• Title/Summary/Keyword: Treatment Grade

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Clinical outcome of fiducial-less CyberKnife radiosurgery for stage I non-small cell lung cancer

  • Jung, In-Hye;Song, Si Yeol;Jung, Jinhong;Cho, Byungchul;Kwak, Jungwon;Je, Hyoung Uk;Choi, Wonsik;Jung, Nuri Hyun;Kim, Su Ssan;Choi, Eun Kyung
    • Radiation Oncology Journal
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    • v.33 no.2
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    • pp.89-97
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    • 2015
  • Purpose: To evaluate the treatment results in early stage non-small cell lung cancer patients who have undergone fiducial-less CyberKnife radiosurgery (CKRS). Materials and Methods: From June 2011 to November 2013, 58 patients underwent CKRS at Asan Medical Center for stage I lung cancer. After excluding 14 patients, we retrospectively reviewed the records of the remaining 44 patients. All analyses were performed using SPSS ver. 21. Results: The median age at diagnosis was 75 years. Most patients had inoperable primary lung cancer with a poor pulmonary function test with comorbidity or old age. The clinical stage was IA in 30 patients (68.2%), IB in 14 (31.8%). The mean tumor size was 2.6 cm (range, 1.2 to 4.8 cm), and the tumor was smaller than 2 cm in 12 patients (27.3%). The radiation dose given was 48-60 Gy in 3-4 fractions. In a median follow-up of 23.1 months, local recurrence occurred in three patients (2-year local recurrence-free survival rate, 90.4%) and distant metastasis occurred in 13 patients. All patients tolerated the radiosurgery well, only two patients developing grade 3 dyspnea. The most common complications were radiation-induced fibrosis and pneumonitis. Eight patients died due to cancer progression. Conclusion: The results showed that fiducial-less CKRS shows comparable local tumor control and survival rates to those of LINAC-based SABR or CKRS with a fiducial marker. Thus, fiducial-less CKRS using Xsight lung tracking system can be effectively and safely performed for patients with medically inoperable stage I non-small cell lung cancer without any risk of procedure-related complication.

Preoperative short course radiotherapy with concurrent and consolidation chemotherapies followed by delayed surgery in locally advanced rectal cancer: preliminary results

  • Aghili, Mahdi;Sotoudeh, Sarvazad;Ghalehtaki, Reza;Babaei, Mohammad;Farazmand, Borna;Fazeli, Mohammad-Sadegh;Keshvari, Amir;Haddad, Peiman;Farhan, Farshid
    • Radiation Oncology Journal
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    • v.36 no.1
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    • pp.17-24
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    • 2018
  • Purpose: This study aimed to assess complications and outcomes of a new approach, that is, combining short course radiotherapy (SRT), concurrent and consolidative chemotherapies, and delayed surgery. Materials and Methods: In this single arm phase II prospective clinical trial, patients with T3-4 or N+ M0 rectal adenocarcinoma were enrolled. Patients who received induction chemotherapy or previous pelvic radiotherapy were excluded. Study protocol consisted of three-dimensional conformal SRT (25 Gy in 5 fractions in 1 week) with concurrent and consolidation chemotherapies including capecitabine and oxaliplatin. Total mesorectal excision was done at least 8 weeks after the last fraction of radiotherapy. Primary outcome was complete pathologic response and secondary outcomes were treatment related complications. Results: Thirty-three patients completed the planned preoperative chemoradiation and 26 of them underwent surgery (24 low anterior resection and 2 abdominoperineal resection). Acute proctitis grades 2 and 3 were seen in 11 (33.3%) and 7 (21.2%) patients, respectively. There were no grades 3 and 4 subacute hematologic and non-hematologic (genitourinary and peripheral neuropathy) toxicities and perioperative morbidities such as anastomose leakage. Grade 2 or higher late toxicities were observed among 29.6% of the patients. Complete pathologic response was achieved in 8 (30.8%) patients who underwent surgery. The 3-year overall survival and local control rates were 65% and 94%, respectively. Conclusion: This study showed that SRT combined with concurrent and consolidation chemotherapies followed by delayed surgery is not only feasible and tolerable without significant toxicity but also, associated with promising complete pathologic response rates.

Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

  • Yu, Jeong Il;Yoo, Gyu Sang;Cho, Sungkoo;Jung, Sang Hoon;Han, Youngyih;Park, Seyjoon;Lee, Boram;Kang, Wonseok;Sinn, Dong Hyun;Paik, Yong-Han;Gwak, Geum-Youn;Choi, Moon Seok;Lee, Joon Hyeok;Koh, Kwang Cheol;Paik, Seung Woon;Park, Hee Chul
    • Radiation Oncology Journal
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    • v.36 no.1
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    • pp.25-34
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    • 2018
  • Purpose: This study aimed to evaluate the initial outcomes of proton beam therapy (PBT) for hepatocellular carcinoma (HCC) in terms of tumor response and safety. Materials and Methods: HCC patients who were not indicated for standard curative local modalities and who were treated with PBT at Samsung Medical Center from January 2016 to February 2017 were enrolled. Toxicity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Tumor response was evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST). Results: A total of 101 HCC patients treated with PBT were included. Patients were treated with an equivalent dose of $62-92GyE_{10}$. Liver function status was not significantly affected after PBT. Greater than 80% of patients had Child-Pugh class A and albumin-bilirubin (ALBI) grade 1 up to 3-months after PBT. Of 78 patients followed for three months after PBT, infield complete and partial responses were achieved in 54 (69.2%) and 14 (17.9%) patients, respectively. Conclusion: PBT treatment of HCC patients showed a favorable infield complete response rate of 69.2% with acceptable acute toxicity. An additional follow-up study of these patients will be conducted.

Intensity-modulated radiotherapy for stage I glottic cancer: a short-term outcomes compared with three-dimensional conformal radiotherapy

  • Cho, Ick Joon;Chung, Woong-Ki;Lee, Joon Kyoo;Lee, Min-Cheol;Paek, Jayeong;Kim, Yong-Hyub;Jeong, Jae-Uk;Yoon, Mee Sun;Song, Ju-Young;Nam, Taek-Keun;Ahn, Sung-Ja;Lee, Dong Hoon;Yoon, Tae Mi;Lim, Sang-Chul
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.271-278
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    • 2019
  • Purpose: To investigate the differences in treatment outcomes between two radiation techniques, intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT). Materials and Methods: We retrospectively analyzed 160 (IMRT = 23, 3DCRT = 137) patients with stage I glottic cancer treated from January 2005 through December 2016. The IMRT was performed with TomoTherapy (16 patients), volumetric-modulated arc therapy (6 patients), and step-and-shoot technique (1 patient), respectively. The 3DCRT was performed with bilateral parallel opposing fields. The median follow-up duration was 30 months (range, 31 to 42 months) in the IMRT group and 65 months (range, 20 to 143 months) in the 3DCRT group. Results: The 5-year overall survival and 3-year local control rates of the 160 patients were 95.7% and 91.4%, respectively. There was no significant difference in 3-year local control rates between the IMRT and 3DCRT groups (94.4% vs. 91.0%; p = 0.587). Thirteen of 137 patients in the 3DCRT group had recurrences. In the IMRT group, one patient had a recurrence at the true vocal cord. Patients treated with IMRT had less grade 2 skin reaction than the 3DCRT group, but this had no statistical significance (4.3% vs. 21.2%; p = 0.080). Conclusion: IMRT had comparable outcomes with 3DCRT, and a trend of less acute skin reaction in stage I glottic cancer patients.

Impacting Student Confidence : The effects of using virtual manipulatives and increasing fraction understanding. (수학에 대한 자신감 증진: 가상학습교구를 통한 분수 개념 이해의 결과)

  • ;Jenifer Suh;Patricia S. Moyer
    • Journal of Educational Research in Mathematics
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    • v.14 no.2
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    • pp.207-219
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    • 2004
  • There have been studies reporting the increase in student confidence in mathematics when using technology. However, past studies indicating a positive correlation between technology and confidence in mathematics do not explain why they see this positive outcome. With increased availability and easy access to the Internet in schools and the development of free online virtual manipulatives, this research was interested in how the use of virtual manipulatives in mathematics can affect students confidence in their mathematical abilities. Our hypothesis was that the classes using virtual manipulatives which allows students to connecting dynamic visual image with abstract symbols will help students gain a deeper conceptual understanding of math concept thus increasing their confidence and ability in mathematics. The participants in this study were 46 fifth-grade students in three ability groups: one high, one middle and one low. During a two-week unit on fractions, students in three groups interacted with several virtual manipulative applets in a computer lab. Data sources in the project included a pre and posttest of students mathematics content knowledge, Confidence in Learning Mathematics Scale, field notes and student interviews, and classroom videotapes. Our aim was to find evidence for increased level of confidence in mathematics as students strengthened their understanding of fraction concepts. Results from the achievement score indicated an overall main effect showing significant improvement for all ability groups following the treatment and an increase in the confidence level from the preassessment of the Confidence in Learning Mathematics Scale in the middle and high ability groups. An interesting finding was that the confidence level for the low ability group students who had the highest confidence level in the beginning did not change much in the final confidence scale assessment. In the middle and high ability groups, the confidence level did increase according to the improvement of the contest posttest. Through interviews, students expressed how the virtual manipulatives assisted their understanding by verifying their answers as they worked and facilitated their ability to figure out math concept in their mind and visually.

