• Title/Summary/Keyword: Trial

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Therapeutic Angiogenesis by Intramyocardial Injection of pCK-VEGF165 in Pigs (돼지에서 pCK-VEGF165의 심근내 주입에 의한 치료적 혈관조성)

  • Choi Jae-Sung;Han Woong;Kim Dong Sik;Park Jin Sik;Lee Jong Jin;Lee Dong Soo;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.323-334
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    • 2005
  • Background: Gene therapy is a new and promising option for the treatment of severe myocardial ischemia by therapeutic angiogenesis. The goal of this study was to elucidate the efficacy of therapeutic angiogenesis by using VEGF165 in large animals. Material and Method: Twenty-one pigs that underwent ligation of the distal left anterior descending coronary artery were randomly allocated to one of two treatments: intramyocardial injection of pCK-VEGF (VEGF) or intramyocardial injection of pCK-Null (Control). Injections were administered 30 days after ligation. Seven pigs died during the trial, but eight pigs from VEGF and six from Control survived. Echo-cardiography was performed on day 0 (preoperative) and on days 30 and 60 following coronary ligation. Gated myocardial single photon emission computed tomography imaging (SPECT) with $^{99m}Tc-labeled$ sestamibi was performed on days 30 and 60. Myocardial perfusion was assessed from the uptake of $^{99m}Tc-labeled$ sestamibi at rest. Global and regional myocardial function as well as post-infarction left ventricular remodeling were assessed from segmental wall thickening; left ventricular ejection fraction (EF); end systolic volume (ESV); and end diastolic volume (EDV) using gated SPECT and echocardiography. Myocardium of the ischemic border zone into which pCK plasmid vector had been injected was also sampled to assess micro-capillary density. Result: Micro-capillary density was significantly higher in the VEGF than in Control ($386\pm110/mm^{2}\;vs.\;291\pm127/mm^{2};\;p<0.001$). Segmental perfusion increased significantly from day 30 to day 60 after intramyocardial injection of plasmid vector in VEGF ($48.4\pm15.2\%\;vs.\;53.8\pm19.6\%;\;p<0.001$), while no significant change was observed in the Control ($45.1\pm17.0\%\;vs.\;43.4\pm17.7\%;\;p=0.186$). This resulted in a significant difference in the percentage changes between the two groups ($11.4\pm27.0\%\;increase\;vs.\;2.7\pm19.0\%\;decrease;\;p=0.003$). Segmental wall thickening increased significantly from day 30 to day 60 in both groups; the increments did not differ between groups. ESV measured using echocardiography increased significantly from day 0 to day 30 in VEGF ($22.9\pm9.9\;mL\;vs.\;32.3\pm9.1\;mL;\; p=0.006$) and in Control ($26.3\pm12.0\;mL\;vs.\;36.8\pm9.7\;mL;\;p=0.046$). EF decreased significantly in VEGF ($52.0\pm7.7\%\;vs.\;46.5\pm7.4\%;\;p=0.004$) and in Control ($48.2\pm9.2\%\;vs.\;41.6\pm10.0\%;\;p=0.028$). There was no significant change in EDV. The interval changes (days $30\~60$) of EF, ESV, and EDV did not differ significantly between groups both by gated SPECT and by echocardiography. Conclusion: Intramyocardial injection of pCK-VEGF165 induced therapeutic angiogenesis and improved myocardial perfusion. However, post-infarction remodeling and global myocardial function were not improved.

Studies on the Nutritional Effects of Locally Produced Dried Formula Milk and Fermented Milk -2. Effect of Feeding Dried Formula Milk and Fermented Milk on the Growing Performance, Protein Utilizability and Intestinal Microbial Changes of Albino Rats (국산(國産) 조제분유(調製粉乳)와 발효유(醱酵乳)의 영양효과(營養效果)에 관한 연구(硏究) - 2. 유제품(乳製品)이 성장기(成長期) 흰쥐에 미치는 영양효과(營養效果) 및 장내미생물(腸內微生物)의 변화(變化)에 관한 연구(硏究) -)

