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Favorable Outcome in Elderly Asian Patients with Metastatic Renal Cell Carcinoma Treated with Everolimus: The Osaka Urologic Oncology Group

  • Inamoto, Teruo;Azuma, Haruhito;Nonomura, Norio;Nakatani, Tatsuya;Matsuda, Tadashi;Nozawa, Masahiro;Ueda, Takeshi;Kinoshita, Hidefumi;Nishimura, Kazuo;Kanayama, Hiro-Omi;Miki, Tsuneharu;Tomita, Yoshihiko;Yoshioka, Toshiaki;Tsujihata, Masao;Uemura, Hirotsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1811-1815
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    • 2014
  • Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.

Theoretical Analysis of FBARs Filters with Bragg Reflector Layers and Membrane Layer (브래그 반사층 구조와 멤브레인 구조의 체적 탄성파 공진기 필터의 이론적 분석)

  • Jo, Mun-Gi;Yun, Yeong-Seop
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.39 no.4
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    • pp.41-54
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    • 2002
  • In this study, we have analyzed the effects of the membrane layer and the bragg reflector layers on the resonance characteristics through comparing the characteristics of the membrane type FBAR (Film Bulk Acoustic Wave Resonator) and the one type bragg reflector layers with those of the ideal FBAR with top and bottom electrode contacting air by using equivalent circuit technique. It is assumed that ZnO is used for piezoelectric film, $SiO_2$ are used for membrane layer and low acoustic impedance layer, W are used for the high acoustic reflector layer and Al is used for the electrode. Each layer is considered to have a acoustic propagation loss. ABCD parameters are picked out and input impedance is calculated by converting 1-port equivalent circuit to simplified equivalent circuit that ABCD parameters are picked out possible. From the variation of resonance frequency due to the change of thickness of electrode layers, reflector layers and membrane layer it is confirmed that membrane layer and the reflector layer just under the electrode have the greatest effect on the variation of resonance frequency. From the variation of resonance properties, K and electrical Q with the number of layers, K is not much affected by the number of layers but electrical Q increases with the number of layers when the number of layers is less than seven. The electrical Q is saturated when the number of layers is large than six. The electrical Q is dependent of mechanical Q of reflector layers and membrane layer. Both ladder filter and SCF (Stacked Crystal Filters) show higher insertion loss and out-of-band rejection with the increase of the number of resonators. The insertion loss decreases with the increase of the number of reflector layers but the bandwidth is not much affected by the number of reflector layers. Ladder Filter and SCF with membrane layer show the spurious response due to spurious resonance properties. Ladder filter shows better skirt-selectivity characteristics in bandwidth but SCF shows better characteristics in insertion loss.

Orientation, Surface Roughness and Piezoelectric Characteristics of AlN Thin Films with RF Magnetron Sputtering Conditions (RF 마그네트론 스퍼터링 공정 조건에 따른 AlN 박막의 배향성, 표면 거칠기 및 압전 특성에 관한 연구)

  • Bang Jung-Ho;Chang Dong-Hoon;Kang Seong-Jun;Kim Dong-Guk;Yoon Yung-Sup
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.43 no.4 s.346
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    • pp.1-7
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    • 2006
  • AlN thin films have been fabricated by using RF magnetron sputtering method and their crystal orientations, microstructures and piezoelectric properties have been investigated with variation of the $Ar/N_2$ gas ratio and the substrate temperature. Particularly, when the $Ar/N_2$ gas ratio and the substrate temperature are 10/10 (sccm) and $400^{\circ}C$, respectively, the AlN thin film exhibits the highest (002) orientation. The result of the surface roughness measurement by using AFM shows that the surface roughness becomes better as the partial pressure of $N_2$ increases at the substrate temperature of $400^{\circ}C$ and it becomes the smallest value of 2.1 nm when $Ar/N_2$ is 0/20 (sccm). The AFM measurement also shows that when $Ar/N_2$ is 10/10 (sccm) shows that surface roughness becomes better as the substrate temperature increases from room temperature up to $300^{\circ}C$ and then it becomes worse as the substrate temperature goes up from $300^{\circ}C$. At the substrate temperature of $300^{\circ}C$ and $Ar/N_2$=10/10 (sccm), the surface roughness is 3.036 nm. The piezoelectric constant ($d_{33}$) of AlN thin film is measured by Pneumatic probe method. The measurement shows that the AlN thin film with the highest (002) orientation, fabricated at $Ar/N_2$=10/10 (sccm) and the substrate temperature of $400^{\circ}C$, has the best Piezoelectric constant ($d_{33}$) of 6.01 pC/N.

