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.
The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
/
v.4
no.3
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pp.226-236
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1999
Growth, reproduction, mortality, and production of Laminaria japonica were experimentally studied at a cultivation ground on the coast of llkwang, where the largest amount of cultivated Laminaria has been produced in Korea. For this experiment, young sporophytes (0.33 cm in mean length) grown in the laboratory were transplanted at the depth of 3 m and field surveys on them were conducted twice a month from December, 1995 to August, 1996. Plants exhibited an annual life span; they were completely dead by August. Frond width, thickness, and wet weight showed similar pattern of seasonal growth and reached their maxima in July, but frond length showed no more increment after May. Maximum mean frond length and weight were 199.8 cm and 333.0 g wet wt., respectively. Overall meristematic growth in length and weight were 384.0 cm and 393.6 g wet wt., respectively. Absolute growth rates (AGR) which were calculated from the length of tissue developed from meristem varied seasonally; AGR of length and weight reached maxima in March (3.6 $cm{\cdot}d^{-1}$) and May (3.8 g wet $wt{\cdot}d^{-1}$), respectively. Absolute attrition rates gradually increased from February to July. Seasonal differences in growth and attrition rates appeared to be related to seawater temperature and nitrogen concentration in seawater. Reproductive sporophytes bearing sprorangium sorus began to occur from April, and the ratio of sorus area to blade area reached its maximum in July (0.034). Survival rate was exponentially decreased; more than 90% of plants decayed within 56 days after outplanting. After February, mortality was size-specific; mortality of smaller plants less than 30 cm in length were relatively higher. Maximum biomass occured in July (285.6 kg wet $wt{\cdot}m^{-2}$) and annual production was 758.7 kg wet $wt{\cdot}m^{-2}$.
Although there is a controversy on the optimal timing for active infective endocarditis(IE), recently good results of early surgical intervention have been published. Herein, we analyzed the results of surgery for active IE according to the duration of preoperative antibiotic treatment. Material and Method : Retrospectively, we analyzed 51 patients who underwent operation for active IE at the department of thoracic and cardiovascular surgery of Samsung medical center from Mar. 1995 to Oct. 2001. Male to female ratio was 39:12, mean age of the patients was 44.5$\pm$17.8 years(range : 13~74). Infected valves were mitral valve in 17(33.3%), aortic valve in 15(29.4%), mitral and aortic valve in 12(23.5), and tricuspid valve in 5(9.8%) cases. Among them, prosthetic valve endocarditis was present in 10(19.6%) cases. Infecting organism was Staphylococcus in 19(37.3%), Streptococcus in 17(33.3%), Enterococcus in 3(5.9%), fungus in 3(5.9%), and other bacteria in 5(9.8%) cases. Organism was not isolated in 6(11.8%) cases, and two organisms were isolated in 4(7.8%) cases. Dividing these patients into two groups according to the duration of preoperative antibiotic treatment(A: less than 7 days, B: more than 8 days), we compared the surgical results between the two groups. Result : There were 16 cases in group A and 35 in group B. Annular reconstruction was performed in 10(62.5%) cases in group A and 10(28.6%) cases in group B, which has statistically significance(p<0.05). There was one early death in group B. Forty nine patients(96.1%) except two were followed up with mean follow-up duration of 28.7 $\pm$ 23.6 months. Endocarditis was recurred in one in group A, and two in group B. Three late deaths occurred in group B. Recurrence rate and survival were not statistically different between the two groups. Conclusion : Early surgery for active IE showed good results as the result of that which was performed after prolonged antibiotic treatment; therefore, we believe that early surgery for active If could effectively eradicate the infection.