  • Paik, Jeong-J.;Han, In-K.
    • Journal of Nutrition and Health
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    • v.9 no.1
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    • pp.92-98
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    • 1976
  • The present studies were carried out to observe the nutritional effects of three kinds of locally produced dried infantile formula milk (DFM) and one fermented milk (FM). A feeding trial with 60 male growing albino rats weighing $60{\sim}70$ grams was conducted during 6 weeks to compare the nutritive values and protein qualities of three DFM and a FM. The diet treatments consisted of 100% control diet, 70% control diet plus 30% DFM-A, 70% control diet plus 30% DFM-B, 70% control diet plus 30% DFM-C, 100% control diet with FM and 70% control diet plus 30% DFM-B with FM. The items investigated were body weight gain, feed intake, feed efficiency ratio (FER), various organ weights, protein efficiency ratio (PER), digestibility of nutrients, biological value, utilizability of protein and intestinal microbial changes of albino rats. The results obtained are summarized as follows; 1. Although there was no statistical significance, rats fed diets containing DFMs and FM gained faster than the rats fed control diet. The best growth rate was obtained with the DFM-A and DFM-C groups. In spite of the lower protein contents of the three DFM diets than the control diet, the growth rate of albino rats fed the DFM diets was somewhat improved than rats fed control diet. 2. No statistical significance was found in feed consumption but the trend was that the feed intake of control group was higher than those of the DFM diet group. 3. Feed efficiency was inproved significantly (p<0.01) by feeding DFMs as compared with control diet. DFM-A group showed the best FER, although no statistical significance was found. 4. Rats fed the DFM diets showed significantly (p<0.01) higher PER as compared with those of the control group. But no difference was found anions DFM groups. The significant improvement (p<0.01) of PER due also to the feeding of FM was seemed to be brought about by the beneficial effect of FM. 5. The present data revealed that feeding DFM and FM didn't affect the weights of various organs of rats. 6. The protein digestibility of experimental diets was similar to each other. Although no statistical significance was found among treatments, the DFMs and FM surely tended to improve the biological value and utilizability of protein. 7. Microbial study indicated that among intestinal flora FM fed group, there were more Lactic acid bacteria than E. coli. From the experimental results described above, it may be concluded that the nutritive effects of three kinds of locally produced DFMs are much alike and the growth rate of growing albino rats can be improved by feeding either DFM or FM due to their beneficial effects on the feed efficiency and protein utilization.

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Protein Fractionation of Whole Crop Silages, and Effect of Borate-phosphate Buffer Extraction on In vitro Fermentation Characteristics, Gas Production and Degradation (사료작물 사일리지의 단백질 분획 및 Borate-phosphate Buffer 추출이 In vitro 발효성상, Gas 발생 그리고 분해율에 미치는 효과)

  • Shinekhuu, Judder;Jin, Guang-Lin;Ji, Byung-Ju;Li, Xiangzi;Oh, Young-Kyoon;Hong, Seong-Ku;Song, Man-Kang
    • Journal of Animal Science and Technology
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    • v.51 no.5
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    • pp.369-378
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    • 2009
  • Protein fractionation was evaluated from whole crop silages of rye (RS), wheat (WS), triticale (TS), oat (OS), barley (BS), and rice straw silage (RSS), and in vitro trial was carried out to examine the effect of silage and extraction of soluble protein on fermentation characteristics, total gas production and degradation. Soluble protein of silages was extracted with borate-phosphate buffer, and fermentation characteristics, gas production and degradation of silages were estimated by incubating anaerobically the mixed solution of strained rumen fluid and artificial saliva (1:1, v/v) containing dried and ground silages placed in nylon bag at $39^{\circ}C$ up to 48h. Soluble protein (SP) content was lowest for RSS as 2.11% in total CP compared to those for other silages. Highest A fraction (NPN) was observed from RS (74.33% of total CP) while those from TS and RSS were relatively low (48%). B2 fraction was relatively higher for RS, RSS and WS than for TS and BS. $B_3$ fraction was lowest in WS among silages. C fraction (27.07) in RSS was higher than in other silages (1.40~9.93%). pH in incubation solution was increased (P<0.01~P<0.001) for extracted silages up to 12h but decreased (P<0.01) at 48h for non-extracted ones. Contents of ammonia-N (P<0.001) and total VFA (P<0.01~P<0.001) were higher for non-extracted silages than for extracted ones. Acetate proportion was increased (P<0.001) in buffer extracted silages while those of propionate and butyrate were decreased (P<0.001) up to 24h incubation. Increased (P<0.001) total gas production was obtained from non-extracted silages up to 12h while gas production was increased (P<0.01) in extracted ones thereafter. In vitro degradation of dry matter and CP was increased (P<0.001) in non-extracted silages but that of neutral detergent fiber was increased (P<0.001) in extracted ones without difference among silages. Difference in mean values of degradability for each silage prior to- and post extraction with borate buffer, however, was not found among silages. It may be concluded that high NPN content of silages may reduce the protein availability in silages and borate buffer soluble components in silages can stimulate the early stage of fermentation.

