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Comparison of the Result of Radiation Alone and Radiation with Daily Low Dose Cisplatin in Management of Locally Advanced Cervical Cancer (국소적으로 진행된 자궁경부암에서 방사선 단독치료와 방사선 및 저용량 Cisplatin 항암화학요법 병용치료의 비교)

  • Kim Hun Jung;Kim Woo Chul;Lee Mee Jo;Kim Chul Su;Song Eun Seop;Loh John J K.
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.200-207
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    • 2004
  • Purpose: An analysis was to compare the results of radiation alone with those of radiation with dally low dose cisplatin as a radiation sensitizer in locally advanced cervical cancer. Materials and Methods: A retrospective analysis of 59 patients diagnosed with locally advanced uterine cervix cancer between December 1996 and March 2001 was peformed. Thirty one patients received radiation alone and 28 patients received dally low dose cisplatin, as a radiation sensitizer, and radiation therapy. The median follow-up period was 34 months, ranging from 2.5 to 73 months. The radiation therapy consisted of 4500 cGy external beam irradiation to the whole pelvis (midline block after 3060 cGy), a 900$\~$l,000 cGy boost to the involved parametrium and high dose-rate intracavitary brachytherapy (a total dose of 3,000$\~$3,500 cGy/500 cGy per fraction to point A, twice per week). In the chemoradiation group, 10 mg of daily intravenous cisplatin was given daily from the 1st day of radiation therapy to the 20th day of radiation therapy. According to the FIGO classification, the patients were subdivided into 51 (86.4$\%$) and 8 (13.6$\%$) stages IIB and stage IIIB, respectively. Results: The overall 5 year survival rate was 65.65$\%$ and according to treatment modality were 56.75$\%$ and 73.42$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.180). The 5 year disease-free survival rates were 49.39$\%$ and 63.34$\%$ in the radiation alone and chemoradiatoin groups, respectively (p=0.053), The 5 year locoregional control rates were 52.34$\%$ and 73.58$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.013). The 5 year distant disease-free survival rates were 59.29$\%$ and 81.46$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.477), Treatment related hematologic toxicity were prominent in the chemoradiation group. Leukopenia $\geq$grade) occurred in 3.2$\%$and 28.5$\%$ of the radiation alone and chemoradiation groups, respectively (p=0.02). There were no statistical differences in the incidences of vesical, rectal and small bowel complications between two groups. Conclusion: Radiation therapy with low dose cisplatin did not improve the rates of survival and response rates, but did improve the rate of disease free survival and locoregional control rates In locally advanced cervical cancer. The incidence of bone marrow suppression was higher in the chemoradiation group.

The Role of Primary Radiotherapy for Squamous Cell Carcinoma of the Suprag1ottic Larynx (성문상부 상피세포암에서의 근치적 방사선치료의 역할)

