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Role of Postoperative Radiotherapy for Patients with Pathological Stage III Non-Small-Cell Lung Cancer after Curative Resection (근치적 절제술 후 병기3의 비소세포성 폐암에서 수술 후 방사선 치료의 역할)

  • Kim, Mi-Young;Wu, Hong-Gyun;Kim, Hak-Jae;Heo, Dae-Seog;Kim, Young-Whan;Kim, Dong-Wan;Lee, Se-Hoon;Kim, Joo-Hyun;Kim, Young-Tae;Kang, Chang-Hyun
    • Radiation Oncology Journal
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    • v.29 no.1
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    • pp.44-52
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    • 2011
  • Purpose: To evaluate the outcomes and prognostic factors of postoperative radiotherapy (PORT) for patients with pathological stage III non-small-cell lung cancer (NSCLC) at a single institution. Materials and Methods: From 2000 to 2007, 88 patients diagnosed as having pathologic stage III NSCLC after curative resection were treated with PORT. There were 80 patients with pathologic stage IIIA and eight patients with pathologic stage IIIB in the AJCC 6th staging system. The majority of patients (n=83) had pathologic N2 disease, and 56 patients had single station mediastinal LN metastasis. PORT was administered using conventional technique (n=76) or three-dimensional conformal technique (n=12). The median radiation dose was 54 Gy (range, 30.6 to 63 Gy). Thirty-six patients received chemotherapy. Radiation pneumonitis was graded by the Radiation Therapy Oncology Group system, and other treatment-related toxicities were assessed by CTCAE v 3.0. Results: Median survival was 54 months (range, 26 to 77 months). The 5-year overall survival (OS) and disease free survival (DFS) rates were 45% and 38%, respectively. The number of metastatic lymph nodes was associated with overall survival (hazard ratio, 1.037; p-value=0.040). The 5-year locoregional recurrence free survival (LRFS) and distant metastasis free survival (DMFS) rates were 88% and 48%, respectively. Multiple stations of mediastinal lymph node metastasis was associated with decreased DFS and DMFS rates (p-value=0.0014 and 0.0044, respectively). Fifty-one relapses occurred at the following sites: 10 loco-regional, 41 distant metastasis. Grade 2 radiation pneumonitis was seen in three patients, and symptoms were well tolerated with anti-tussive medication. Grade 2 radiation esophagitis was seen in 11 patients. There were no grade 3 or more severe complications associated with PORT. Conclusion: Our retrospective data show that PORT for pathological stage III NSCLC is a safe and feasible treatment and could improve loco-regional control. The number of metastatic lymph nodes and stations of mediastinal lymph node metastasis were analyzed as prognostic factors. Furthermore, efforts are needed to reduce distant metastasis, which is a major failure pattern of advanced stage NSCLC.

Experimental Studies on the Immunization Against Metastrongylus apri Infection with X-irradiated Infective Larvae (X 선조사감염자충(線照射感染仔蟲)에 의한 돈폐충증(豚肺蟲症)의 면역(免疫)에 관한 실험적연구(實驗的硏究))

