evaluation was done on the day of hospital admission and the method was changed on the second day of surgery and re-evaluated. PADAS 2.0 (https://www.proscore.kr) was used as an electronic evaluation program. Results: There were no differences in age and sex in both groups. The intraclass correlation coefficient (ICC) evaluation revealed an eFFI ICC of 0.924, showing that both results were similar. The evaluation time was shorter in the tablet-based group than the paper-based group (paper vs tablet, $3.7{\pm}3.8$ vs $2.3{\pm}1.3minutes$). Thirty-nine patients (17.2%) preferred to use paper and 131 patients (57.7%) preferred the tablet. Fifty-seven patients (25.1%) found both ways to be acceptable. Conclusion: eFFI through tablet devices appears to be more constant than the paper-based program. In addition, it required a shorter amount of time and the patients tended to prefer the tablet-based program. Overall, tablet and cloud system can be beneficial to a clinical study.

Multi-Institute, Single Group, Prospective Observational Study to Evaluate the Efficacy of Mucomyst® in Relieving Symptoms of Globus Pharyngeus Refractory to Proton Pump Inhibitor (양성자펌프억제제에 반응하지 않는 인두이물감 환자에서 "뮤코미스트Mucomyst®" 객담제거 및 상기도 염증치료를 통한 증상개선효과 평가 다기관, 단일군, 전향적 관찰 연구)

  • Park, Hannah;Park, Il-Seok;Lee, Sang Hyuk;Lee, Seung-Won;Lee, Sang Joon;Lee, Byung-Joo;Cheon, Yong-Il;Park, Jun-Ook;Oh, Kyoung Ho;Shin, Yoo Seob
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.1
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    • pp.20-25
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    • 2022
  • Background and Objectives Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI). Materials and Method We prospectively evaluated the efficacy of Mucomyst® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst® for 4 and 8 weeks. Results The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. Conclusion Inhaled Mucomyst® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst® treatment as a standard treatment for globus.

Yield, Nitrogen Use Efficiency and N Uptake Response of Paddy Rice Under Elevated CO2 & Temperature (CO2 및 온도 상승 시 벼의 수량, 질소 이용 효율 및 질소 흡수 반응)

  • Hyeonsoo Jang;Wan-Gyu Sang;Youn-Ho Lee;Pyeong Shin;Jin-hee Ryu;Hee-woo Lee;Dae-wook Kim;Jong-tag Youn;Ji-Won Han
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.25 no.4
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    • pp.346-358
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    • 2023
  • Due to the acceleration of climate change or global warming, it is important to predict rice productivity in the future and investigate physiological changes in rice plants. The research aimed to explore how rice adapts to climate change by examining the response of nitrogen absorption and nitrogen use efficiency in rice under elevated levels of carbon dioxide and temperature, utilizing the SPAR system for analysis. The temperature increased by +4.7 ℃ in comparison to the period from 2001 to 2010, while the carbon dioxide concentration was held steady at 800 ppm, aligning with South Korea's late 21st-century RCP8.5 scenario. Nitrogen was applied as fertilizer at rates of 0, 9, and 18 kg 10a-1, respectively. Under conditions of climate change, there was an 81% increase in the number of panicles compared to the present situation. However, grain weight decreased by 38% as a result of reduction in the grain filling rate. BNUE, indicative of the nitrogen use efficiency in plant biomass, exhibited a high value under climate change conditions. However, both NUEg and ANUE, associated with grain production, experienced a notable and significant decrease. In comparison to the current conditions, nitrogen uptake in leaves and stems increased by 100% and 151%, respectively. However, there was a 25% decrease in nitrogen uptake in the panicle. Likewise, the nitrogen content and NDFF (Nitrogen Derived from Fertilizer) in the sink organs, namely leaves and roots, were elevated in comparison to current levels. Therefore, it is imperative to ensure resources by mitigating the decrease in ripening rates under climate change conditions. Moreover, there seems to be a requirement for follow-up research to enhance the flow of photosynthetic products under climate change conditions.