  • Kim, Won-Taek;Kim, Dong-Won;Kwon, Byung-Hyun;Nam, Ji-Ho;Hur, Won-Joo
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.233-243
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    • 2000
  • Purpose : First of all, this study was performed to assess the result of curative radiotherapy and to evaluate different possible prognostic factors for squamous cell carcinoma of the supraglottic larynx treated at the Pusan National University Hospital. The second goal of this study was by comparing our data with those of other study groups, to determine the better treatment policy of supraglottic cancer in future. Methods and Material : Thirty-two patients with squamous cell carcinoma of the supraglottic larynx were treated with radiotherapy at Pusan National University Hospital, from August 1985 to December 1996. Minimum follow-up period was 29 months, Twenty-seven patients (84.4$\%$) were followed up over 5 years. Radiotherapy was delivered with 6 MV photons to the primary laryngeal tumor and regional iymphatics with shrinking field technique. Ail patients received radiotherapy under conventional fractionated schedule (once a day). Median total tumor dose was 70.2 Gy (range, 55.8 to 75.6 Gy) on primary or gross tumor lesion. Thirteen patients had Induction chemotherapy with cisplatln and 5-fluorouracil (1-3 cycles). Patient distribution, according to the different stages, were as follows: stage I, 5/32 (15.6$\%$): stage II, 10/32 (31.3$\%$); stage III, 8/32 (25$\%$): stage IV, 9/32 (28.1$\%$). Results :The 5-year overall survival rate of the whole series (32 patients) was 51.7$\%$. The overall survival rate at 5-years was 80$\%$ in stage I, 66.7$\%$ in stage II, 42.9$\%$ in stage III, 25$\%$ in stage IV (p=0.0958). The S-year local control rates after radiotherapy were as fellows: stage I, 100$\%$; stage II, 60$\%$ stage III, 62.5$\%$; stage IV, 44.4$\%$ (p=0.233). Overall vocal preservation rates was 65.6$\%$, 100% In stage I, 70% in stage II, 62.5$\%$ In stage III, 44.4$\%$ in stage IV (p=0.210). There was no statistical significance in survival and local control rate between neoadjuvant chemotherapy followed by radiotherapy group and radiotherapy alone group. Severe laryngeal edema was found in 2 cases after radiotllerapy, emergent tracheostomy was done. Four patients were died from distant metastsis, . three in lung, one in brain. Double primary tumor was found in 2 cases, one in lung (metachronous), another in thyroid (synchronous). Ulcerative lesions were revealed as unfavorable prognostic factor ( p=0.0215), and radiation dose (more or less than 70.2 Gy) was an important factor on survival (p=0.002). Conclusion : The role of radiotherapy treatment of supraglottic carcinoma is to important factor on survival and to preserve the laryngeal function. Based on our data and other studies, early and moderately advanced supragiottic carcinomas could be successfully treated with either consewative surgery or radiotherapy alone. Both modalities showed similar results in survival and vocal preservation. For the advanced cases, radiotherapy alone is Inadequate for curative aim and surgery combined with radiotherapy should be done in operable patients. When patients refuse operation or want to preserve vocal function, or for the patients with inoperable medical conditions, combined chemoradiotherapy (concurrent) or altered fractionated radiotherapy with or without radiosensitizer should be taken into consideration in future.

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Effects of Feeding Eucommia ulmoides Leaves Substituted for Rice Straw on Growth Performance, Carcass Characteristics and Fatty Acid Composition of Muscle Tissues of Hanwoo Steers (볏짚을 두충잎으로 대체급여 시 거세한우의 생산성, 도체특성 및 육의 지방산 조성에 미치는 영향)

  • Kim, J.H.;Kim, Y.M.;Lee, M.D.;Shin, J.H.;Ko, Y.D.
    • Journal of Animal Science and Technology
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    • v.47 no.6
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    • pp.963-974
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    • 2005
  • This study was conducted to examine the growth performance, carcass characteristics, physico-chemical properties and fatty acid composition of muscle tissues of Hanwoo steers when they were fed diets containing four levels of E. ulmoides leaves. Steers were allotted to one of four dietary treatments, which were designed to progressively substitute Eucommia ulmoides for 0, 3, 5 and 10% of the rice straw in the basal diet. Seventy two Hanwoo steers (321±13kg) were used. Average daily gain (0.81-0.86kg) and feed conversion (10.05-10.59) were not changed by feeding E. ulmoides leaves. Emission of fecal ammonia gas was decreased by increasing substitution levels of E. ulmoides leaves. Emission of ammonia gas in feces of steers were significantly (p<0.05) decreased in the 5% and 10% treatments at 40℃ compared with in control (30.6ppm) and 3% treatment (29.8ppm), respectively 20.3 and 21.6ppm. Back fat thickness was higher (p<0.05) in steers fed control diet (15.0mm) than 5 and 10% E. ulmoides diets (10.2 and 10.5mm respectively). The grade ‘A’ appearances of meat yield of steers were increased up to 20% by the 3% substitution of E. ulmoides leaves, and the grades ‘1+’ and ‘1’ appearances of meat quality were significantly improved (p<0.05) by the 5 and 10% Eucommia ulmoides feeding. There was no statistical difference in meat color of loin and top round among all treatments. It appeared that the 5% and 10% E. ulmoides leaves feeding affected (p<0.05) a increase in oleic acid concentration in loin and top round muscles. The concentration of serum cholesterol was lower (p<0.05) in steers fed 10% E. ulmoides (53.3mg/100g) than that of the other treatments (55.7-57.0mg/100g). The diarrhea incidence was about 20.26% in control, while it was lower (p<0.05) in the 5 and 10% E. ulmoides leaves treatments (10.4-12.5%) than control. There was no statistical difference in the occurrences of respiratory disease among all treatments. It is concluded that E. ulmoides leaves should be a prospective feed additive because it contains various functional substances. It is likely that air-dried E. ulmoides leaves can reduce the back fat thickness of Hanwoo steers and the occurrences of diarrhea. Therefore, the 5 and 10% substitution of E. ulmoides for roughage are highly recommended to be used in practice.