Effect of Supplementary Actinomycetes (Nocardia sp. CS682) Ferment on the Laying Performance, Blood Parameters, Immunoglobulin and Small Intestinal Microflora Contents in Laying Hens (방선균(Nocardia sp. CS682) 발효물의 급여가 산란계의 생산성, 혈액성상, 면역글로불린 및 소장내 미생물 함량에 미치는 영향)

  • Rhee, Ah-Reum;Shin, Dong-Hun;Kim, Chan-Ho;Jung, Byoung-Yun;Yoo, Jin-Chul;Hong, Young-Ho;Paik, In-Kee
    • Korean Journal of Poultry Science
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    • v.38 no.1
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    • pp.59-69
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    • 2011
  • This study was conducted to investigate the effects of dietary supplementation of CS682, a fermentation product of Actinomycetae(Nocardia sp. CS682), and its commercial product DSC682$^{(R)}$ on the performance, blood parameters, intestinal microflora, and immune response in laying hens. Hy-Line Brown$^{(R)}$ laying hens were housed in two bird cages. Feeding trial lasted 5 wk under 16.5 h:7.5 h(L:D) lighting regimen. In Exp.1, a total of 480 birds of 86 wk old were assigned to four dietary treatments: Control, Antibiotics (6 ppm avilamycin), CS682-0.1 (CS682 0.1%) and CS682-1.0 (CS682 1.0% supplementation). Each treatment was replicated five times with 24 birds (or 12 cages) per replication. In Exp. 2, a total of 1,000 birds of 26 wk old were assigned to five dietary treatments: Control, Antibiotics (6 ppm avilamycin), DCS682-0.05 (DCS682 0.05%), DCS682-0.1 (DCS682 0.1%), DCS682-0.2 (DCS682 0.2% supplementation). Each treatment was replicated five times with 40 birds (or 20 cages) per replication. In Exp. 1, there were no significant differences among treatments in egg production, egg weight, broken & soft egg production, feed intake, and feed conversion ratio. Also, there were no significant differences among treatments in eggshell thickness, eggshell color and Haugh unit. However, eggshell strength was significantly (p<0.05) greater in CS682 and Antibiotics treatments than Control, and egg yolk color was significantly (p<0.05) higher in CS682-1.0 than Control. In Exp. 2, feed intake was significantly (p<0.05) lower in DSC682-0.05 than Control. Lightness(L) of Hunter Lab color of eggshell of DCS and Antibiotics treatments was significantly (p<0.05) lower than Control. Egg yolk color of DCS 0.1 and 0.2 treatments was significantly (p<0.05) higher than Control. Haugh unit increased significantly (p<0.05) in Antibiotics and DCS682-0.1 treatments. The immunoglobulin levels of plasma (IgG and IgA) and eggyolk (IgY) were not significantly affected by treatments. Antibiotics and CS682 or DCS682 treatments significantly (p<0.05 or 0.01) influenced some of the erythrocytes and leukocytes parameters in blood. In Exp.1, mean corpuscular volume (MCV) decreased by CS682 treatments and mean corpuscular hemoglobin (MCH) was highest in Antibiotics treatments. In Exp.2, the level of monocyte (MO) decreased in DCS682-0.10 and 0.20 treatments. The cfu of C. perfringens and S. typhimurium in small intestinal content were highest in Control and lowest in Antibiotics in both experiments. In Exp. 2, DSC682-0.05 and -0.1 treatments were highest and Antibiotic treatment was lowest in Lactobacilli spp. The results of the present layer experiments indicated that supplementation of 0.1~0.2% CS682 or DCS682 may increase eggshell strength, color of eggshell and eggyolk, Haugh unit, and control harmful intestinal microbes.