In this study, the radioprotective effects of Grifola umbellata hot water extracts (Gu-extract) on mice were investigated. Single pre-administration of Gu-extract increased the 40-day survival ratio of irradiated mice from 65.5% to 78.6%. The growth of 3 week old male mice in the irradiated group was slightly retarded as compared to those of the control and Gu-extract treated mice. The average spleen and thymus weights of the irradiated mice were lower than those of the control and Gu-extract treated mice. The weight reduction of testis in the irradiated mice was significant. While it was relatively slight in the Gu-extract treated mice as compared to that of control mice. No significant difference in the weight was observed in heart, kidney or liver among three groups. The leukocytes of the Gu-extract treated mice did not decrease dramatically as in the irradiated group, but recovery patterns were similar in both groups. Reduction of erythrocytes were similar in both groups but its recovery occurred more rapidly in the extract treated group. The glucose level of the Gu-extract treated group did not change during the period examined, while it was still higher in the irradiated group than the level in the control group in two weeks. The cholesterol levels in the irradiated and the Gu-extract treated groups were higher than that of control group on day 7, but decreased to the level of the control group on day 14. No difference was observed in total protein amount of the serum among the three groups. SDS-polyacrylamide gel electrophoresis of the soluble proteins extracted from various organs did not reveal differences to any extent in all groups except in the livers of the irradiated and extract treated groups, in which some proteins were missing or less present.
The objectives of this study were performed to increase the efficiency of the culture conditions of embryos produced in vitro, and to assess the developmental potential after transfer of those embryos into recipients. The mean number of folliclular oocytes recovered from an ovary was 10.7. The rates of maturation and fertilization in Grade I oocytes were significantly (P<0.05) higher than Graden and III. Developmental rate into blastocyst in the culture group of TCM-199 with BOEC were significantly higher (P<0.05) than the groups of TCM-199 and conditioned medium (24.7% vs. 12.4% and 18.2%). The survivability of post-thawed blastocysts equilibrated for 3 min in EFS solution was significantly (P<0.05) lower than l0 for 1 and 2 min (32.1% vs. 82.9% and 73.3%). Significantly higher (P<0.05) survival rate in blastocysts was seen after freezing than in morulae stage embryos. Out of all 105 recipients, 49 (46.7%) were confirmed in pregnant. On pregnancy of cattle, 48 calves were born from 40 recipients. The ratio of twin and single calves was 30.5% (32/40 and 7.6% (8/40), respectively. However, the others composed of abnormal, as judging as 6 (12.2%) for abortion and 3 (6.1%) for stillbirth during the pregnant period.
This experiment was conducted to find out the simultaneous control effect of granulated insecticides on the several major rice insect pests in Korea. The granulated insecticides used were Terracur P$5\%$ (one of the phosphoric insecticides), Lebaycid $5\%$, and Sang-gamma (gamma-BHC) $6\%$. Those insecticides were broadcasted by hand on the paddy field at the ratio of 3kg. in June and 4kg. in August per 10 a, and the date of insecticidal application was based on the maximum moth occurrence of the rice stem borer in 1969. The rice insect pests tested in this study were rice stem borer (Chilo suppressalis W.), green rice leafhopper (Nephotettix bipunctatus cincticeps U.), smiller brown planthopper (Laodelphax striatellus F.), and white back planthopper (Sogotella furcifera H.). For the study of residual effectiveness of the insecticides, the rice stem borer larvae just hatched from the eggs were installed on the sheath of rice plants collected from the paddy field after insecticidal treatment, and the mortality was made at 48 hours after installation. High mortality was observed in Terracur P and Sang-gamma treatments and low mortality in Lebaycid treatment. The duration of residual effects giving about 50% mortality was about 14 days in Sang-gamma and about 6 days in Terracur P treatments. The study on the effectiveness of the insecticides to the rice stem borer in the paddy field was made by the number of dead blades and white heads of the rice plants injured by the larvae, and the number of survival larvae in the straws after crop harvest. The order of insecticidal effectiveness to the rice stem borer was Terracur P=Sang-gamm>Lebaycid. The study on the effectiveness of the insecticides to the leafhoppers and planthoppers in the paddy field was made by the population density by sweeping (5 times) at the given day intervals after treatments. Terracur P was highly effective for the control of the green rice leafhoppers and Lebaycid was moderately effective, but Sang-gamma seemed not to be effective. The effectiveness of the insecticides tested to the planthoppers was not clear, and it seemed to related with the low insect population density. Study on the determination of proper timing of insecticidal application was not also made clear, and it seemed to be short in the range of day intervals in the insecticidal application. For the study on the control effects of the rice insect pests, rice yield per 100 hills per plot was observed. There was no statistically significant difference among the treatments in rice yields, but the order of yield (Terracur P>Sang-gamma>Lebaycid>Control) was paralleled with the tends of control effects above mentioned. In a view point of simultaneous control of the rice stem borers and green rice leafhoppers by the application of granulated insecticides, Terracur P and Lebaycid were more effective than Sang-gamma which have been used.
