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Role of Concomitant Chemoradiation in Locally Advanced Head and Neck Cancers

  • Lasrado, Savita;Moras, Kuldeep;Pinto, George Jawahar Oliver;Bhat, Mahesh;Hegde, Sanath;Sathian, Brijesh;Luis, Neil Aaron
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4147-4152
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    • 2014
  • Standard therapy for advanced head and neck cancer consists of a combination of surgery and radiation. However, survival of this patient population has not improved during the past 20 years. Many different multimodality treatment schedules have been proposed, and chemotherapy is often used with the intent of organ preservation. The present study was intended to establish the efficacy of concomitant chemoradiation with a single agent carboplatin in advanced head and neck cancers.The objectives were to investigate the feasibility of concomitant administration of carboplatin, monitor acute toxicity during radiotherapy, and determine subacute side effects, such as wound healing following surgery after chemoradiotherapy. A prospective study was conducted wherein a total of 40 patients with stage III and IV squamous cell carcinomas of oral cavity, oropharynx, hypopharynx and larynx were enrolled. All patients were treated with external beam radiotherapy and weekly carboplatin area under curve (AUC of 5). Radiotherapy was given in single daily fractions of 1.8-2 grays (Gy) to a total dose of 66-72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Neck dissection was recommended for all patients with neck disease showing less than a complete response after chemoradiation. A total of 40 patients were enrolled of whom 32 were males and 8 were females. Highest incidence of cancer was seen in the 5th-6th decades of life with a median age of 47.7 years. Oropharyngeal tumours constituted a maximum of 21 patients followed by hypopharynx in 10, larynx in 7 and oral cavity in 2. 80% of the patients had a neck node on presentation of which 40% had N2-N3 nodal status. TNM staging revealed that 58% of patients were in stage III and 43% in stage IV. Evaluation of acute toxicity revealed that 50% had grade II mucositis, 25% grade III mucositis, 2.5% grade IV mucositis. 50% of patients had grade I skin reactions, 65% of patients had grade I thrombocytopenia, and 24% of patients had grade I anaemia. After completion of treatment 65% of patients had complete response at the primary and regional sites, and 35% of patients had a partial response of whom 23% underwent neck dissection and 5% of them underwent salvage surgery at the primary site. At the end of one year there were six deaths and four recurrences and 70% were free of disease. Concurrent chemoradiation with carboplatin provided good locoregional control for locally advanced head and neck cancers. This regimen, although toxic, is tolerable with appropriate supportive intervention. Primary site conservation is possible in many patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancers.

The study on the causal agent of Streptococcicosis (Lactococcus garvieae), isolated from cultured marine fishes (해산 양식어류로부터 분리된 연쇄구균증의 원인균, Lactococcus garvieae에 대한 연구)

  • Lee, Deok-Chan;Lee, Jae-Il;Park, Chan-Il;Park, Soo-Il
    • Journal of fish pathology
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    • v.14 no.2
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    • pp.71-80
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    • 2001
  • The purpose of this study was to investigate the microbiological characteristics and the distributions of the bacteria causing streptococcicosis occurred in marine fish farm, Korea. Many kinds of cultures fishes suffered from the disease accompanied with typical symptoms, including darkening of the skin, exophthalmia, petechiae inside of the opercula and distended abdomen. The isolates from the diseased fishes were compared with Lactococcus garvieae by biochmical, biophysical and serological methods and polymerase chain reaction(PCR) assay. We isolated 35 strains of the geuns Streptococcus from the diseased olive flounder, Paralichthys olivaceus, yellow tail, Seriola quinqueradiata and Korean rockfish, Sebastes schlegeli. 15 strains out of the isolates were identified to L. garvieae and the others were not because of their different biochemical and biophysical charateristics. Seven strains of the isolates were agglutinated by rabbit serum raised against L. garvieae $KG^+$ phenotypic cells(ATCC49156)as a reference strain. Twenty-one strains of the isolates identified to L. garvieae since they were formed the expected band through performing PCR assay using specific primers, pLG-1(5'-CATAACAATGAGATCGC-3') and pLG-2(5'-GCACCCCGCGGTTG-3'). In the present study, it showed that L. garvieae was a dominant strain causing streptococcicosis in the tested area due to occurrence of 21 strains as L. garvieae out of all the isolates, 9 atrains as Streptococcus sp. and 5 strains as Enterococcus sp.