A 10b 200MS/s 75.6mW $0.76mm^2$ 65nm CMOS Pipeline ADC for HDTV Applications (HDTV 응용을 위한 10비트 200MS/s 75.6mW $0.76mm^2$ 65nm CMOS 파이프라인 A/D 변환기)

  • Park, Beom-Soo;Kim, Young-Ju;Park, Seung-Jae;Lee, Seung-Hoon
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.46 no.3
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    • pp.60-68
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    • 2009
  • This work proposes a 10b 200MS/s 65nm CMOS ADC for high-definition video systems such as HDTV requiring high resolution and fast operating speed simultaneously. The proposed ADC employs a four-step pipeline architecture to minimize power consumption and chip area. The input SHA based on four capacitors reduces the output signal range from $1.4V_{p-p}$ to $1.0V_{p-p}$ considering high input signal levels at a low supply voltage of 1.2V. The proposed three-stage amplifiers in the input SHA and MDAC1 overcome the low output resistance problem as commonly observed in a 65nm CMOS process. The proposed multipath frequency-compensation technique enables the conventional RNMC based three-stage amplifiers to achieve a stable operation at a high sampling rate of 200MS/s. The conventional switched-bias power-reduction technique in the sub-ranging flash ADCs further reduces power consumption while the reference generator integrated on chip with optional off-chip reference voltages allows versatile system a locations. The prototype ADC in a 65nm CMOS technology demonstrates a measured DNL and INL within 0.19LSB and 0.61LSB, respectively. The ADC shows a maximum SNDR of 54.BdB and 52.4dB and a maximum SFDR of 72.9dB and 64.8dB at 150MS/S and 200MS/s, respectively. The proposed ADC occupies an active die area of $0.76mm^2$ and consumes 75.6mW at a 1.2V supply voltage.

A 0.31pJ/conv-step 13b 100MS/s 0.13um CMOS ADC for 3G Communication Systems (3G 통신 시스템 응용을 위한 0.31pJ/conv-step의 13비트 100MS/s 0.13um CMOS A/D 변환기)

  • Lee, Dong-Suk;Lee, Myung-Hwan;Kwon, Yi-Gi;Lee, Seung-Hoon
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.46 no.3
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    • pp.75-85
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    • 2009
  • This work proposes a 13b 100MS/s 0.13um CMOS ADC for 3G communication systems such as two-carrier W-CDMA applications simultaneously requiring high resolution, low power, and small size at high speed. The proposed ADC employs a four-step pipeline architecture to optimize power consumption and chip area at the target resolution and sampling rate. Area-efficient high-speed high-resolution gate-bootstrapping circuits are implemented at the sampling switches of the input SHA to maintain signal linearity over the Nyquist rate even at a 1.0V supply operation. The cascode compensation technique on a low-impedance path implemented in the two-stage amplifiers of the SHA and MDAC simultaneously achieves the required operation speed and phase margin with more reduced power consumption than the Miller compensation technique. Low-glitch dynamic latches in sub-ranging flash ADCs reduce kickback-noise referred to the differential input stage of the comparator by isolating the input stage from output nodes to improve system accuracy. The proposed low-noise current and voltage references based on triple negative T.C. circuits are employed on chip with optional off-chip reference voltages. The prototype ADC in a 0.13um 1P8M CMOS technology demonstrates the measured DNL and INL within 0.70LSB and 1.79LSB, respectively. The ADC shows a maximum SNDR of 64.5dB and a maximum SFDR of 78.0dB at 100MS/s, respectively. The ABC with an active die area of $1.22mm^2$ consumes 42.0mW at 100MS/s and a 1.2V supply, corresponding to a FOM of 0.31pJ/conv-step.