Kim, Jin Ho;Shin, Jin Hee;Chie, Eui Kyu;Wu, Hong-Gyun;Kim, Jae Sung;Kim, Il Han;Ha, Sung Whan;Park, Charn Il;Kang, Wee-Saing
Radiation Oncology Journal
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v.22
no.2
/
pp.138-141
/
2004
Purpose : We have previously reported that human glioblastoma cells are sensitized to radiation-induced death after their exposure to trichostatin A (TSA), a histone deacetylase inhibitor (HDAC-1), prior to the irradiation. We aimed to measure the magnitude of the radiosensitizing effect of TSA in human head and neck cancer cell lines. Materials and Methods : Human head and neck cancer cell lines, HN-3 and HN-9, were exposed to 0, 50, 100, and 200 nM TSA for 18 hr prior to irradiation. Then, the TSA-treated cells were irradiated with 0, 2, 4, 6, and 8 Gy, and cell survival was measured by clonogenic assay. Results : Pre-irradiation exposure to TSA was found to radiosensitize HN-3 and HN-9 cell lines. In HN-9 cells, the fraction surviving after 2 Gy (SF2) was significantly reduced by treatment of TSA at concentration as low as 50 nM. However, a treatment with 200 nM TSA was required to significantly decrease SF2 in the HN-3 cell line. SER of pre-irradiation treatment with 200 nM TSA was 1.84 in HN-3 and 7.24 in HN-9, respectively. Conclusions : Our results clearly showed that human head and neck cancer cell lines can be sensitized to ionizing radiation by pre-irradiation inhibition of histone deacetylase (HDAC) using TSA, and that this potentiation might well be a general phenomenon.
Background: The St. Jude Medical prosthesis is one of the popularly used artificial prosthesis, therefore the National Medical Center reports the long-term clinical results of patients who underwent prosthetic valve replacement with St. Jude medical valve for 18 years. Material and Method: Between January, 1984 and June, 2002, a series of 163 consecutive patients who had Implanted St. Jude prosthesis at the National Medical Center were reviewed. Mean age was 42.9$\pm$15.1 years and male to female ratio was 69:94. The operative procedure comprised of 87 MVR, 30 AVR, 45 DVR, and 1 TVR. The reoperative procedure comprised of 21 MVR, 2 AVR, and 14 DVR. Follow-up rate was 96.9%, and cumulative follow-up was 823.8 patient-years. Result: Early mortality rate was 7.9% (13 patients), late mortality rate was 8.7% (13 patients) and late mortality due to valve related complication was 47% (7 patients). Actual survival rate at 10 and 18 years were 91.7$\pm$2.1% and 91.0$\pm$1.9%. Linearized Incidence was as follows: thromboembolism, 1.09%/ patient-year; anticoagulant related hemorrhage, 0.36%/patient-year; valve thrombosis, 0.24%/patient-year; paravalvular leakage, 0.12%/patient-year; and prosthetic bacterial endocarditis, 0.12%/patient-year linearized incidence of over all valve related complication was 1.94%/patient-year. Freedom from valve related complication at 10 and 18 years were 89.1$\pm$3.3% and 88.4$\pm$3.9%. Freedom from valve related death at 10 and 18 years were 95.1$\pm$1.2% and 95.1$\pm$1.0%. Valve related complication was related the age of patient, especially anticoagulant related hemorrhage was more common in patients over 60 years of age. Valve related complication, death were higher in DVR than AVR or MVR, and valve related death was higher in reoperation. There was no relationship between valve related complication or death and implant valve of size. Conclusion: The long-term clinical results of patients implanted with St. Jude Mechanical prosthesis was quite satisfactory with a low incidence of valve related complication and mortality.