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The Lines Extraction and Analysis of The Palm using Morphological Information of The Hand and Contour Tracking Method (손의 형태학적 정보와 윤곽선 추적 기법을 이용한 손금 추출 및 분석)

  • Kim, Kwang-Baek
    • The Journal of the Korea institute of electronic communication sciences
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    • v.6 no.2
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    • pp.243-248
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    • 2011
  • In this paper, we propose a new method to extract palm lines and read it with simple techniques from one photo. We use morphological information and 8-directional contour tracking algorithm. From the digitalized image, we transform original RGB information to YCbCr color model which is less sensitive to the brightness information. The palm region is extracted by simple threshold as Y:65~255, Cb:25~255, Cr:130~255 of skin color. Noise removal process is then followed with morphological information of the palm such that the palm area has more than quarter of the pixels and the rate of width vs height is more than 2:1 and 8-directional contour tracking algorithm. Then, the stretching algorithm and Sobel mask are applied to extract edges. Another morphological information that the meaningful edges(palm lines) have between 10 and 20 pixels is used to exclude noise edges and boundary lines of the hand from block binarized image. Main palm lines are extracted then by labeling method. This algorithm is quite effective even reading the palm from a photographed by a mobile phone, which suggests that this method could be used in various applications.

Development of Korean Exposure Factors for Children in Korea (국내 어린이 위해성평가를 위한 노출계수 연구)

  • Yoon, Hyojung;Seo, Jungkwan;Kim, Taksoo;Kim, Joohyun;Jo, Areum;Lee, Byeongwoo;Lim, Hyunwoo;Lee, Daeyeop;Kim, Pilje;Choi, Kyunghee;Yang, Wonho
    • Journal of Environmental Health Sciences
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    • v.43 no.3
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    • pp.167-175
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    • 2017
  • Objectives: Children may be more exposed to certain environmental contaminants because they react with greater sensitivity and have different food intakes and breathing rate per unit of body weight compared to adults. The aim of this study was to determine general exposure factors such as skin surface area, period and frequency of exposure, and others among Korean children aged ${\leq}18$ years old. This study was carried out as the first of its kind in Korea. Methods: We developed 23 recommended exposure factors for Korean children aged 0 to 18 years by reclassifying raw data from the National Health and Nutrition Examination Survey and the National Statistical Information Service, as well as through investigation by experiments in the absence of related data. Results: Reflecting the activity patterns of about 9,000 children, the daily inhalation rates for long-term exposure ranged from $9.49m^3/day$ for children from birth to <2 years to $14.98m^3/day$ for children aged 16 to <18 years. The research found that Korean children spent an average of 22.21 hours indoors, 0.67 hours outdoors, and 1.12 hours in-transit every day. Young children (${\leq}2$ years old) spent approximately 34 more minutes outdoors on weekends than they did on weekdays. Conclusion: Various physiological variables in the human body reflect characteristics of children that can directly influence risk exposure. Therefore, the identification of general exposure factors based on Korean children is required for appropriate risk assessment.

Airborne Nicotine Concentrations in Harvesting and the Processing of Tobacco Leaves (담뱃잎 수확 및 가공 과정에서 공기 중 니코틴농도)

  • Park, Sung-Jun;Kim, Jong-Seuk;Kim, Jik-Su;Lee, Kwan;Lim, Hyun-Sul
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.20 no.1
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    • pp.47-52
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    • 2010
  • Green tobacco sickness (GTS) is known as an occupational disease among tobacco harvesters, and a form of acute nicotine intoxication by the absorption of nicotine through the skin from the wet green tobacco plant. On the assumption that GTS may occur by inhalation as well as absorption of nicotine, we measured the airborne nicotine concentration in tobacco field and the processing room of tobacco leaves. We measured the airborne nicotine concentrations in the tobacco field and processing room between 13 and 30 July 2008. All sampling and analyses of airborne nicotine were conducted according to the manual of analytic methods of NIOSH 2551, and we sampled 2 times at 11 points in the tobacco field by area sampling. The sampling in the processing room of tobacco leaves was conducted at 3 points, and earlymorning dew was collected from the tobacco by wringing the moisture into specimen bottles. The airborne nicotine concentration [geometric mean (geometric standard deviation)] in the tobacco field in the P.M. was higher [49.2 mg/$m^3$ (1.3)] than the A.M. concentration [43.4 mg/$m^3$ (1.4)]. Similarly, the nicotine concentration in the processing room of tobacco leaves was 224.4 mg/$m^3$ (1.2), and the concentration of nicotine in the dew was 64.7 mg/${\ell}$ (1.7). Based on our results, the airborne nicotine concentration in the tobacco field and the processing room of tobacco leaves were 100 and 400 times higher than the occupational recommended values (TLV-TWA of 0.5 mg/$m^3$), respectively. In the future, it is hoped that epidemiologic studies and environmental measurements will be conducted for GTS which occurs by inhalation of nicotine. If GTS is confirmed to occur by inhalation of nicotine, respiratory and dermal protective equipment must be distributed.