  • Hyun-Beom, Lee
    • Korean Journal of Veterinary Research
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    • v.11 no.1
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    • pp.1-39
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    • 1971
  • The purpose of present study was to investigate the possibility to immunize guineapigs and swine against Metastrongylus apri infection by the administration of irradiated infective larvae. Four main experiments were undertaken. Firstly, three groups of infective larvae irradiated at $3{\times}10^4r$, $4{\times}10^4r$, and $5{\times}10^4r$ respectively were inoculated to guineapigs and their immunogenic effects were examined from the clinical, anatomical, and serological viewpoints to decide the optimal dose of X-ray for the atenuation of them. Secondly, the migratory behavior of the larvae irradiated at the optimal dose was compared with that of normal infective larvae. Thirdly, pigs were inoculated with each 5,000 infective larvae irradiated at the optimal dose and the clinical, anatomical and serological responses of them before and after challenge were examined. Fourthly, the heated extract of adult M. apri which had been used as an antigen in the serological examinations was analyzed and compared with that of adult Ascaris suis and of adult Trichuris suis by immunoelectrophoretic method. The results obtained are summerized as follows: 1) The optimal dose of X-ray for the atenuation of the infective larvae which can minimize the pathogenecity but keep the antigenecity of the infective larvae was $5{\times}10^4r$. 2) Guineapigs could become completely resistant to subsequent challenge infection by the administration of 1,000 infective larvae irradiated at $5{\times}10^4r$, without showing any symptom of disease before and after the challenge. 3) There were some indication that guineapigs could acquire complete immunity after they overcome the infection with normal infective larvae. 4) It was shown that, in guineapigs, the $5{\times}10^4r$-irradiated larvae can migrate to the large intestine and mesenteric lymph node within a day, where they stay for as long as 16 days to stimulate the host's immunity. 5) It also was shown that, in guineapigs, the normal infective larvae challenged to resistant guineapigs can migrate to the large intestine and mesenteric lymph node, where they are affected by the immune mechanism of host within 10 days without further migration. 6) Pigs could become partially resistant to subsequant challenge by the administration of 5,000 infective larve irradiated at $5{\times}10^4r$; no clinical symptom occurred after the administration, but milder symptoms of parasitic bronchitis were observable after the challenge infection and fewer number of worms were detected from the lungs at autopsy compared with severe symptoms and much number of worms in control pigs. 7) It was shown that, in pigs, a few of the $5{\times}10^4r$-irradiated larvae can migrate to the lungs, where they stay for as long as 104 days in stunted and sterile states; their body-lengths were short and their uteri developted no eggs. 8) There was evidence that the male larvae were more susceptible to X-ray than the female larvae. 9) Antibodies relating to the administration with $5{\times}10^4r$-irradiated or normal larvae were detected from the sera of both guineapigs and pigs by means of indirect haemagglutination and agar diffusion precipitin tests. Relatively higher antibody titers were recorded by the former test, but precipitin bands were demonstrable only when the positive sera were concentrated in one tenth of original volume in the later one. 10) The antibody titers of pig sera began to rose on 14 days, kept their peak during the period from 14 th day to 21st day, and fell to a low level on 28 days after the administration of $5{\times}10^4r$ or normal infective larvae. 11) A slight increase in gamma globublin of the pig sera occurred following the administration. The gamma globulin level showed a tendency to fluctuate in acordance with the antibody level. 12) A marked eosionophilia occurred in pigs on 7 or 14 days following the administration. The eosinophil count showed the same tendency to fluctuate as the gamma globulin did. 13) It was shown that the serum antibodies detected by the heated extract of adult Metastrongylus apri react crossly with the heated extract of adult Ascaris suis but not with that of adult Trichuris suis in indirect haemagglutination and agar diffusion preciption reactions. 14) The heated extract of adult Metastrongylus apri could he divided into 9 antigenic components by immunoelectrophoresis, one (arc 4) of which was shown to be common to both extracts of adult Ascaris suis and adult Trichuris suis, and the other one (arc 9) to only the extract of adult Ascaris suis.

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Factors Affecting Herbicidal Phytotoxicity and Efficacy of Antidote, CGA 123' 407, in Rice Nursery (못자리용(用) 제초제(除草劑)의 약해발생(藥害發生) 요인(要因)과 해독제(解毒劑) "CGA 123' 407" 효과(效果))

  • Kim, Soon-Chul;Lee, Soo-Kwan
    • Korean Journal of Weed Science
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    • v.5 no.1
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    • pp.63-72
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    • 1985
  • To establish the method of integrated weed management in rice nurserybed, phytotoxic factors of herbicide and antidote efficacy were evaluated at the Yeongnam Crop Experiment Station in 1982 and 1984. Seven hundred eighty four research items were carried out as weed control research since 1961. While 65% of these were belonged to rice research, only 6% was attributed to nurserybed among rice research. More herbicidal phytotoxicity exhibited when seedbed was pressed just after seeding than sand covered or uncovered seedbed and also this phytotoxic symptom enhanced by using intact seed compared to pregerminated seed. Rinsing practice of seedbed reduced the phytotoxic effect of butachlor and this effect was more pronounced with the number of rinsing operation increase and at the pressed plot. However, herbicidal efficacy was not significantly decreased by rinsing operation. Growth of rice seedling hardly affected where the herbicide was absorbed through root only compared to absorption from both of root and shoot for pyrazolate, butachlor and thiobencarb. Herbicide antidote `CGA 123'407' completely protected from the phytotoxic effect of pretilachlor without arising any adversal effect in weed control. However, without antidote, pretilachlor showed the most severe phytotoxic symptom among used herbicides.