Effect of Different Stunning Time on Meat Quality of Broiler (육계 도축 시 전기 실신 시간이 육질에 미치는 영향)

  • Chae, H.S.;Ahn, C.N.;Yoo, Y.M.;Ham, J.S.;Jeong, S.G.;Lee, J.M.;Choi, Y.I.
    • Journal of Animal Science and Technology
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    • v.47 no.6
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    • pp.1017-1024
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    • 2005
  • This study was investigated the effect of the length of stunning time on pH, water holding capacity(WHC), cooking loss(CL), meat color and incidence rate of blood spot in broiler carcass. One-hundred and forty broiler chickens were slaughtered by three different length of stunning times(5 sec., 8 sec., 11 sec.) with the same electrical frequency(255Hz) and 50 voltage in a commercial abattoir. The WBS values and cooking loss of breast muscle were increased with increasing the stunning time, while WHC of breast muscle were decreased. Lightness(L* value) and yellowness(b* value) scores of leg muscle and skin stunned with 50V, 255Hz, 8 sec, 11 sec. were higher than those of broilers stunned with 50V, 255Hz, 5sec(P<0.05). But, there was no significant difference in color on breast and wing muscle. In subjective evaluation, frequence of the first grade had a trend of being increased by extending the stunning time. There was only a few cases of PSE chicken with 0.02%, while blood spot was observed at the highest rate for the 5 sec. treatment. TBARS indicated that a longer length of stunning resulted in a higher rate of fat oxidation. This experiment demonstrated that the length of stunning time has a significant effect on meat quality and its stability during chiller storage.

Effects of Different Additives on the Growth Performance and Carcass Characteristics of Holstein Steers (첨가물질의 급여가 홀스타인 거세우의 발육, 도체특성에 미치는 영향)

  • Cho, Won-Mo;Yang, Sung-Hak;Lee, Sang-Min;Jang, Sun-Sik;Kim, Hyeong-Cheol;Hong, Seong-Koo;Park, Woon-Yeoul;Kim, Hyun-Soo
    • Journal of Life Science
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    • v.22 no.2
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    • pp.161-166
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    • 2012
  • This study was performed to investigate the feeding effects of different additives on the growth performance and carcass characteristics of Holstein steers. Twenty-four Holstein steers, five months of age and 176.6 kg, were randomly allocated to three experimental groups of eight animals each for an 18-month feeding trial. The groups were control (not additive), T1 (fed zinc, vitamin C, and sulfur), and T2 (fed choline and lysine). The average daily gain was no different between the treatment groups during the growing to early fattening period, but it was significantly higher in the T1 group than the T2 group in the late fattening period (p<0.05). The final BW of the T1 group was relatively high in relation to the other groups, but was not significantly different. The additives had no effects on DMI during the experimental period; however, the feed conversion ratio of the T1 group in the late fattening period was significantly lower than that of the T2 group (p<0.05). The results of yield traits, carcass weight, and yield index were similar between groups, but back fat thickness and rib eye area were relatively lower in the T2 group than in the other groups. In terms of quality traits, meat color, texture, and maturity were not significantly different between the three groups. However, marbling score and appearance rate of high quality grade ($1^{++}$, $1^+$, and 1) were higher in the T1 group compared with the T2 group. Thus, the present results suggest that vitamin C, zinc, and sulfur supplementation may improve the growth performance and carcass characteristics of Holstein steers.

Arthroscopic Treatment of Metallic Suture Anchor Failures after Bankart Repair (Bankart 수술 후 발생한 금속 봉합 나사못 합병증의 관절경적 치료)