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CLINICOSTASTICAL STUDY OF INPATIENTS OF ABSCESS IN FASCIAL SPACES FOR THE LAST 5 YEARS (최근 5년간 치성감염으로 인한 구강악안면부 근막간극에 발생한 농양환자의 임상 통계학적 검토)

  • Lee, Won-Hyuk;Ahn, Kyung-Mi;Jang, Bo-Young;Ahn, Mi-Ra;Lee, Jung-Yub;Sohn, Dong-Suk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.497-503
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    • 2004
  • One of the most difficult problems to damage in dentistry is an odontogenic infection. These infections may range from low-grade, well-localized infections that require only minimal treatment to a severe, life-threatenig fascial space infection. Although the overwhelming majority of odontogenic infections are easily managed by minor surgical procedures and supportive medical therapy that includes antibiotic administration, the practitioner must constantly bear in mind that these infections may become severe in a very short time. We made an investigation was targeting on 78 male and 47 female patients (125 patients in total) who had been hospitalized because of the fascial space abscess on the oral and maxillofacial area and gained a complete recovery in Daegu Catholic University Hospital, Oral & Maxillofacial Surgery from January 1999 to December 2003. By tracing their charts, we could grasp the characteristics such as age, gender, the time of breakout and specific areas of the attacks, making a conclusive study of the statistical analysis and finally, we could reach conclusions. Now, we report the conclusion from the investigation with the literature. The proportion of males and females was approximately 3 to 2, and in age group, patients under 10 years old marked the highest, 22.4%. The patients between the age of 10 and 40 were only 14.4%, yet those who were between 40 and 80 marked 53.6% in contrast. In the monthly distribution, the order was Dec.(13.6%)-Sep.(12%)-Jan.(10.4%) and in seasonal distribution, it was winter(30.4%)-fall(28%)- summer(24.4%)- spring(19.2%). Considering the medical history, D.M. was the highest which was 30.3%, hypertension marked 24.4%, and the patients with both D.M. and hypertension were 9.0%. The major cause of infection of oral and maxillofacial areas was odontogenic infection, which marked about 96%, and especially the cases related to dental caries occurred most frequently, which was 51.2%. In the number of relaxed fascial space, single fascial space was 81.6%, and in the degree of relaxation of fascial space, the buccal space abscess marked 40.8%, following submandibular space abscess, which was 30.4%.

Comparison of air pollution and the prevalence of allergy-related diseases in Incheon and Jeju City

  • Jeong, Su-Ho;Kim, Jeong-Hee;Son, Byong-Kwan;Hong, Seong-Chul;Kim, Su-Young;Lee, Geun-Hwa;Lim, Dae-Hyun
    • Clinical and Experimental Pediatrics
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    • v.54 no.12
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    • pp.501-506
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    • 2011
  • Purpose: A high level of air pollutants can increase the number of patients with allergy-related diseases such as asthma and allergic rhinitis (AR). To analyze the association between air pollution and allergic disease, we investigated 2 areas in Korea: Incheon, an industrial area, and Jeju, a non-industrialized area. Methods: Second grade students at elementary schools (11 schools in Incheon and 45 schools in Jeju) were examined in a cross-sectional study. A questionnaire was used and a skin prick test was performed. The levels of $NO_2$, $CO_2$, $O_3$, particulate matter (PM) $PM_{10/2.5}$, formaldehyde, tVOCs, and dust mites in the classrooms and grounds were determined. Results: The levels of outdoor CO, $PM_{10}$, and $PM_{2.5}$ were significantly higher in Incheon (P<0.01). The levels of indoor CO, $CO_2$, $PM_{10}$, $PM_{2.5}$ were significantly higher in Incheon (P<0.01). The prevalence rates of AR symptoms at any time, AR symptoms during the last 12 months, diagnosis of rhinitis at any time, and AR treatment during the last 12 months were significantly higher in Incheon (P<0.01). The prevalence rate of wheezing or whistling at any time, and wheezing during the last 12 months were significantly higher in Incheon (P<0.01). Conclusion: We found that the children living in Incheon, which was more polluted than Jeju, had a higher rate of AR and asthma symptoms compared to children in Jeju. To determine the effect of air pollution on the development of the AR and asthma, further studies are needed.