A study of the relationship between clinical phenotypes and plasma iduronate-2-sulfatase enzyme activities in Hunter syndrome patients

  • Lee, Ok-Jeong;Kim, Su-Jin;Sohn, Young-Bae;Park, Hyung-Doo;Lee, Soo-Youn;Kim, Chi-Hwa;Ko, Ah-Ra;Yook, Yeon-Joo;Lee, Su-Jin;Park, Sung-Won;Kim, Se-Hwa;Cho, Sung-Yoon;Kwon, Eun-Kyung;Han, Sun-Ju;Jin, Dong-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.3
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    • pp.88-92
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    • 2012
  • Purpose: Mucopolysaccharidosis type II (MPS II or Hunter syndrome) is a rare lysosomal storage disorder caused by iduronate-2-sulfatase (IDS) deficiency. MPS II causes a wide phenotypic spectrum of symptoms ranging from mild to severe. IDS activity, which is measured in leukocyte pellets or fibroblasts, was reported to be related to clinical phenotype by Sukegawa-Hayasaka et al. Measurement of residual plasma IDS activity using a fluorometric assay is simpler than conventional measurements using skin fibroblasts or peripheral blood mononuclear cells. This is the first study to describe the relationship between plasma IDS activity and clinical phenotype of MPS II. Methods: We hypothesized that residual plasma IDS activity is related to clinical phenotype. We classified 43 Hunter syndrome patients as having attenuated or severe disease types based on clinical characteristics, especially intellectual and cognitive status. There were 27 patients with the severe type and 16 with the attenuated type. Plasma IDS activity was measured by a fluorometric enzyme assay using 4-methylumbelliferyl- ${\alpha}$-iduronate 2-sulphate. Results: Plasma IDS activity in patients with the severe type was significantly lower than that in patients with the attenuated type ($p$=0.006). The optimal cut-off value of plasma IDS activity for distinguishing the severe type from the attenuated type was 0.63 $nmol{\cdot}4hr^{-1}{\cdot}mL^{-1}$. This value had 88.2% sensitivity, 65.4% specificity, and an area under receiver-operator characteristics (ROC) curve of 0.768 (ROC curve analysis; $p$=0.003). Conclusion: These results show that the mild phenotype may be related to residual lysosomal enzyme activity.

Experimental Studies on the Hair Growth Activity of Trimix Extracts of Mylabris Phalerata Pall., Arisaematis Rhizoma and Pinelliae Rhizoma Ternata in C57BL/6N mice (반모(斑蝥), 남성(南星), 반하(半夏)(생(生))추출 혼합물의 발모효과에 대한 실험적 연구)

  • Chung, Han-Sol;Cho, Han-Young;Lee, Chang-Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.5
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    • pp.1116-1124
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    • 2009
  • To determine whether topical application of trimix extracts of Mylabris phalerata Pall., Arisaematis Rhizoma and Pinelliae Rhizoma Ternata lead to affects on the hair growth activity in C57BL/6N mice. To examine the hair growth activity of the extracts of Mylabris phalerata Pall., Arisaematis Rhizoma and Pinelliae Rhizoma Ternata gross, microscopic, and immunohistochemical method were performed. In order to examine the mRNA expression of hair growth related substance, RT-PCR method was performed. Experimental group I on day 14, The most extensive hair growth activity was observed in whole skin area of all the mice whose hair had been clipped. Brdu immunoreactive cells of all the experimental groups were more heavily stained in epidermis, bulge, outer root sheath, inner root sheath, subcutaneous tissue, hair bulb and cutaneous trunci muscles than that of control group on day 12 of hair growing cycle in C57BL/6N mice. VEGF immunoreactive density of all the experimental groups was more heavily stained in epidermis, bulge and cutaneous trunci muscles than that of control group on day 12. FGF and c-kit immunoreactive cells of all the experimental groups were heavily stained in epidermis, outer root sheath, inner root sheath and cutaneous trunci muscles on day 12. PKC-$\alpha$ immunoreactive density of all the experimental groups was mildly stained in epidermis and cutaneous trunci muscles than that of control group on day 12. On day 12, the expression of bFGF (138%, 119%, 120%), VEGF (146%, 144%, 133%), IGF-1 (165%, 141%, 119%) and PLI (121%, 116%, 123&) in each experimental groups was more increased than that of control group. On day 16, The expression of IGF-1 (126%, 149%, 151%) in all the experimental group was more increased than that of control group (100%). The expression of bFGF (92%, 94%) and VEGF (101%, 97%), PL1 (102%, 109%) in all the experimental group was more decreased than that of experimental group I, II on day 12. But the expression of bFGF (109%) and VEGF (127%), and PL1 (105%) in each experimental group III was more increased than that of control group (100%). These experiments suggest that trimix extracts of Mylabris phalerata pall., Arisaematis Rhizoma and Pinelliae Rhizoma Ternata may stimulate the topical hair growth activity and its experimental group I can be useful for treatment of alopecia areata.