  • Shin, Sang-Jin;Jung, Jae-Hoon;Kim, Sung-Jae;Yoo, Jae-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.70-76
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    • 2006
  • Purpose: This study presents 5 patients who had metallic anchor protrusion on glenoid after Bankart repair in anterior shoulder instability and reviewed the cause, clinical feature and arthroscopic removal technique. Method and Materials: 5 male with average age of 22 years (range 19 to 25 years) were included. 4 patients had arthroscopic Bankart repair and 1 patient had open repair for anterior shoulder instability. They had protruded metallic suture anchors on glenoid and the protruded suture anchors were removed arthroscopically using larger suture anchor empty inserter. Results: 4 patients had painful clicking sound with motion of abduction and external rotation and 1 patient showed shoulder instability. The ROM showed normal except mild degrees loss of external rotation. The position of protruded metallic anchor was 2, 3 and 5 O'clock in three patients and 4 O'clock in 2 patients. In 2 patients, the metallic suture anchor was malpositioned about 5mm off on the medial side from the anterior glenoid edge. All had Outerbrige classification Grade II-III chondral damage on humeral head and 1 patient showed glenoid cartilage destruction. None had shoulder instability after 2 years of follow-up. Constant score was 65 preoperatively and 89 postoperatively. ASES score was 67 preoperatively and 88 postoperatively. Conclusion: Symptoms of protruded suture anchor are not combined with instability. Most of symptoms were revealed from the rehabilitation period and confused with postoperative pain. Prompt diagnosis and early arthroscopic removal or impaction of protruded metallic suture anchor is recommended because of serious glenohumeral cartilage destruction. This is easy and simple and reproducible method to remove protruded metallic suture anchor arthroscopically.

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Radiofrequency thermal Shrinkage for Elongated Anterior Cruciate Ligament after Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술 이후 이완된 전방십자인대에 시행한 고주파 에너지 열 수축)

  • Kim, Yeung-Jin;Chun, Churl-Hong;Kim, Tae-Kyun;Yang, Hwan-Deok;Kim, Hyoung-Joon;Kim, Young-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.27-32
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    • 2008
  • Purpose: To evaluate the clinical results of the patients who underwent radiofrequency thermal shrinkage (RFTS) for treatment of anterior cruciate ligament (ACL) laxity after ACL reconstruction. Material and Methods: From October 1999 to March 2006, we performed 133 cases of ACL reconstruction. Among them we experienced 16 patients who had the laxity of reconstructed ACL in second look arthroscopy. Mean follow-up was 20.4 months. Mean age was 33.5 years. 12 cases were male and 4 cases were female. The elongated ACL were treated by bipolar radiofrequency energy with an output of grade II. Subjective and objective parameters were utilized in analyses, such as: the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test, IKDC score. Wilcoxon signed-rank test was used to perform the data analysis. P<0.05 was considered to be statistically significant. Results: Postoperative mean Lysholm knee score (preop: $82.2{\pm}5.2(77{\sim}85))$ (P=0.04), postop: $85.2{\pm}4.8$(82-90)) and anterior displacement by the Telos stress test (preop: $5.4{\pm}4.6(3{\sim}10)mm$, postop: $2.1{\pm}1.9(0{\sim}4)mm)$ (P=0.02), Lachman's test, and IKDC scores (P=0.04) demonstrated significant differences statistically compared to the preoperative. There were no statistical differences in mean range of motion, Tegner activity scale. Conclusions: Arthroscopic shrinkage for the ACL laxity after ACL reconstruction with radiofrequency device showed good clinical results and was applicable operative technique.

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Effects of Dietary Astragalus membranaceus, Ginseng and Onion Complex on Growth Performance and Carcass Characteristics in Finishing Pigs (비육돈에 있어 황기, 인삼, 양파 혼합물의 급여가 성장 밑 도체 특성에 미치는 영향)

  • Hong, Jong-Wook;Kim, In-Ho;Kim, Ji-Hoon;Kwon, Oh-Suk;Lee, Sang-Hwan;Seo, Wan-Soo;Kim, Chul;Kim, Eul-Sang;Chung, Yun-Hwa
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.1
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    • pp.149-154
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    • 2002
  • Seventy two Duroc $\times$ Yorkshire $\times$ Landrace pigs (75.66$\pm$1.86 kg average initial body weight) were used in a 45 days growth assay to determine the effects of Astragalus membranaceus, ginseng and onion complex on growth performance and carcass characteristics of finishing pigs. Dietary treatments included 1) Control (basal diet), 2) AGO 0.25 (basal diet + 0.25% Astragalus membranaceus, ginseng and onion complex), 3) AGO 0.50 (basal diet+0.50% Astragalus membranaceus. ginseng and onion complex). For overall period, average daily weight gain increased as the concentration of Astragalus membranaceus, ginseng and onion complex in the diets was increased (linear effect, p<0.01). Gain/feed improved without significant difference (p>0.05) as the concentration of Astragalus membranaceus, ginseng and onion complex in the diets was increased. As adding level of Astragalus membranaceus, ginseng and onion complex increased in the diets, A grade appearances of carcass tended to increase (linear effect, p<0.01). The total and LDL+VLDL cholesterol concentrations in serum of pigs fed AGO 0.25 diet were lower than them of pigs fed Control and AGO 0.50 diets without significant difference (p>0.05). $L^{*}$-, $a^{*}$-, and $b^{*}$- value of M. longissimus dorsi muscle were not significantly different among the treatments (p>0.05). Total feed cost per kg of weight gain was lower in the AGO 0.50 treatment (813 won) than in the Control (830 won). The results obtained from this feeding trial suggest that the Astragalus membranaceus, ginseng and onion complex supplementation for finishing pigs had improved growth performance. However, carcass characteristic was not affected by supplemental Astragalus membranaceus, ginseng and onion complex.lex.x.