Studies on Takju Brewing with Potatoes (감자를 이용(利用)한 탁주제조(濁酒製造)에 관(關)한 연구(硏究))

  • Kim, S.Y.;Oh, M.J.;Kim, C.J.
    • Applied Biological Chemistry
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    • v.17 no.2
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    • pp.81-92
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    • 1974
  • In order to prepare the mashing materials for 'Takju', Korean wine, with potatoes, theywere steamed, dryed, and pulverized, and their chemical components were analyzed. As a brewing method of Takju with potatoes, general 2nd stage process with Ipkuk and Bunkuk (enzyme sources), commonly used now, was carried out and the effects of preparing conditions of Ipkuk(koji) with potato flour, mashing materials and brewing conditions on the contents of Takju mash, and of storing time on the contents of Takju, were investigated and the results obtained were summarized as follows, 1. Chemical components of steamed potatoes and potato flour were Moisture; 76.2, 10.8%, Total sugar; 16.1, 69.8%, Reducing sugar; 3.45, 13.4%, Crude protein; 2.1, 11.3%, Total acid; 0.012, 0.023% and Volatile acid; 0.0012, 0.0025% respectively. 2. The most effective preparing conditions of Ipkuk with potato flour were to incubate the potato flour added 40-50% of water for 48 hours by general preparing process of Koji, and liquefying and saccharogenic amylase activities of Ipkuk incubated at above conditions were $D40^{\circ}$ 30' 128 W.V. and 13.2 A.U.. 3. The effects of various brewing conditions on the contents of Takju mashes were as follows; 1) Optimum ratio of mashing water and materials for Takju brewing with potato flour was 140ml of water to 60g of flour in 1st stage and 260ml to 140g in 2nd stage. 2) Optimum fermentating times and temperatures for Takju brewing were at $25^{\circ}C$ for 48 hours in 1st stage and at $30^{\circ}C$ for 48 hours in 2nd stage. 3) Optimum amounts of enzyme sources for Takju brewing were 20-30% of Ipkuk and 0.5% of Bunkuk in 1st stage and 1.0% of Bunkuk in 2nd stage. 4) Methanol content of the Takju mash brewed with raw potato flour was much more than that with steamed potato flour. 5) Alcohol, fusel oil and Formol nitrogen contents of the Takju mash brewed with potato flour were less than that with wheat flour, on the contrary, methanol contents and total acidifies of them were showed conversely above. 4. The changes of chemical components and microflora in the mashes during the brewing potato flour Takju were as follows; 1) The accumulation of ethanol followed rapidly in early stage, being the highest at 72 hours (11.9%). 2) Total sugar content of the mash was decreased considerably within 48-72 hours, being 2.62% at 72 hours, and thereafter slowly. 3) Reducing sugar of the mash had a tendency of decreasing, being 0.29% at 48 hours. 4) Total acidity, volatile acidity and Formol nitrogen content of the mash were increased slowly, being 7.30, 0.20, 2.55 at 48 hours. 5) Total cells of yeast appeared the highest in 72 hours ($2.1{\times}10^8$) and thereafter decreased slowly. 6) Total cells of bacteria appeared the highest in 48 hours ($2.4{\times}10^8$) and thereafter decreased or increased slightly. 5. Takju was made from the fermented mash mixed with water to be 6% of alcohol content, and the change of alcohol content, total acidity, total cells of yeast and bacteria during the storing at $30^{\circ}C$ were as follows; 1) Alcohol content of Takju was increased slightly at 24 hours (6.2%), and thereafter decreased slowly. 2) Total acidity of Takju was increased gradually, being 6.1 at 72 hours 3) Total cells of yeast and bacteria appeared the highest at 48 hours ($2.3{\times}10^8,\;1.5{\times}10^8$), and thereafter decreased slowly. 6. Alcohol content, total acidity and Formol nitrogen content of the Takju brewed with potato flour Ipkuk or wheat flour Ipkuk and steamed potatoes(1:5) were 9.8-11.3%, 5.8-7.4, 2.5-3.3 respectively, and the color of the Takju. was similar to commercial Takju. 7. The results of sensory test for various experimental Takju, showed that the Takjues brewed with the materials combined with wheat flour and steamed potatoes(4:5 or 3.5:7.5) were not significantly different in color, taste and flavor from commercial Takju, However, those with potato flour and wheat flour (1:1 or 7:3) were significantly different from commercial Takju.