Revisit of the Extended Indications and Clinical Utilities of Arterialized Venous Flap for Hand Reconstruction (수부 재건을 위한 동맥화 정맥 피판의 확장된 적응증과 임상적 유용성의 재조명)

  • Woo, Sang-Hyun;Kim, Kyung-Chul;Lee, Gi-Jun;Ha, Seung-Han;You, Sun-O;Kim, Joo-Sung
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.1-13
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    • 2005
  • Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

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Face Tracking Method based on Neural Oscillatory Network Using Color Information (컬러 정보를 이용한 신경 진동망 기반 얼굴추적 방법)

  • Hwang, Yong-Won;Oh, Sang-Rok;You, Bum-Jae;Lee, Ji-Yong;Park, Mig-Non;Jeong, Mun-Ho
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.48 no.2
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    • pp.40-46
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    • 2011
  • This paper proposes a real-time face detection and tracking system that uses neural oscillators which can be applied to access regulation system or control systems of user authentication as well as a new algorithm. We study a way to track faces using the neural oscillatory network which imitates the artificial neural net of information handing ability of human and animals, and biological movement characteristic of a singular neuron. The system that is suggested in this paper can broadly be broken into two stages of process. The first stage is the process of face extraction, which involves the acquisition of real-time RGB24bit color video delivering with the use of a cheap webcam. LEGION(Locally Excitatory Globally Inhibitory)algorithm is suggested as the face extraction method to be preceded for face tracking. The second stage is a method for face tracking by discovering the leader neuron that has the greatest connection strength amongst neighbor neuron of extracted face area. Along with the suggested method, the necessary element of face track such as stability as well as scale problem can be resolved.

A New Kiwifruit Variety, 'Halla Gold' with High Soluble Solids Content and Early Harvesting (고당도 조생종 참다래 신품종 '한라골드')

  • Kim, Seong-Cheol;Song, Eun-Young;Kim, Chun-Hwan
    • Horticultural Science & Technology
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    • v.30 no.3
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    • pp.334-337
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    • 2012
  • A new promising kiwifruit, 'Halla Gold' variety with yellow flesh and being harvested in October, was developed at the Agricultural Research Center for Climate Change, National Institute of Horticultural and Herbal Science, Rural Development Administration, Korea in 2007. This variety was derived from the seedling population crossed between Actinidia chinensis cv. Golden Yellow and A. chinensis cv. Songongu in 1997. It was selected out of 2,971 seedlings. Characteristic trials were carried out from 2001 to 2003. After the selection, adaptability test was also conducted at kiwifruit orchards in Jeju Island from 2003 to 2007. Shoots of 'Halla Gold' sprout slightly stronger than those of 'Jecy Gold' but weaker than 'Hort16A' and the color of leaf is green. Fruit shape is oblong and fruit skin color is yellowish-dark green without hair. The average weight of fruit is 106.3 g. Fruit has a moderate size soft core, yellow pericarp, and fragile and juicy flesh. Soluble solids content is $14.7^{\circ}$ Brix and acidity is 1.4%. The harvesting time is about 10 days earlier than 'Jecy Gold' and about 20 days ahead of 'Hort16A'. The storage life is about 90 days at $2^{\circ}C$. This variety can be recommended for cultivating at low land area bellow 100 m sea level in Jeju Island or under shelter to prevent disease and cold injury.