• Title/Summary/Keyword: Trial Results

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Acute Respiratory Distress Syndrome in Respiratory Intensive Care Unit (호흡기계 중환자실에서 치료 관리된 급성호흡곤란증후군의 임상특성)

  • Moon, Seung-Hyug;Song, Sang-Hoon;Jung, Ho-Seuk;Yeun, Dong-Jin;Uh, Su-Tack;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1252-1264
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    • 1998
  • Background : Patients with established ARDS have a mortality rate that exceeds 50 percent despite of intensive care including artificial ventilation modality, Mortality has been associated with sepsis and organ failure preceding or following ARDS ; APACHE II score ; old age and predisposing factors. Revised ventilator strategy over last 10 years especially at ARDS appeared to improve the mortality of it. We retrospectively investigated 40 ARDS patients of respiratory-care unit to examine how these factors influence outcome. Methods : A retrospective investigation of 40 ARDS patients in respiratory-care unit with ventilator management over 46 months was performed. We investigated the clinical characteristics such as a risk factor, cause of death and mortality, and also parameters such as APACHE II score, number of organ dysfunction, and hypoxia score (HS, $PaO_2/FIO_2$) at day 1, 3, 7 of severe acute lung injury, and simultaneously the PEEP level and tidal volume. Results : Clinical conditions associated with ARDS were sepsis 50%, pneumonia 30%, aspiration pneumonia 20%, and mortality rate based on the etiology of ARDS was sepsis 50%, pneumonia 67%(p<0.01 vs sepsis), aspiration pneumonia 38%. Overall mortality rate was 60%. In 28 day-nonsurvivors, leading cause of death was severe sepsis(42.9%) followed by MOF(28.6%), respiratory failure(19.1 %), and others(9.5%). There were no differences in variables of age, sex, APACHE II score, HS, and numbers of organ dysfunction at day 1 of ARDS between 28-days survivor and nonsurvivors. In view of categorized variables of age(>70), APACHE II score(>26), HS(<150) at day 1 of ARDS, there were significant differences between 28-days survivor and nonsurvivors(p<0.05). After day 1 of ARDS, the survivors have improved their APACHE II score, HS, numbers of organ dysfunction over the first 3d to 7d, but nonsurvivors did not improve over a seven-day course. There were significant differences in APACHE II score and numbers of organ dysfunction of day 3, 7 of ARDS, and HS of day 7 of ARDS between survivors and nonsurvivors(p<0.05). Fatality rate of ARDS has been declined from 68% to less than 40% between 1995 and 1998. There were no differences in APACHE II score, HS, numbers of organ dysfunction, old age at presentation of ARDS. In last years, mean PEEP level was significantly higher and mean tidal volume was significantly lower than previous years during seven days of ARDS(p<0.01). Conclusions : Improvement of HS, APACHE II score, organ dysfunction over the first 3d to 7d is associated with increased survival Decline in ARDS fatality rates between 1995 and 1998 seems that this trend must be attributed to improved supportive therapy including at least high PEEP instead of conventional-least PEEP approach in ventilator management of acute respiratory distress syndrome.

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Clinical Efficacy of Erdosteine in Patients with Acute or Chronic Bronchitis -A Randomized, Double Blind, Comparative Study vs. Ambroxol- (급.만성 기관지염 환자에서 엘도스$^{(R)}$(Erdosteine)의 임상효과 -염산 암브록솔과의 무작위 이중맹검 비교시험-)