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Studies on Takju Brewing with Potatoes (감자를 이용(利用)한 탁주제조(濁酒製造)에 관(關)한 연구(硏究))

  • Kim, S.Y.;Oh, M.J.;Kim, C.J.
    • Korean Journal of Agricultural Science
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    • v.1 no.1
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    • pp.67-81
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    • 1974
  • In order to prepare the mashing materials for "Takju", Korean wine, with potatoes they were steamed, dryed, and pulverized, and their chemical components were analyzed. As a brewing method of Takju with potatoes, general 2nd stage process with Ipkuk and Bunkuk (enzyme sources), commonly used now, was carried out and the effects of preparing conditions of Ipkuk(koji) with potato flour, mashing materials and brewing conditions on the contents of Takju mash and of storing time on the contents of Takju, were investigated and the results obtained were summarized as follows. 1. Chemical components of steamed potatoes and potato flour were Moisture; 76.2, 10.8%, Total sugar; 16.1, 69.8%, Reducing sugar; 3.45, 13.4%, Crude protein; 2.1, 11.3%, Total acid; 0.012, 0.023% and Volatile acid; 0.0012, 0.0025% respectively 2. The most effective preparing conditions of Ipkuk with potato flour were to incubate the potato flour added 40-50% of water for 48 hours by general preparing process of Koji, and liquefying and saccharogenic amylase activities of Ipkuk incubated at above conditions were $D_{40^{\circ}}{^{30{\prime}}}$ 128 W.V. and 13.2 A. U. 3. The effects of various brewing conditions on the contents of Takju mashes wereas follows; 1) Optimum ratio of mashing water and materials for Takju brewing with potato flour was 140ml of water to 60g of flour in 1st stage and 260ml to 140g in 2nd stage. 2) Optimum fermentating times and temperatures for Takju brewing were at $25^{\circ}C$ for 48 hours in 1st stage and at $30^{\circ}C$ for 48 hours in 2nd stage. 3) Optimum amounts of enzyme sources for Takju brewing 20-30% of Ipkuk and 0.5% of Bunkuk in 1st stage and 1.0% of Bunkuk in 2nd stage. 4) Methanol content of the Takju mash brewed with raw potato flour was much more than that with steamed potato flour. 5) Alcohol fusel oil and Formal nitrogen contents of the Takju mash brewed with potato flour were less than that with wheat flour, on the contrary, methanol contents and total acidities of them were showed conversely above. 4. The changes of chemical components and microflora in the mashes during the brewing potato flour Takju were as follows; 1) The accumulation of ethanol followed rapidly in early stage, being the highest at 72 hours (11.9%) 2) Total sugar content of the mash was decreased considerably within 48-72 hours, being 2.62% at 72 hours, and thereafter slowly. 3) Reducing sugar of the mash had a tendency of decreasing, being 0.29% at 48 hours. 4) Total acidity, volatile acidity and Formal nitrogen content of the mash were increased slowly, being 7.30, 0.20, 2.55 at 48 hours. 5) Total cells of yeast appeared the highest in 72 hours ($2.1{\times}10^8$) and thereafter decreased slowly. 6) Total cells of bacteria appeared the highest in 48 hours ($2.4{\times}10^8$) and thereafter decreased or increased slightly. 5. Takju was made from the fermented mash mixed with water to be 6% of alcohol content, and the change of alcohol content, total acidity, total cells of yeast and bateria during the storing at $30^{\circ}C$ were as follows; 1) Alcohol content of Takju was increased slightly at 24 hours (6.2%), and thereafter decreased slowly. 2) Total acidity of Takju was increased gradually, being 6.1 at 72 hours 3) Total cells of yeast and bacteria appeared the highest at 48 hours ($2.3{\times}10^8$, $1.5{\times}10^8$) and thereafter decreased slowly. 6. Alcohol content, total acidity and Formol nitrogen content of the Takju brewed with potato flour Ipkuk or wheat flour Ipkuk and steamed potatoes(1:5) were 9.8-11.3%, 5.8-7.4, 2.5-3.3 respectively, and the color of the Takju was similar to commercial Takju. 7. The results of sensory test for various experimental Takju, showed that the Takjues brewed with the materials combined with wheat flour and steamed potatoes (4:5 or 3.5:7.5) were not significantly different in color, taste and flavor from commercial Takju, However, those with potato flour and wheat flour (1:1 or 7:3) were significantly different from commercial Takju.