The Effects of Supplemental Bacterial Phytase to the Calcium and Nonphosphorus Levels in Feed of Laying Hens (산란계 사료 내 칼슘 및 무기태 인 수준에 따른 Bacterial Phytase 급여 효과)

  • Kang, H.K.;Park, S.Y.;Yu, D.J.;Kim, J.H.;Kang, G.H.;Na, J.C.;Kim, D.W.;Suh, O.S.;Lee, S.J.;Lee, W.J.;Kim, S.H.
    • Korean Journal of Poultry Science
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    • v.35 no.2
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    • pp.143-151
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    • 2008
  • This study was conducted to identify the correlation of bacterial phytase ($Transphos^{(R)}$) to the calcium level in feed. Of all 21-week-old 720 HyLine brown laying hens, 2 birds of similar weight were placed on each individual cage. The experiment was conducted by $3{\times}2{\times}3$ factorial design with including 3 different levels of phytase (0, 300, and 1,000 DPU/kg), 2 different levels of calcium (3.5% and 4.0%), and 3 different levels of no NPP addition 0% (0.095 NPP), 0.5% (0.185% NPP), and 1.0% (0.275% NPP). The feeding trial maintained the ME level of 2,800 kcal/kg and 16% for crude protein. The diet was fed ad libitum and 17 hours of lighting was provided throughout the experimental period. Egg production seemed to increase, in the 300 DPU of bacterial phytase added group and the cracked egg tended to reduce in Transphos added group. The egg productivity between treatment groups did not show significant difference by dietary calcium level, whereas non NPP added group (0.095% NPP) was found to be low compared to NPP added groups (P<0.05). The highest mean egg weight and the highest daily egg mass were detected in 300 DPU phytase added group. Although the mean egg weight was significantly higher in treatment groups fed with 3.5% calcium containing feeds (P<0.05), daily egg mass was no among treatment groups. The mean egg weight and daily egg mass were the lowest in non NPP added group (0.095% NPP) compared to other treatment groups (P<0.05). The feed intake showed similar pattern regardless of the bacterial phytase and calcium levels in the diet. However, the treatment groups fed diets containing NPP level of 0.275% and 0.165% showed significantly higher feed intake than the group fed with 0.095% NPP (P<0.05). Although the feed conversion was not affected by calcium and NPP levels in the diet, the most improved result was obtained from 300 DPU phytase added group (P<0.05). The eggshell breaking strength and thickness increased as dietary calcium level increase the level of calcium increases in diet. The treatment groups fed diet containing 0.275% and 0.165% NPP revealed to show improvement in eggshell breaking strength and yolk color index compared to the NPP non added (0.095% NPP) treatment group. The result of the present study suggests that the appropriate level of microbial phytase is 300 DPU and at this level, tricalciumphosphate supplementation in feed can be reduced to 40% of NRC recommendation. Higher calcium level in feed fail to show synergistic effect by adding microbial phytase.

Low Dose Cisplatin as a Radiation Sensitizer in Management of Locally Advanced Scluamous Cell Carcinoma of the Uterine Cervix : Evaluation of Acute Toxicity and Early Response (국소 진행된 자궁경부암의 방사선치료와 저용량 cisplatin 항암요법 동시치료시 급성독성 밀 초기반응 평가)