Design of DVB-T/H SiP using IC-embedded PCB Process (IC-임베디드 PCB 공정을 사용한 DVB-T/H SiP 설계)

  • Lee, Tae-Heon;Lee, Jang-Hoon;Yoon, Young-Min;Choi, Seog-Moon;Kim, Chang-Gyun;Song, In-Chae;Kim, Boo-Gyoun;Wee, Jae-Kyung
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.47 no.9
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    • pp.14-23
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    • 2010
  • This paper reports the fabrication of a DVB-T/H System in Package (SiP) that is able to receive and process the DVB-T/H signal. The DVB-T/H is the European telecommunication standard for Digital Video Broadcasting (DVB). An IC-embedded Printed Circuit Board (PCB) process, interpose a chip between PCB layers, has applied to the DVB-T/H SiP. The chip inserted in DVB-T/H SiP is the System on Chip (SoC) for mobile TV. It is comprised of a RF block for DVB-T/H RF signal and a digital block to convert received signal to digital signal for an application processor. To operate the DVB-T/H IC, a 3MHz DC-DC converter and LDO are on the DVB-T/H SiP. And a 38.4MHz crystal is used as a clock source. The fabricated DVB-T/H SiP form 4 layers which size is $8mm{\times}8mm$. The DVB-T/H IC is located between 2nd and 3rd layer. According to the result of simulation, the RF signal sensitivity is improved since the layout modification of the ground plane and via. And we confirmed the adjustment of LC value on power transmission is necessary to turn down the noise level in a SiP. Although the size of a DVB-T/H SiP is decreased over 70% than reference module, the power consumption and efficiency is on a par with reference module. The average power consumption is 297mW and the efficiency is 87%. But, the RF signal sensitivity is declined by average 3.8dB. This is caused by the decrease of the RF signal sensitivity which is 2.8dB, because of the noise from the DC-DC converter.

Breeding status and nest site characteristics of Black-faced Spoonbills Platalea minor on Chilsando Islands, Korea (칠산도의 저어새 번식 현황과 둥지장소 특성)

  • Kwon, In-Ki;Kang, Jung-Hoon;Lee, Ki-Sup;Lee, Ji-Yeon;Kim, In-Kyu;Yoo, Jeong-Chil
    • Korean Journal of Environment and Ecology
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    • v.29 no.5
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    • pp.703-709
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    • 2015
  • A breeding pair of the Black-faced Spoonbill Platalea minor was firstly recorded on Chilsando Islands, Younggwang, Jeollanamdo Province in 1991. Since the mid 2000s, breeding population on the breeding sites has gradually increased. This study was conducted to identify breeding status and nest site characteristics of the species from May to August, 2013 on Chilsando Islands. We recorded number of nests, length and width of the nest base, slope around the nests, nest materials, distances from the nearest nest, presence of nest cover and nesting area. In 2013 breeding season, 25 of 49 nests produced at least one successful fledging. A total of 55 youngs were successfully fledged and number of fledging per nest was 2.20 individuals. Nesting area was $77.8m^2$ and $93.4m^2$ for Sansando and Yuksando Islet, respectively. Soil and soil mixed with tree root were preferred for substrate of nest base over rock and Brassica napus was dominantly selected as nest materials by Black-faced Spoonbills. Nest characteristics of 22 nests in Sasando and Yuksando Islet varied $49.59{\pm}6.53cm$(mean${\pm}$SD) for length of nest base, $41.00{\pm}5.82cm$ for width of nest base, $20.85{\pm}9.96^{\circ}$ for slope above the nest, $34.09{\pm}17.75^{\circ}$ for slope below the nest and $130.82{\pm}84.17cm$ for distances from the nearest nest. Fifteen pairs (68.2%) occupied where nest cover existed. Nest cover were located in front of the nest for 5 pairs, back of the nest for 9 pairs and both front and back of the nest for 1 pair.