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Studies on Dry Matter Yields , Chemical Composition and Net Energy Accumulation in Three Leading Temperate Grass Species I. Influence of meteorolgical factors on the dry matter productivity and net energy value under different cutting management (주요 북방형목초의 건물수량 , 화학성분 및 Net Energy 축적에 관한 연구 I. 기상환경 및 예취관리에 따른 건물 및 에너지 생산성 변화)

  • F. Muhlschlegel;G. Voigtlander
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.6 no.2
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    • pp.103-110
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    • 1986
  • The experiments were carried out to study the influence of meteorological factors and cutting management on dry matter accumulation and net energy value in orchardgrass (Dactlylis glomerata L.) cv. Potomac and Baraula, perennial ryegrass (Lolium perenne L.) cv. Reveille and Semperweide and meadow fescue (Festuca pratensis Huds.) cv. Cosmos 11 and N.F.G.. The field trials were designed as a split plot design with three cutting regimes of 6-7 cuts at grazing stage, 4-5 cuts at silage stage and 3 cuts at hat stage in Korea and West Germany from 1975 to 1979. The results obtained are summarized as follows: 1. Productivity of orchardgrass, perennial ryegrass and meadow fescue were mainly affected by cutting systems and meteorological factors, especially air temperature, rainfalls, solar radiation and their interactions. In West Germany, cutting frequency was to be found asan most important factor influenced to dry matter yield and net energy value. 2. Orchardgrass, taken as average of all experimental sites in Korea, produced high yield of 875 kg/10 a in dry matter, which was as much as 32% and 27% higher than those of perennial ryegrass and meadow fescue, respectively. The annual dry matter yields of orchardgrass from 1976 to 1977 were shown a little variation. Dry matter yields in Freising and Braunschweig in West Germany were increased in all grass species continuously. 3. Orchardgrass, perennial ryegrass and meadow fescue showed different response to cutting frequency. The highest dry matter yields were found under 3 cuts at hay stage for orchardgrass and 4-5 cuts at silage stage for perennial ryegrass and meadow fescue. In West Germany, dry matter yields, as average of all grass species under different cutting systems, were 1326 kg, 1175 kg and 1098 kg/10a for 3 cuts, 4-5 cuts and 6-7 cuts, respectively. 4. Chemical composition and net energy concentration of temperate grasses were influenced by cutting managements. The highest yields of digestible crude protein were obtained under 6-7 cuts at grazing stage both in Korea and West Germany. In net energy yields, 3 cutting system produced the highest yield with 694 (orchardgrass), 665 (perennial ryegrass) an 623 kStE/10 a (meadow fescue). However, frequent cutting at grazing and silage stage produced higher yields than 3 cuts at hay stage in Cheju, Suweon and Taekwalyong.

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The Lung Expression of Proinflammatory Cytokines, TNF-$\alpha$ and Interleukin 6, in Early Periods of Endotoxemia (내독소혈증 유발 급성폐손상에서 폐장내 Proinflammatory Cytokines 발현에 관한 고찰)

  • Moon, Seung-Hyug;Kim, Yong-Hoon;Park, Choon-Sik;Lee, Shin-Je
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.553-564
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    • 1998
  • Background: The immediate hoot response to LPS is the production of proinflammatory cytokines that act as intercellular mediators in inflammatory reactions, including acute lung injury. These "early response" cytokines transmit signals from recognition cells to target or effector cells. This host response is further amplified by the expression of leukocyte chemoattractants, growth factors, and adhesion molecules, resulting in an array of proinflammatory events. This experiment was performed to define the lung origin of proinflammatory cytokines, such as TNF-$\alpha$, IL 6 in early periods of endotoxin induced acute lung injury (ALI). Method: The healthy male Sprague-Dawley, weighted 150 - 250g, were divided into saline control (NC) and endotoxemia-induced ALI (ETX-), and leukopenic endotoxemia-induced ALI (CPA-ETX-Group) which was induced by cyclophosphamide, 70 mg/kg i.p. injection. Acute lung injury was evoked by LPS, 5 mg/kg, intravenously administered. Bronchoalveolar lavage was performed at 0, 3, 6 h after LPS-treated to estimate the influx of phagocytes and concentration of total protein, and cytokines as TNF-$\alpha$ and IL 6 by a bioassy using MIT method. We also examined the localization of TNF-$\alpha$ and IL 6 protein in endotoxemia-challenged lung tissue by immunohistochemical stain (IH). Results: The total cell, macrophage and PMN count in BALF were elavated in ETX group compared to NC(p<0.05). In CPA-ETX group, total cell and macrophage count in BALF were not changed compared to NC. but PMN count was markedly reduced and it took part in less than 0.1 % of total BAL cells (p<0.01). The protein concentration in BALF were significantly increased in ETX and CPA-ETX group Compared to NC (p<0.05), but there was significant difference between ETX- and CPA-ETX group only at 6 h (p<0.05). This observation suggested that even if PMNs are involved in the pathogenesis of acute lung injury, their role cannot be viewed as essential The concentration of TNF-$\alpha$ and IL 6 in BALF was significantly increased in the ETX- and CPA-ETX group compared to NC. There was no difference between ETX- and CPA-ETX group. In IH, anti-TNF-$\alpha$- and anti-IL 6 antibody was strongly localized at interstitial monocytes and alveolar macrophages in endotoxemia-challenged lung tissue. From above point of view, activated alveolar macrophage/monocyte considered as a prominent source of proinflammatory cytokines in endotoxemia-challenged lung injury. Conclusion: The prominent source of proinflammatory cytokines in early periods of endotoxemia-induced lung injury will be the activated resident macrophages like an alveolar macrophage and interstitial monocytes. The pulmonary macrophage/monocyte will impact the initiation and continuance of lung injury without PMNs's certain inflammatory role, particularly in endotoxemia-induced acute lung injury.