  • Kim Hunjung;Cho Young Kap;Kim Chulsu;Kim Woo Chul;Lee Sukho;Loh J K
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.113-119
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    • 1999
  • Purpose : To evaluate possible acute toxicity and early response of concurrent radiation therapy and low dose daily cisplatin as a radiosensitizer in patients with locally advanced uterine cervical carcinomas. Materials and Method : From December 1996 to January 1999, 38 previously untreated Patients with locally advanced squamous cell carcinoma of the uterine cervix (from stage IIB to stage IIIB) were treated at Inha University Hospital. All patients underwent standard pretreatment staging Procedures after the initial evaluation by gynecologists and radiation oncologists. Sixteen Patients with huge cervical mass (>4 cm) were submitted to the group treated with concurrent radiation therapy and low dose daily cisplatin while the remainder was treated with radiation therapy alone. Radiation therapy consisted of 4500 cGy external beam irradiation to whole pelvis (midline block after 3000 cGy), 900$\~$1000 cGy boost to involved parametrium, and high dose-rate intracavitary brachytherapy (a total dose of 3000$\~$3500 cGy/500 cGy per fraction to point A, twice per week). In the group treated with low dose cisplatin concurrently, 10 mg of daily intravenous cisplatin was given from the 1st day of radiation therapy to the 20th day of radiation therapy. Acute toxicity was measured according to expanded common toxicity criteria of the NCI (C) Clinical Trials. Early response data were analyzed at minimum 4 weeks' follow-up after completion of the treatment protocol. Results: Hematolgic toxici쇼 was more prominent in patients treated with radiation therapy and cisplatin. Six of 16 patients (37.5$\~$) treated with radiation therapy and cisplatin and one of 22 patients (4.5$\~$) treated with radiation therapy alone experienced grade 3 leukopenia. In Fisher's exact test, there was statistically significant difference between two groups regarding leukopenia (P=0.030). There was no apparent difference in the frequency of gastrointestinal and genitourinary toxicity between two groups (P=0.066). Three of 16 patients (18.7$\~$) treated with radiation therapy and cisplatin and two of 22 patients (9.1$\~$) treated with radiation therapy alone experienced more than 5 kg weight loss during the treatment. There was no statistically significant difference on weight loss between two groups (P=0.63). Two patients on each group were not evaluable for the early response because of incomplete treatment. The complete response rate at four weeks' follow-up was 80$\~$(16/20) for the radiation therapy alone group and 78$\~$ (11/14) for the radiation therapy and cisplatin group. There was no statistically significant difference in early response between two treatment groups (P=0.126). Conclusion : This study led to the conclusion that the hematologic toxicity from the treatment with concurrent radiation therapy and low dose daily cisplatin seems to be more prominent than that from the treatment of radiation therapy alone. There was no grade 4 hematologic toxicity or mortality in both groups. The hematologic toxicity in both treatment groups seems to be well managable modically. Since the risk factors were not balanced between two treatment groups, the direct comparison of early response of both groups was not possible. However, preliminary results regarding early response for patients with bulky cervical tumor mass treated with radiation therapy and low dose daily cisplatin was encouraging. Longer follow-up is necessary to evaluate the survival data. A phase III study is needed to evaluate the efficacy of concurrent daily low dose cisplatin with radiation therapy in bulky cervical cancer.

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Effect of Dietary Streptococcus faecium on the Performances and the Changes of Intestinal Microflora of Broiler Chicks (Streptococcus faecium의 급여가 육계의 성장과 장내 세균총 변화에 미치는 영향)