Evaluation of Aging Characteristics of Selected PMA using HP-GPC (HP-GPC를 이용한 폴리머개질 아스팔트의 노화특성 분석)

  • Kim, Kwang-Woo;Doh, Young-Soo;Amerkhanian, Serj N.
    • International Journal of Highway Engineering
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    • v.6 no.2 s.20
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    • pp.15-24
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    • 2004
  • Oxidation causes increment of the quantity of large molecular size or LMS in asphalt and is a major reason for hardening of asphalt binder. An extended service life of pavement on a road is expected by reducing oxidation of binder. Oxidation of binder occurs during hot mixing with aggregates before placement on road and then during in-service after the asphalt pavement is constructed. Quantitative increase of LMS as result of aging after RTFO and PAV was analyzed based on the data from high-pressure gel-permeation chromatography (HP-GPC). Polymer modified asphalt (PMA) after RTFO procedure showed 20-30% increment in LMS and then after PAV procedure more than twice, although the percentage of increment was different according to asphalt brand and grade. The PMAs containing LDPE or SBS, which showed a great mechanical property improvement in previous studies, were selected for characterizing PMA aging In this study. Considerably reduced increment of LMS was observed from the PMA containing LDPE after RTFO and PAV procedures. The GPC result showing the binder with less LMS increment means that the asphalt while being mixed with LDPE was aged less during the aging treatment. The dispersed particle of LDPE in asphalt cement seems to disturb oxidative aging reaction and evaporation.

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The Effect of Dodamtang(DDT) on Brain damage and Hypertension (도담탕(導痰湯)이 뇌손상(腦損傷) 및 고혈압(高血壓)에 미치는 영향(影響))

  • Lim, Seong-Min;An, Joung-Jo;Choi, Young;Kim, Yong-Jin;Yoo, Ho-Ryoung;Park, Yang-Chun;Seol, In-Chan;Hwang, Chi-Won;Cho, Hyun-Kyung
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.503-512
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    • 2001
  • Objective : This study was carried out to investigate the effects of DDT on the brain damage and hypertension. Methods : We observed the effect of Dodamtang(DDT) extract on KCN-induced coma, focal brain ischemia by MCA occlusion, cytotoxicity and protection of PC12 cells and B103 cells induced by amyloid ${\beta}$ protein(25-35). To prove the effect of DDT as a blood pressure depressant, we measured aldosterone, renin activity, catecholamine, sodium and NO density using the seperated blood plasma. Results : DDT showed a protective effect on cytotoxicity of PC12 cells and B103 cells induced by amyloid ${\beta}$ protein(25-35) in a dose dependent manner and proved the significant abridgement of brain ischemic area and edema induced by MCA occlusion, a critical decrease of neurologic deficitic grade in the fore-limbs. DDT didn't reduce the duration of KCN(1.87mg/kg iv.)-induced coma and prolonged the survival rate in the case of KCN(3.0mg/kg iv.)-induced coma by the ratio of 20%. While DDT increased the value of NO in SHR, it significantly decreased the blood pressure of SHR and the value of aldosterone& epinephrine in SHR. Conclusions : These results suggested that DDT might be usefully applied for treatment of hypertension, cerebral infarction, and brain damage.

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The Effect of Science Experiments in Collaboration with Art Activities for Students' Self-directed Learning Skills and the Creative Personality in Elementary School (미술활동과 연계한 과학실험활동이 초등학생의 자기주도학습능력과 창의적 성격에 미치는 영향)

  • Son, Jeongwoo;Heo, Minyoung
    • Journal of Science Education
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    • v.37 no.1
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    • pp.68-78
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    • 2013
  • Until now, research to integrate art activities and science education have been making steady progress in the field of primary education and early childhood education that are directly involved in the art education of students. However, some science educators were interested in visualizing the artifacts by using design principles and experimental results through STEAM education. So, when conducting lessons for integrating science education with art activities, research is needed on the changing of the students' ability. Therefore, the purpose of this study is to investigate the effect of science experiments in collaboration with art activities for students' self-directed learning skills and creative personality in elementary school. This study was applied to 30 students(16 male, 14 female) of 4th grade in Changwon C elementary school. The teaching materials of this study was extracted some of the experiments from the 2007 revised national curriculum in elementary science textbook and 'Teachers for Exciting Science'. Experimental treatment was performed over a total of 10 class 5 subjects and a pre-post test was conducted through G-TAGAS. As a result, science experiments in collaboration with art activities have improved significantly students' self-directed learning skills and creative personality.

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