  • Kim, Seok-Chan;Lee, Sang-Hoak;Song, So-Hyang;Kim, Young-Kyoon;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1296-1307
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    • 1997
  • Background : Erdosteine is a thiol derivative developed for the treatement of chronic obstructive bronchitis, including acute infective exacerbation of chronic bronchitis. Erdosteine has mucomodulating and antioxidant properties and especially exhibits excellent gastrointestinal tolerability. Methods : The study was conducted as a prospective evaluation, with 2 comparative groups orally treated with erdosteine 300mg (bid.) or ambroxol 30mg (b.i.d.) for 7 days and the design of trial was double-blind. The treatments have been assigned randomly to patients (n=80) with acute or chronic bronchitis. The primary end-point used to determine efficacy in this study was subjective symptoms including expectorating frequence, expectoration volume, expectorating difficulty, expectoration viscosity, cough intensity and dyspnea. The secondary end-points of efficacy was the result of arterial blood gas analysis and pulmonary function test. Safety was evaluated with adverse drug reactions and laboratory tests monitoring. 61 patients was included in the efficacy analysis, due to the fact that 19 patients drop-out for different reasons. The obtained values have been analyzed with paired Hest., ANOVA test., multivariate $t^2$-test, repeated measures analysis of covariance, two sample t-test, loglinear-logit model analysis, Fisher's exact test. Results : 1) There was no significant difference on demographic data and vital signs between erdosteine and ambroxol treated groups. 2) The comparison between erdosteine and ambroxol treated groups showed no significant difference in improvement of each symptom in spite of the more favorable efficacy obtained with erdosteine. No difference on the contrary was observed for arterial blood gas analysis and pulmonary function test. 3) As safety is concerned, no clinical significant changes in laboratory test and symptom were induced in erdosteine and ambroxol treated group and two patients in ambroxol treated group drop-out for adverse reactions in symptom. 4) In the evaluation of final clinical efficacy, erdosteine improved more effectively patient's overall symptoms {very good effect (11/31), good effect (12/31), moderate effect (6/31), no effect (2/31), aggravation (0/31)} than ambroxol {very good effect (6/30), good effect (14/30), moderate effect (5/30), no effect (4/30), aggravation (2/30)}. And the probability of symptomatic improvement by erdosteine compared to ambroxol was 2.5 times. (p<0.05). Conclusion : This study showed that erdosteine was clinically effective and safe drug for treatment of acute and chronic bronchitis.

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Combined Modality Therapy with Selective Bladder Preservation for Muscle Invading Bladder Cancer (침윤성 방광암 환자에서 방광 보존 치료)

  • Youn Seon Min;Yang Kwang Mo;Lee Hyung Sik;Hur Won Joo;Oh Sin Geun;Lee Jong Cheol;Yoon Jin Han;Kwon Heon Young;Jung Kyung Woo;Jung Se Il
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.237-244
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    • 2001
  • Purpose : To assess the tolerance, complete response rate, bladder preservation rate and survival rate in patients with muscle-invading bladder cancer treated with selective bladder preservation protocol. Method and Materials : From October 1990 to June 1998, twenty six patients with muscle-invading bladder cancer (clinical stage T2-4, N0-3, M0) were enrolled for the treatment protocol of bladder preservation. They were treated with maximal TURBT (transurethral resection of bladder tumor) and 2 cycles of MCV chemotherapy (methotrexate, crisplatin, and vinblastine) followed by $39.6\~45\;Gy$ pelvic irradiation with concomitant cisplatin. After complete urologic evaluation (biopsy or cytology), the patients who achieved complete response were planed for bladder preservation treatment and treated with consolidation cisplatin and radiotherapy (19.8 Gy). The patients who had incomplete response were planed to immediate radical cystectomy. If they refused radical cystectomy, they were treated either with TURBT followed by MCV or cisplatin chemotherapy and radiotherapy. The median follow-up duration is 49.5 months. Results : The Patients with stage T2-3a and T3b-4a underwent complete removal of tumor or gross tumor removal by TURBT, respectively. Twenty one out of 26 patients $(81\%)$ successfully completed the protocol of the planned chemo-radiotherapy. Seven patients had documented complete response. Six of them were treated with additional consolidation cisplatin and radiotherapy. One patient was treated with 2 cycles of MCV chemotherapy due to refusal of chemo-radiotherapy. Five of 7 complete responders had functioning tumor-free bladder. Fourteen patients of incomplete responders were further treated with one of the followings : radical cystectomy (1 patient), or TURBT and 2 cycles of MCV chemotherapy (3 patients), or cisplatin and radiotherapy (10 patients). Thirteen patients of them were not treated with planned radical cystectomy due to patients' refusal (9 patients) or underlying medical problems (4 patients). Among twenty one patients, 12 patients $(58\%)$ were alive with their preserved bladder, 8 patients died with the disease, 1 patient died of intercurrent disease. The 5 years actuarial survival rates according to CR and PR after MCV chemotherapy and cisplatin chemoradiotherapy were $80\%\;and\;14\%$, respectively (u=0.001). Conclusion : In selected patients with muscle-invading bladder cancer, the bladder preservation could be achieved by MCV chemotherapy and cisplatin chemo-radiotherapy. All patients tolerated well this bladder preservation protoco. The availability of complete TURBT and the responsibility of neoadjuvant chemotherapy and chemoradiotherapy were important predictors for bladder preservation and survival. The patients who had not achieved complete response after neoadjuvant chemotherapy and chemoradiotherapy should be immediate radical cystectomy. A randomized prospective trial might be essential to determine more accurate indications between cystectomy or bladder preservation.