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Tectonic evolution of the Central Ogcheon Belt, Korea (중부 옥천대의 지구조 발달과정)

  • Kang, Ji-Hoon;Hayasaka, Yasutaka;Ryoo, Chung-Ryul
    • The Journal of the Petrological Society of Korea
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    • v.21 no.2
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    • pp.129-150
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    • 2012
  • The tectonic evolution of the Central Ogcheon Belt has been newly analyzed in this paper from the detailed geological maps by lithofacies classification, the development processes of geological structures, microstructures, and the time-relationship between deformation and metamorphism in the Ogcheon, Cheongsan, Mungyeong Buunnyeong, Busan areas, Korea and the fossil and radiometric age data of the Ogcheon Supergroup(OSG). The 1st tectonic phase($D^*$) is marked by the rifting of the original Gyeonggi Massif into North Gyeonggi Massif(present Gyeonggi Massif) and South Gyeonggi Massif (Bakdallyeong and Busan gneiss complexes). The Joseon Supergroup(JSG) and the lower unit(quartzose psammitic, pelitic, calcareous and basic rocks) of OSG were deposited in the Ogcheon rift basin during Early Paleozoic time, and the Pyeongan Supergroup(PSG) and its upper unit(conglomerate and pelitic rocks and acidic rocks) appeared in Late Paleozoic time. The 2nd tectonic phase(Ogcheon-Cheongsan phase/Songnim orogeny: D1), which occurred during Late Permian-Middle Triassic age, is characterized by the closing of Ogcheon rift basin(= the coupling of the North and South Gyeonggi Massifs) in the earlier phase(Ogcheon subphase: D1a), and by the coupling of South China block(Gyeonggi Massif and Ogcheon Zone) and North China block(Yeongnam Massif and Taebaksan Zone) in the later phase(Cheongsan subphase: D1b). At the earlier stage of D1a occurred the M1 medium-pressure type metamorphism of OSG related to the growth of coarse biotites, garnets, staurolites. At its later stage, the medium-pressure type metamorphic rocks were exhumed as some nappes with SE-vergence, and the giant-scale sheath fold, regional foliation, stretching lineation were formed in the OSG. At the D1b subphase which occurs under (N)NE-(S)SW compression, the thrusts with NNE- or/and SSW-vergence were formed in the front and rear parts of couple, and the NNE-trending Cheongsan shear zone of dextral strike-slip and the NNE-trending upright folds of the JSG and PSG were also formed in its flank part, and Daedong basin was built in Korean Peninsula. After that, Daedong Group(DG) of the Late Triassic-Early Jurassic was deposited. The 3rd tectonic phase(Honam phase/Daebo orogeny: D2) occurred by the transpression tectonics of NNE-trending Honam dextral strike-slip shearing in Early~Late Jurassic time, and formed the asymmetric crenulated fold in the OSG and the NNE-trending recumbent folds in the JSG and PSG and the thrust faults with ESE-vergence in which pre-Late Triassic Supergroups override DG. The M2 contact metamorphism of andalusite-sillimanite type by the intrusion of Daebo granitoids occurred at the D2 intertectonic phase of Middle Jurassic age. The 4th tectonic phase(Cheongmari phase: D3) occurred under the N-S compression at Early Cretaceous time, and formed the pull-apart Cretaceous sedimentary basins accompanying the NNE-trending sinistral strike-slip shearing. The M3 retrograde metamorphism of OSG associated with the crystallization of chlorite porphyroblasts mainly occurred after the D2. After the D3, the sinistral displacement(Geumgang phase: D4) occurred along the Geumgang fault accompanied with the giant-scale Geumgang drag fold with its parasitic kink folds in the Ogcheon area. These folds are intruded by acidic dykes of Late Cretaceous age.

Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer (조기유방암에서 유방보존치료와 유방전절제술의 치료결과 및 실패양상 비교)

  • Kim Yeon-Sil;Yoon Sei-Chul;Chung Su-Mi;Ryu Mi-Ryeong;Jung Sang-Sul;Choi Ihl-Bohng
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.115-123
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    • 2004
  • Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

The micro-tensile bond strength of two-step self-etch adhesive to ground enamel with and without prior acid-etching (산부식 전처리에 따른 2단계 자가부식 접착제의 연마 법랑질에 대한 미세인장결합강도)

  • Kim, You-Lee;Kim, Jee-Hwan;Shim, June-Sung;Kim, Kwang-Mahn;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.148-156
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    • 2008
  • Statement of problems: Self-etch adhesives exhibit some clinical benefits such as ease of manipulation and reduced technique-sensitivity. Nevertheless, some concern remains regarding the bonding effectiveness of self-etch adhesives to enamel, in particular when so-called 'mild' self-etch adhesives are employed. This study compared the microtensile bond strengths to ground enamel of the two-step self-etch adhesive Clearfil SE Bond (Kuraray) to the three-step etch-and- rinse adhesive Scotchbond Multi-Purpose (3M ESPE) and the one-step self-etch adhesive iBond (Heraeus Kulzer). Purpose: The purpose of this study was to determine the effect of a preceding phosphoric acid conditioning step on the bonding effectiveness of a two-step self-etch adhesive to ground enamel. Material and methods: The two-step self-etch adhesive Clearfil SE Bond non-etch group, Clearfil SE Bond etch group with prior 35% phosphoric acid etching, and the one-step self-etch adhesive iBond group were used as experimental groups. The three-step etch-and-rinse adhesive Scotchbond Multi-Purpose was used as a control group. The facial surfaces of bovine incisors were divided in four equal parts cruciformly, and randomly distributed into each group. The facial surface of each incisor was ground with 800-grit silicon carbide paper. Each adhesive group was applied according to the manufacturer's instructions to ground enamel, after which the surface was built up using Light-Core (Bisco). After storage in distilled water at $37^{\circ}C$ for 1 week, the restored teeth were sectioned into enamel beams approximately 0.8*0.8mm in cross section using a low speed precision diamond saw (TOPMET Metsaw-LS). After storage in distilled water at $37^{\circ}C$ for 1 month, 3 months, microtensile bond strength evaluations were performed using microspecimens. The microtensile bond strength (MPa) was derived by dividing the imposed force (N) at time of fracture by the bond area ($mm^2$). The mode of failure at the interface was determined with a microscope (Microscope-B nocular, Nikon). The data of microtensile bond strength were statistically analyzed using a one-way ANOVA, followed by Least Significant Difference Post Hoc Test at a significance level of 5%. Results: The mean microtensile bond strength after 1 month of storage showed no statistically significant difference between all adhesive groups (P>0.05). After 3 months of storage, adhesion to ground enamel of iBond was not significantly different from Clearfil SE Bond etch (P>>0.05), while Clearfil SE Bond non-etch and Scotchbond Multi-Purpose demonstrated significantly lower bond strengths (P<0.05), with no significant differences between the two adhesives. Conclusion: In this study the microtensile bond strength to ground enamel of two-step self-etch adhesive Clearfil SE Bond was not significantly different from three-step etch-and-rinse adhesive Scotchbond Multi-Purpose, and prior etching with 35% phosphoric acid significantly increased the bonding effectiveness of Clearfil SE Bond to enamel at 3 months.