A Comparison of Needs for Hospice Care between Families of Children and Adult with Cancer (암 환아 및 암 환자 가족의 호스피스 요구도 비교)

  • Kang, Kyung-Ah;Kim, Shin-Jeong
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.216-223
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    • 2005
  • Purpose: The purpose of this study was to compare the need for hospice care between families of children and adults with cancer. Methods: The data was collected from 190 families of children and adult with cancer using self-rating questionnaires from December, 2004 to February, 2005. Data was analyzed using SPSS/Win program by Mean, SD and t-test. Results: The mean score of the need for hospice care in families of children with cancer was greater significantly than in families of adults with cancer (t=-2.126, P=.035). The scores of two factors among the five factors evaluated for the need for hospice care were different significantly. The mean score of control of major terminal physical symptoms' in families of children with cancer was greater significantly than the mean score of adults with cancer (t=-2.165, P=.032). The mean score of 'spiritual care to prepare for death' in families of adults with cancer was greater significantly than the mean score of children with cancer (t=-2.380, P=.018). Conclusion: For improving the quality of life for both patients and families, the hospice service program needs to consider the life cycle of patients.

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Study of Kidney Toxicity of Azadirachta Indica Extract for Oral Administration in Rats (님추출물의 경구투여에 따른 랫드의 신장독성 연구)

  • Yoon, Hyunjoo;Choe, Miseon;Cho, Hyeon-Jo;Han, Beom Seok;Park, Kyung-Hun;Oh, Jin-Ah;Cho, Namjun;Paik, Min-Kyoung
    • Korean Journal of Environmental Agriculture
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    • v.33 no.2
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    • pp.103-110
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    • 2014
  • BACKGROUND: Azadirachta indica has been widely used as environment-friendly organic materials because of its insecticidal properties. This study was carried out to investigate the acute toxicity and the subacute toxicity of Azadirachta indica extract(AIE) in rats. METHODS AND RESULTS: For the oral acute toxicity test, Sprague-Dawley rats were gavaged with 2.0 g/Kg bw of AIE. The $LD_{50}$ value was greater than 2.0 g/Kg bw for both male and female rats. For the subacute toxicity study, rats were treated with AIE at doses of 0.5, 1.0, 2.0 mg/Kg bw once a day for 4 weeks(n=10 animals per each group). There were no significant changes in body weight, food intake and water consumption observed during the experimental duration. In addition, no difference of relative kidney weight was observed among all treated groups. Serum creatinine level in the AIE 2.0 g/Kg group increased significantly compared with that of control group in male rats, but serum blood urea nitrogen was significantly decreased in a dose-dependent manner (p<0.05). Significant increase of serum cholesterol levels were observed in all AIE groups, compared with the control group, in the female rats (p<0.05). However, histopathological examination of the kidney did not reveal any significant lesions in all groups. CONCLUSION: On the basis of results, it could be concluded that oral administration AIE didn't cause any toxic response in kidney, except the increased serum cholesterol.

Reduction of Postsurgical Adhesion Formation of Reproductive Tract with Sodium Carboxymethylcellulose in Korean Black Goats (Sodium Carboxymethylcellulose가 개복 수술한 한국흑염소의 생식기 유착 방지에 미치는 영향 평가)

  • Shin, H.G.;Choi, Y.S.;Lee, S.J.;Lee, D.S.;Cho, J.K.;Shin, S.T.
    • Journal of Embryo Transfer
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    • v.22 no.1
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    • pp.63-67
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    • 2007
  • This study was performed to evaluate the efficacy of sodium carboxymethylcellulose (SCMC) for the prevention of postoperative uterus and ovary adhesion formation in the Korean black goats. Twenty adult female Korean black goats randomly were divided into five groups with four animals in each group. After the routine laparotomy, catheter for injection was inserted into the abdomen. Before abdominal closure, saline, 1% SCMC, 2% SCMC or 0.4% HA solution (50ml/10kg of body weight/head) were injected in the abdominal cavity in each group. Three weeks after surgery, second laparotomy was performed and the adhesions were scored on a scale of 0 to 10 according to their vascularity and adhesion size in uterus and ovary. This trial was repeated the four times with the interval of three weeks. In the first and second trial, the group treated with 2% SCMC significantly reduced the adhesion formation than other treatment groups (P<0.05). In the third trial, the adhesion formation was significantly reduced in 2% SCMC and 1% SCMC (P<0.05). In the fourth trial, 2% SCMC reduced the adhesion formation. However, there was no significant difference among other groups. This study showed that the 2% SCMC administered at the end of the surgery reduced the adhesion formation in the Korean black goats.