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Changes in Centration of Contact Lenses on Cornea and Blink Rate Associated with Overusage of Disposable Lenses (일일 착용 렌즈의 착용기간 초과시 유발되는 렌즈의 중심 안정 위치 및 순목횟수 변화)

  • Park, Mijung;Yang, Jae Heon;Kim, Sun Mi;Park, Sang-Il;Park, Sang Hee;Kim, So Ra
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.4
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    • pp.51-58
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    • 2008
  • Purpose: This study was assessed to investigate adverse effect induced by overuse of disposable soft contact lenses (CL). Methods: Three disposable lenses (etafilcon A, hilabilcon A, and nelfilcon A) were applied to 19 normal subjects free from any eye diseases for either a single day or variable periods by when subjects complained any discomforts. On the first and last days, localizations of lens' center on corneal surface and blink rates were recorded at every case. Results: Among CL wearers, 10.5% and 47.4% of total subjects quit wearing on the second day and third day, respectively. The case of stopping disposable lens wear was continuously increased with extended hour of lens application. On fourth day, 70.2% of CL wearers reported severe discomforts such as redness, dryness, irritation, pain and blurred vision. When subjects stopped CL wear, decentration of lens from the center of cornea was observed when it compared to the case of single usage of disposable CL. Also about 80% of total subjects showed increased blink rate when CL were worn for more than 2 days. These changes in lens centration and blink rate were consistantly shown regardless of lens types. Conclusions: Blurred vision and acute/chronic discomforts could occur to CL wearers by decentration of lens and increased blink rate when CL were overused more than 2 days even the numbers of two parameters measured in this study were variable by each subject or lens types. Therefore, consideration of individual characteristics and lens types is critical to prevent adverse effects may induced by overusage of disposable lens.

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Stratigraphy and Provenance of Non-marine Sediments in the Tertiary Cheju Basin (제주분지 제삼기 육성층의 층서 및 퇴적물 기원)

  • Kwon Young-In;Park Kwan-Soon;Yu Kang-Min;Son Jin-Dam
    • The Korean Journal of Petroleum Geology
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    • v.3 no.1 s.4
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    • pp.1-15
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    • 1995
  • Seismic reflection profiles and exploratory drilling well samples from the southern marginal-continental shelf basin of Korea delineate that the Tertiary sedimentary sequences can be grouped into five sequences (Sequence A, Sequence B, Sequence C, Sequence D and Sequence E, in descending order). Paleontologic data, K-Ar age datings, correlation with tuff layers and sequence stratigraphic analysis reveal that the sequences A, B, C, D and E can be considered as the deposits of Holocene $\~$ Pleistocene, Pliocene, Late Miocene, Early $\~$ Middle Miocene and Oligocene, respectively. The sequence stratigraphic and structural analyses suggest that the southern part of the Cheju Basin had experienced severe folding and faulting. NE-SW trending strike-slip movement is responsible for the deformation. The sinistral movement of strike-slip fault ceased before the deposition of Sequence B. Age dating and rare-earth elements analysis of volvanic rocks reveal+ that the Sequence D was deposited during the Early $\~$ Middle Miocene and the Sequence I was deposited earlier than the deposition of the Green Tuff Formation. Sedimentary petrological studies indicate that sediments of the Sequence I came from the continental block provenance. After the deposition of the Sequence E, uplift of the source area resulted in increase of sediment supply, subsidence and volcanic activities. The Sequence D show these factors and the sediments of the Sequence D are considered to be transported from the recycled orogenic belt.

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The Immunogenicity and Safety Study of 47 Passaged Oka Strain Live Attenuated Varicella Vaccine in Healthy Children (건강한 소아에서의 47계대 Oka주 수두약독화 생백신의 면역원성 및 안전성에 관한 연구)