  • Kim, K.S.;Chee, K.M.;Lee, S.J.;Cho, S.K.;Kim, S.S.;Lee, W.
    • Korean Journal of Poultry Science
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    • v.18 no.2
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    • pp.97-119
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    • 1991
  • Effect of Streptococcus faecium(SF) and an antibiotic, Colistin(Col), supplemented to diets singly or in combination, on the performances and changes of intestinal population of microflora of broiler chicks studied. A total of 252, day-old chicks(Arbor Acre) of mixed sex(M:F=1:1) were alloted into six groups. A diet with no Col and SF was referred as a control diet. The basal diets were added with two levels of SF, 0.04 and 0.08%, singly or in combination with Col 10ppm Another diet was prepared by adding only Col 10 ppm. Numbers of the microorganism in diets added with SF 0.04% and 0.08% were 7$\times$10$^{4}$ and 1.4$\times$10$^{5}$ /g diet respectively The diets consisting of corn and soybean meal as major ingredients were fed for a period of seven weeks . During the feeding trial, fresh excreta were sampled at the end of every week in a sterilized condition to count microbial changes from each dietary group. Microbial changes of large intestine were also measured from nine birds sacrificed at the end of the 4th and 7th weeks each time per dietary group. Excreta from all the groups were also collected quantitatively at the end of 3rd and 6th weeks to measure digestibility of the diets, At the end of 7th week, nine birds from each group were also sacrificed to measure weight changes of gastrointestinal tracts . Average body weight gains of broilers fed the diets added with SF 0.08% (2.37kg) or SF 0. 08%+col 10ppm(2.34kg) were significantly larger than that of the control(2.18kg). The weight gains of the other groups were not statistically different from that of the control Feed/gain ratios of the supplemental groups were better than that of control (P<0.05) except that of birds fed the diet added only with SF 0.04%. Digestibilities of nutrients such as dry matter, crude protein, crude fat and total carbohydrates were not altered by the consumption of the diets added with SF and/or Col throughout the whole feeding period. As expected, the numbers of Streptococci in the excreta from birds fed diets added with SF increased significantly with a statistical difference between groups with SF 0.04% and SF 0.08% most of the time. However. addition of Colistin to the diets supplemented with SF did not give any effects on the number of the microorganism. Numbers of coliforms in the excreta were apparently reduced by feeding the diets added with SF and/or Col(P<0.05). There were, however, no additive effects observed between the two feed additives in this regard when supplementing Col to the SF diets. Distributions of intestinal microflora exhibited exactly the same pattern as those of the excreta. Length of small intestine of the birds fed diets added with SF 0.08% with or without Col 10 ppm became significantly longer with a range of about 10% than those of the birds fed diets without SF. However, the empty weight of the small inestine of the former group was lighter than that of control These changes resulted in a significant reduction in weight/unit length of the intestine of the birds fed diets supplemented with Col and SF singly or in combination. In overall conclusion, diet added with SF 0.08% appeared most effective in improving broiler performances. Colistin added at a level of 10ppm was not beneficial at all in itself or in combination with SF in terms of broiler performances or changes of intestinal microflora population. The efficacy of SF and Col could be attributed to the changes of wall thickness of the small intestine.

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A Phase I/II Trial of $DCVac/IR^{(R)}$ Dendritic Cell Immunotherapy Combined with Irradiation in Cases of Refractory Colorectal Cancer with Multiple Liver Metastases (기존의 치료에 반응하지 않는 다발성 간전이 대장암 환자에서 방사선조사와 병합한 수지상세포 면역치료의 1, 2상 임상시험)

  • Choi, Young-Min;Lee, Hyung-Sik;Kwon, Hyuk-Chan;Han, Sang-Young;Choi, Jong-Cheol;Chung, Ju-Seop;Kim, Chang-Won;Kim, Dong-Won;Kang, Chi-Duk
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.104-112
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    • 2008
  • Purpose: To assess the toxicity and tumor response induced by $DCVac/IR^{(R)}$ dendritic cell(DC) immunotherapy combined with irradiation for refractory colorectal cancer patients with multiple liver metastases. Materials and Methods: Between May 2004 and November 2006, applicants from a pool of refractory colorectal cancer patients with multiple liver metastases were enrolled. The patients were registered after having signed the informed consent form, which had been approved by the Institutional Review Board from the Dong-A University and Busan National University Hospital. DCs were obtained from peripheral blood of each patient, and then cultured in vitro. A total of $6{\times}10^6$ DCs were packed into a vial($DCVac/IR^{(R)}$, 0.5 ml) at the convenience of each patient's schedule. On the day before and on the day of each vaccination, each patient received a 4 Gy radiation dose to the target tumor. On the day of vaccination, the indicated dose of autologous DCs was injected into the irradiated tumor using ultrasound-guided needle injection procedures. A total of four vaccinations were scheduled at three 2-week intervals and one 4 week interval at the Dong-A University and Busan National University Hospital. If the tumor status was deemed to be stable or responding to therapy, an additional vaccination dose or two was approved at 4 week intervals beyond the fourth immunization. A tolerance test for DCs was conducted by injecting a range of doses($3{\times}10^6\;to\;12{\times}10^6$ DCs) after the 3rd injection. Moreover, the maximal tolerable dose was applied to additional patients. Treatment safety was evaluated in all patients who had at least one injection. Treatment feasibility was evaluated by the 10th week by assessing the response of patients having at least 4 injections. For systemic toxicities, the evaluation was performed using the National Cancer Institute Common Toxicity Criteria, whereas adverse effects were recorded using common WHO toxicity criteria. Results: Of the 24 registered patients, 22 received the DCs injections. Moreover, of the 14 patients that applied for the tolerance test, only 11 patients completed it because 3 patients withdrew their testing agreement. A grade 3 or more side effect, which was possibly related to the DC injection, did not occur in additional patients. The $12{\times}10^6$ DC injection was identified as the maximum tolerable dose, and was then injected in an additional 8 patients. Patients tolerated the injection fairly well, with no fatal side effects. In order to assess the feasibility of DC immunotherapy, the response was evaluated in other hepatic lesions outside of the targeted hepatic lesion. The response evaluation was performed in 15 of the 17 patients who received at least 4 injections. Stable and progressive disease was found in 4 and 11 patients, respectively. Conclusion: The DC-based immunotherapy and radiotherapy is theoretically synergistic for the local control and systemic control. The $DCVac/IR^{(R)}$ immunotherapy combined with irradiation was tolerable and safe in the evaluated cases of refractory colorectal cancer with multiple liver metastases. Future work should include well designed a phase II clinical trials.