LEE Sang-Min;KIM Dong-Ju;KIM Joong Kun;HHR Sung Bum;LEE Jong Kwan;LIM Han Kyu
Korean Journal of Fisheries and Aquatic Sciences
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v.33
no.5
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pp.463-468
/
2000
This study was conducted to investigate the effects of Kluyveromyces fragilis, Candida utilis and brewer's yeast as an additive in formulated diets containing different fish meal levels ($55{\%} and 45{\%}$) on growth and body composition of juvenile Korean rockfish (Sebastes schlegeli). Juvenile rockfish (average weight, 2.6 g) were distributed into 24 tanks with 3 replication groups and fed eight isoproteic ($41{\%}$) and isolipidic ($11{\%}$) diets containing each level ($3{\%}$) of K. frayilis, C. utilis and brewer's yeast as an additive. Survival rate of fish was not affected by dietary fish meal level and yeast kind (P > 0.05). Weight gain of fish fed the control and diets containing C. utilis and brewer's yeast was not influenced by fish meal level (P > 0.05), Weight gain of fish fed the $55{\%}$ fish meal diet containing C. utilis and $45{\%}$ fish meal diets containing K. fragilis and C. utilis was lower than that of fish fed the control diet (P < 0.05). Feed efficiency and protein efficiency ratio of fish fed the control and diet containing brewer's yeast were not affected by fish meal level, but these value of fish fed the diets containing K, fragilis and C. utilis were lower in $45{\%}$ fish meal diets than in $55{\%}$ fish meal diets. Hepatosomatic index and liver lipid content of fish fed the diet containing C. utilis were decreased regardless of fish meal level (P < 0.05), Hemoglobin, hematocrit, red blood cell, plasma total protein and plasma total glucose were not affected by dietary fish meal levels and yeast supplements (P > 0.05). From the above results, it can be concluded that yeast supplement in this formulated diet for growth of juvenile rockfish is not necessary.
Purpose: A primary adenosquamous carcinoma of the stomach is relatively rare, accounting for only about 0.5% of all gastric cancers. However, its histopathologic characteristics are still unclear, and the most appropriate form of therapy has not been established yet. Materials and Methods: We retrospectively reviewed the clinicopathologic features of 8 patients with pathologically confirmed primary adenosquamous carcinomas out of 8,268 patients who underwent gastric cancer surgery at Samsung Medical Center between September 1994 and December 2004. Results: The median age of the 8 patients was 49 ($41{\sim}69$) years, and the male : female ratio was 5 : 3. In 3 patients, the tumor was located at the mid body of the stomach, and in 5 patients, at the lower body or antrum. The tumor sizes were $2.5{\sim}8cm$. Seven patients showed metastases to the regional lymph nodes. The UICC stage distribution were: 5 stage II, 2 stage III, and 1 stage IV. In the stage IV patient, a palliative gastrojejunostomy was performed, and he died 5 months after surgery. Of the 7 patients who underwent a radical gastrectomy and adjuvant chemotheratpy, the median survival was 34 ($12{\sim}66$) months, 2 patients died of cancer recurrence, and 4 patients are being followed up without evidence of recurrence. Conclusion: As for an adenocarcinoma of the stomach, a radical gastrectomy including regional lymph node dissection and postoperative adjuvant therapy should be performed for appropriate treatment of an adenosquamous carcinoma of the stomach.
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