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The relationship of nutrition of rice and positive evaluation of the rice-based meal on the physical and emotional self-diagnosis and learning efficiency of the middle and highschool students in the jeonju area (전주 지역 청소년 대상 쌀의 영양과 쌀을 기반으로 한 식사에 대한 긍정적 평가에 따른 신체·정서적 자각증상 및 학습 효능감과의 관련성)

  • Lee, Hyeon Kyeong;Lee, Young Seung;Jung, Soo Jin;Kang, Min Sook;Hwang, Yu Jin;Yoo, Sun Mi;Cha, Yeon Soo;Cho, Soo Muk
    • Journal of Nutrition and Health
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    • v.52 no.1
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    • pp.90-103
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    • 2019
  • Purpose: This study examined the relationship of the nutrition of rice and the positive evaluation of the rice-based meal with the food consumption habits, physical and emotional health status, and learning efficacy of 601 middle and high school students in Jeonju area. Methods: The participants were divided into two groups using cluster analysis in that the participants belonging to the upper groups had a center score of 46.86 (n = 348), while the people belonging to the lower group had a center score of 36.89 (n = 253). Statistical differences were tested for all the relationships between the physical and emotional health symptoms and learning efficacy between the groups at the ${\alpha}=0.05$ level. Results: Significant differences in the physical self-evaluated symptoms were observed in all five items in each cluster (p < 0.05). In the case of the emotional health status, nine out of 10 items showed significant differences between the groups. Similarly, significant differences in all five items in learning efficacy questionnaire were noted (p < 0.05). Positive attitudes of the parents toward having breakfast also showed significant differences among the groups. Conclusion: The nutrition of rice and a positive evaluation of the rice-based meals significantly affect the physical and emotional health status and learning efficacy of juveniles. These findings can be used as baseline information for promoting nutrition education, particularly rice-based breakfast.

Comparison of Growth Characteristics and Productivity of Summer Forage Crops in Sihwa Reclaimed Land (시화 간척지에서 하계 사료작물의 초종 및 품종에 따른 생육특성 및 생산성 비교)

  • Kim, Jong Geun;Jeong, Eun Chan;Kim, Meing Joong;Li, Yan Fen;Kim, Hak Jin;Lee, Su Hwan
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.41 no.2
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    • pp.110-118
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    • 2021
  • This study was conducted to investigate the effects of species and varieties of summer forage crops on growth characteristics and productivity in Sihwa reclaimed land. The summer forage crops used in the trial were silage corn, sorghum×sudangrass hybrid(SSH), and proso millet. For each forage species, Gwangpyeongok(GPO), P15453, P1952 and P2088 were used for silage corn, and 877F, Green star, Honey chew, and Turbo gold cultivars were used for SSH. For proso millet, Ibaekchal, Geumsilchal and Manhongchal developed by the National Institute of Crop Science were used. Silage corn and SSH were sown on May 21, 2019 and proso millet on June 4, and harvested on September 2. There was no significant difference in plant and ear height of silage corn among varieties. P1543 was the highest and P2088 was the lowest in yield of silage corn, but there was no significant difference among treatments. Among the SSH, the plant height of 877F was the highest and Turbo gold variety had the smallest (p<0.05). As for the dry matter(DM) yields, 877F had the highest at 3,862 kg/ha and Green star had the lowest at 2,669 kg/ha (p<0.05). The fresh matter yield of proso millet was 15,778 kg/ha, which was higher than that of corn or SSH, The average dry matter yield was 4,780 kg/ha, and Ibaekchal variety had the highest DM yield compared to other varieties (p<0.05). P2088 had the highest TDN content and GPO was the lowest (p<0.05). As for the SSH, the TDN content of Green star and Honey chew varieties was significantly higher, and the RFV value was the lowest in Turbo gold. The average crude protein content of proso millet was 7.03%, and the highest TDN and RFV values were 64.36% and 106 in Geumsilchal. In the experiment of the germination rate of summer forage crops according to salt concentration, silage corn showed a germination rate of 83.1% even at 0.4% salinity. In particular, P2088 and P1921 varieties had more than 80% germination rate even at 0.6% salt concentration. As for the SSH, the germination rate of 877F was 93.3% even at 0.8% salinity, and 88.3% with Honey chew, indicating higher resistance to salt concentration compared to other varieties. Proso millet showed a high germination rate of 84.0 to 88.7% even at a salt concentration of 0.6%. Considering the above results, proso millet was recommended as the most suitable forage crop species in the Sihwa reclaimed land with high salt concentration, and the Ibaekchal variety is recommended as a suitable forage crop due to its high yield.