  • Kang, Jin Han;Kim, Jong Hyun;Suh, Byung Kyu
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.257-264
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    • 1997
  • Purpose: We performed this study to find out short period humoral immunogenicity and safety of 47 passaged Oka strain live attenuated varicella vaccine(1,400PFU) in 12 months to 15 years aged healthy children. Methods: Ninety nine healthy chidren, who have no histories of varicella vaccination, recent chicken pox illness and contact, allergy to other vaccines and underlying severe diseases, were involved in this study from April 1997 to August 1997. 5ml blood were collected before vaccination and after vaccination from all vaccinees to measure varicella membrane antibody by FAMA, and varicella IgG antibody by EIA. And immediate reactions within 30 minutes after vaccination, local and systemic reactions within 3 days after vaccination and vaccine induced systemic illness during 6 weeks postvaccination period were observed in all vaccinees to identify side effects of study vaccine. Results: 1) 49 seronegative and 50 seropositive vaccinees were identified in both prevaccination serologic tests. 2) Serologic responses after vaccination measured by the FAMA in seronegative group showed that the mean GMT level revealed 64.0, and seroconversion rate was 97.9%. And serologic responses after vaccination measured by the FAMA in seropositive group showed that the mean GMT level(242.2) was markedly elevated comparing with the mean GMT level(9.2) of pre vaccination. 3) The results of EIA in seronegative group revealed that postvaccination mean GMT was 435.2(prevaccination GMT; 78.7), and 100% seroconversion rate. Also, the results of EIA in seropositve group showed that the mean GMT level(769.9) of postvaccination was almostly two fold hihger than the mean GMT level(419.7) of prevaccination. 4) Observed local reactions like injection sites redness, pain, hardness and itching sense were mild and disappeared within 3 days, also shorterm systemic reactions like irritability, lethargy, poor appetites and rash were not remarkable. And there were no remarkable side effects due to vaccine during study period in all vaccinees. Conclusion: We confirmed that 47 paasaged Oka strain live attenuated varicella vaccine has high shorterm humoral immunogenicity and safety. However, we need more detail and longterm humoral and cell mediated immunogenicity studies of this vaccine including clinical field trials.

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The Influence of Atopic Findings on Severity of Pneumonia in Children with 2009 Pandemic Influenza A (H1N1) Infection (2009 신종 인플루엔자 A (H1N1) 폐렴 환아에서 아토피 소견이 폐렴의 중증도에 미치는 영향)

  • Kim, Jong Hee;Kim, Hyun Jeong;Kang, Im Ju
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.182-192
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    • 2011
  • Purpose : Atopic findings may be associated with severity of pneumonia in 2009 pandemic influenza A (H1N1) infection, which could suggest a possible association between atopic findings and the severity of viral infections. Thus, we studied association between atopic findings and severity of disease in children with H1N1 influenza infection. Methods : A retrospective study was performed in 74 children admitted in a single tertiary institute and confirmed as H1N1 patients by reverse transcriptase (RT) - polymerase chain reaction (PCR). They were divided into 2 groups according to the severity of pneumonia. We evaluated whether the atopic finding is risk factor between the two groups. Results : Children with severe pneumonia had higher percentages of serum eosinophilia (88% vs 40%, P <0.001), asthma (65% vs 35%, P =0.011), allergic rhinitis (71% vs 40%, P =0.009), and IgE level (P =0.007). We found positive correlations between aeroallergen sensitizations and severity of pneumonia (82% vs 53%, P =0.007). Conclusion : Among patients with H1N1 pneumonia, asthma and atopic findings are risk factors for severity of pneumonia.

Analysis of Palivizumab Prophylaxis in Patients with Acute Lower Respiratory Tract Infection Caused by Respiratory Syncytial Virus (Respiratory syncytial virus로 인한 급성 하기도 감염 입원 환자에서 Palivizumab 예방요법 유무에 따른 비교 분석)

  • Min, Sung Ju;Song, Jung Sook;Choi, Jang Hwan;Seon, Han Su;Kang, Eun Kyeong;Kim, Do Hyun;Kim, Hee Sup
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.154-162
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    • 2011
  • Purpose : The aim of this study was to identify the clinical characteristics of lower respiratory tract infection due to respiratory syncytial virus (RSV) in young children and to provide information for an effective guideline for palivizumab administration in Korea. Methods : We reviewed medical charts of 167 patients under 3 years of age who were hospitalized in Dongguk University Ilsan Hospital for lower respiratory tract infection between January 2007 and February 2011. Diagnosis of the virus was made based on the multiplex real time polymerase chain reaction. Results : There were 113 patients who were infected by respiratory syncytial virus. 90 patients were term infants and 23 patients were preterm infants. No difference was shown between term and preterm infants except the days of admission which was 9.0${\pm}$6.0 days and 12.6${\pm}$21.0 days respectively. In the preterm group their mean age at the time of admission was 5.21${\pm}$4.9 months and the mean gestational age was 33.1${\pm}$4.3 weeks, and the mean birth weight was 2,152${\pm}$950 g. Only 4 patients were born under 28 weeks gestational age and were candidates for palivizumab administration. Conclusion : Most of the patients with severe RSV lower respiratory tract infection were term or near term infants who were not candidates for palivizumab prophylaxis. A nationwide study is needed to make a new risk stratified guideline for RSV prophylaxis for our country.