Development and Intervention Effect of Customized Instructional Program for Underachievers in Middle School Science (중학교 과학학습 부진 유형별 맞춤형 프로그램의 개발 및 적용 효과)

  • Lee, Kyung-Hee;Han, Mi-Jung;Kim, Min-Jeong;Choi, Byung-Soon
    • Journal of The Korean Association For Science Education
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    • v.34 no.5
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    • pp.421-436
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    • 2014
  • The purposes of this study were to develop the customized instructional programs by the causes of science underachievement and to identify the effectiveness of these programs. For these, we analyzed the characteristics of underachievers and causes of science underachievement and classified 22 7th grade science underachievers into three different types such as lack of science process skill, lack of science learning motivation, and lack of science learning strategy. They then were divided into the experimental and comparative groups. Instructional programs treated for both groups covered the same topics and were conducted once a week for 60 minutes each time for 15 weeks. Eleven students in the comparative group were treated with an activity-centered science program that dealt with basic science concepts. Unlike science underachievers in the comparative group, those in the experimental group were given customized instructional program. After the treatment, students were administered several tests including a test on awareness of the program, science process skill test, science learning motivation and strategy test, and academic science achievement test. In addition to the results of those tests, worksheets, daily activity reports, and interviews were used to evaluate a customized instructional program that was applied to the experimental group. Results of the study showed that these programs relieved science underachievers from the cause of poor achievement and accordingly help them achieve better performance in academics. In addition, both lack of learning motivation and lack of learning strategy types tended to relieve the other causes of science underachievement. Also, the experimental group showed a high level of satisfaction with the customized instructional programs.

Attitudes of Medical Students' towards End-of-life Care Decision-making (일개 의과대학생의 말기 환자 치료 결정에 대한 태도)

  • Oh, Seung-Min;Cho, Wan-Je;Kim, Jong-Koo;Lee, Hye-Ree;Lee, Duk-Chul;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.11 no.3
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    • pp.140-146
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    • 2008
  • Purpose: Sooner of later, end-of-life care decision-making will unfold and be settled during the professional lives of medical students. However, there is prevalent ambiguity and uncertainty between the palliative treatment and euthanasia. We conducted this survey to investigate attitudes of medical students towards end-of-life making decisions, and to find out which factors primarily influenced the attitudes. Methods: A study was conducted among medical students at one university, the Republic of Korea. A written questionnaire was sent to all the 1st, 2nd, and 3rd-year medical students. It presented 5 statements on end-of-life decision-making. Students were asked whether they agreed or disagreed with each statement. Results: The response rate was 74.4%, and 267 questionnaires were analyzed. Percentages of agreement with each statements on Voluntary active euthanasia (VAE), Physician assisted suicide (PAS), Withholding life-sustaining management, Withdrawing life-sustaining management, and Terminal sedation (TS) was 37.1%, 21.7%, 58.4%, 60.3%, and 41.6%, respectively. The grade of students, religious activity, and educational experience were determinant factors. Agreement on each statements was higher in the low religious activity group than in the high religious activity group. Agreement on TS was higher among 3rd year students during their clerkship than among 1st and 2nd year students. Age of students and the experience of dying-people care had no significant influence. Conclusion: In end-of-life decision-making, religious and educational factors influenced medical students' attitudes. Especially, the experience of education during clerkship had significant influence on the attitude. Proper teaching on end-of-life decisions should further be considered during medical students' clerkship.

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