Review of 2015 Major Medical Decisions (2015년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Lee, Dong Pil;Lee, Jung Sun;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.299-346
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    • 2016
  • There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

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Effects of Applying Livestock Manure on Productivity and Organic Stock Carrying Capacity of Summer Forage Crops (가축분뇨시용이 하계사료작물의 생산성 및 유기가축 사육능력에 미치는 영향)

  • Jo, Ik-Hwan;HwangBo, Soon;Lee, Ju-Sam
    • Korean Journal of Organic Agriculture
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    • v.16 no.4
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    • pp.421-434
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    • 2008
  • This study was carried out to estimate the selection of appropriate forage crops, proper application levels of livestock manure, and carrying capacity per unit area for organic livestock, as influenced by livestock manure application levels compared with chemical fertilizer to corn and sorghum $\times$ sorghum hybrid, in order to produce organic forages by utilizing livestock manure. For both corns and sorghum $\times$ sorghum hybrids, no fertilizer plots had significantly (p<0.05) lower annual dry matter (DM), crude protein (CP) and total digestible nutrients (TDN) yields than those of other plots, whereas the N+P+K plots ranked the highest yields, followed by 150% cattle manure plots and 100% cattle manure plots. Dry matter, CP and TDN yields of cattle manure plots were significantly (p<0.05) higher than those of no fertilizer and P+K plots. In applying cattle manure, the yields of cattle slurry plots tended to be a little higher than those of composted cattle manure plots. Assuming that corns and sorghum $\times$ sorghum hybrids produced from this trial were fed at 70% level to 450kg of Hanwoo heifer with 400g of average daily gain, livestock carrying capacity (head/year/ha) ranked the highest in N+P+K plots of the case of corns (mean 6.7 heads), followed by 150% cattle slurry plots (mean 5.6 heads), 150% composted cattle manure plots (mean 4.8 heads), 100% cattle slurry plots (mean 4.4 heads), 100% composted cattle manure plots (mean 4.3 heads), P+K plots (mean 4.1 heads), and no fertilizer plots (mean 3.1 heads). Meanwhile, in case of sorghum $\times$ sorghum hybrids, N+P+K plots (mean 5.7 heads) ranked the highest carrying capacity, followed by $100{\sim}150%$ cattle slurry plots (mean $4.8{\sim}5.2$ heads), 150% composted cattle manure plots (mean 4.7 heads), 100 % composted cattle manure plots (mean 4.3 heads), P+K plots (mean 3.8 heads), and no fertilizer plots (mean 3.4 heads). The results indicated that replacing chemical fertilizer by livestock manure application to cultivation soil for forage crops could enhance not only DM and TDN yields, but also organic stock carrying capacity. In conclusion, it was conceived that organic forage production by reutilizing livestock manure might contribute to reduced environmental pollution and the production of environment friendly agricultural products through resources recycling.

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