Immunogenicity and Safety of Inactivated Influenza Vaccine in Healthy Korean Children and Adolescent (한국의 건강한 소아청소년을 대상으로 한 인플루엔자 사백신의 면역원성과 안전성 연구)

  • Ri, Soohyun;Kim, Mi Jeong;Kim, Yun-Kyung
    • Pediatric Infection and Vaccine
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    • v.25 no.1
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    • pp.35-44
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    • 2018
  • Purpose: This study aimed to evaluate the immunogenicity and safety of a trivalent inactivated influenza vaccine (TIV) among healthy Korean children and adolescents. Methods: From October to December 2008, 65 healthy patients aged 6 months to 18 years who visited Korea University Ansan Hospital for influenza vaccination were enrolled in this study. We measured the hemagglutinin inhibition antibody titers at baseline and 30 days after vaccinating enrollees with split influenza vaccine and calculated the seroprotection rates, geometric mean titers, and seroconversion rates. Local and systemic adverse events were assessed after vaccination. Results: The seroprotection rates against all three viral strains (A/H1N1, A/H3N2, B) were 87.7%, 89.2%, and 89.2% (${\geq}70%$), respectively; seroconversion rates were 44.6%, 73.8%, and 63.1% (${\geq}40%$), respectively; and seroconversion factors were 4.5, 8.4, and 10.5 (>2.5), respectively. The TIV immunogenicity was acceptable according to the CPMP (Committee for Proprietary Medicinal Products) criteria. Although 48 patients (73.8%) reported one or more adverse events, no severe adverse events such as anaphylaxis and convulsion were observed. Forty-two patients (64.6%) reported a local skin reaction, including redness (29.2%), pain (43.1%), or swelling (41.5%) of the injected site, and 26 (40.0%) reported a systemic reaction: fatigue (23.1%), myalgia (20.0%), headache (10.8%), arthralgia (10.8%), chills (9.2%), or fever (7.7%). Conclusions: This study shows that the immunogenicity of the TIV vaccine is acceptable. As there were no serious adverse events aside from local reactions and mild systemic reactions, this vaccine can be safely used among healthy Korean children and adolescents.

Clinical Spectrum of Norovirus Gastroenteritis Compared to Rotavirus Gastroenteritis at a Single Center in Gwangju, Korea during 2005-2006 (2005-2006년 광주 지역에서 소아 Norovirus 장염의 임상적 고찰; Rotavirus 장염과 비교)

  • Lee, Yang Jin;Jeong, Seong Nam;Yoo, Ju Hee;Cho, Hyoung Min;Yoo, Eun Jung;Kim, Eun Young;Kim, Yong Wook;Kim, Kyoung Sim;Kim, Sun Hee
    • Pediatric Infection and Vaccine
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    • v.16 no.1
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    • pp.61-72
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    • 2009
  • Purpose : We evaluated the clinical features of Norovirus gastroenteritis compared with Rotavirus gastroenteritis in hospitalized children. Methods : We detected causative agents in 3,261 samples of children hospitalized with gastroenteritis symptoms at a single center of pediatrics between 2005 and 2006. Among 266 and 303 samples which tested positive for Norovirus and Rotavirus, we selected 73 and 182 samples of children with relatively pure gastroenteritis symptoms and retrospectively analyzed the corresponding medical records. Results : The male-to-female ratio of the Norovirus (+) and Rotavirus (+) groupswas 1.43:1 and 1.56:1 both groups were predominantly in males. The mean age of the Norovirus (+) and Rotavirus (+) groups was 36.7 and 24.4 months, respectively the children in the former group were older than the children in the latter group. The incidence in the Norovirus (+) group was more concentrated in the winter. The symptoms in the Norovirus (+), in decreasing order, included vomiting, diarrhea, and fever. The duration of vomiting, diarrhea, and fever was 2.1, 1.2, and 1.2 days. The maximum number of episodes of vomiting and diarrhea per day was 3.5 and 4.5, respectively. The severity score was 10.16. The symptoms inthe Rotavirus (+) group, in decreasing order, included diarrhea, vomiting, and fever. The duration of diarrhea, vomiting, and fever was 2.2, 4.3, and 2.2 days, respectively. The maximum number of episodes of vomiting and diarrhea per day was 3.3 and 6.5, respectively. The severity score was 11.9. The severity in the Norovirus (+) group was somewhat lower than the Rotavirus (+) group. The younger the child, the more severe the symptoms in the Norovirus (+) group. There was no difference between mono-and co-infection in severity and between the two groups regarding the hematologic findings. Conclusion : Based on the findings reported herein, additional studies about prophylaxis, as well as the epidemiology and clinical features of pediatric Norovirus gastroenteritis, are required.

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