TECHNICAL STUDY ON THE CONTROLLING MECHANIQUES OF THE ENVIRONMENTAL FACTORS IN THE MUSHROOM GROWING HOUSE IN CHONNAM PROVINCE (전남지방(全南地方)에 있어서의 양송이 재배(栽培)에 최적(最適)한 환경조건(環境條件) 조절법분석(調節法分析)에 관(關)한 연구(硏究))

  • Lee, Eun Chol
    • Journal of Korean Society of Forest Science
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    • v.9 no.1
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    • pp.1-44
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    • 1969
  • The important results which have been obtained in the investigation can be recapitulated as follows. 1. As demostrated by the experimental results and analyses concerning their effects in the on-ground type mushroom house, the constructions in relation to the side wall and ceiling of the experimental houses showed a sufficient heat insulation on effect to protect insides of the houses from outside climatic conditions. 2. As the effect on the solar type experimental mushroom house which was constructed in a half basement has been shown by the experimental results and analyses, it has been proved to be effective for making use of solar heat. However there were found two problems to be improved for putting solar houses to practical use in the farm mushroom growing: (1) the construction of the roof and ceiling should be the same as for the on-ground type house, and (2) the solar heat generating system should be reconstructed properly. A trial solar heat generating system is shown in Fig. 40. 3. Among several ventilation systems which have been studied in the experiments, the underground earthen pipe and ceiling ventilation, and vertical side wall and ceiling ventilation systems have been proved to be most effective for natural ventilation. 4. The experimental results have shown that ventilation systems such as the vertical side wall and underground ventilation systems are suitable to put to practical use as natural ventilation systems for farm mushroom houses. These ventilation systems can remarkably improve the temperature of fresh air which is introduced into the house by heat transfers within the ventilation passages, so as to approach to the desired temperature of the house without any cooling or heating operation. For example, if it is assuming that x is the outside temperature and y is the amount of temperature adjustment made by the influence of the ventilation system, the relationships that exist between x and y can be expressed by the following regression lines. Underground iron pipe ventilation system ${\cdots}{\cdots}$ y=0.9x-12.8 Underground earthen pipe ventilation system ${\cdots}{\cdots}$y=0.96x-15.11 Vertical side wall ventilation system${\cdots}{\cdots}$ y=0.94x-17.57 5. The experimental results have shown that the relationships existing between the admitted and expelled air and the $Co_2$ concentration can be described with experimental regression lines or an exponent equation as follows: 1) If it is assumed that x is an air speed cm/sec. and y is an expelled air speed in cm/sec. in a natural ventilation system, since the y is a function of the x, the relationships that exist between x and y can be expressed by the regression lines shown below: 2) If it is assumed that x is an admitted volume of air in $m^3/hr$ and y is an expelled volume of air in $m^3/hr$ in a natural ventilation system, since the y is a function of the x, the relationships that exist between x and y can be expressed by the regression lines shown below. 3) If it is assumed that the expelled air speed in cm/sec and replacement air speed in cm/sec. at the bed surface in a natural ventilation system are shown as x and y, respectively, since the y is a function of the x, the relationships that exist between x and y can be expressed by the following regression line: G.E. (100%)- C.V. (50%) ventilation system${\cdots}$ y=0.54X+0.84 4) If it is assumed that the replacement air speed in cm/sec. at the bed surface is shown as x, and $CO_2$ concentration which is expressed by multiplying 1000 times the actual value of $CO_2$ % is shown as y, in a natural ventilation system, since the y is a function of the x the relationships that exist between x and y can be expressed by the following regression line: G.E. (100%)- C.V. (50%) ventilation system${\cdots}{\cdots}$ y=114.53-6.42x 5) If it is assumed that the expelled volume of air is shown as x and the $CO_2$ concentration which is expressed by multiplying 1000 times the actual of $CO_2$ % is shown as y in a natural ventilation system, since the y is a function of of the x, the relationships that exist between x and y can be expressed by the following exponent equation: G.E. (100%)-C.V. (50%) ventilation system${\cdots}{\cdots}$ $$y=127.18{\times}1.0093^{-X}$$ 6. The experimental results have shown that the ratios of the crass sectional area of the G.E. and C.V. vent to the total cubic capacity of the house, required for providing an adequate amount of air in a natural ventilation system, can be estimated as follows: G.E. (admitting vent of the underground ventilation)${\cdots}{\cdots}$ 0.30-0.5% (controllable) C.V. (expelling vent of the ceiling ventilation)${\cdots}{\cdots}$ 0.8-1.0% (controllable) 7. Among several heating devices which were studied in the experiments, the hot-water boilor which was modified to be fitted both as hot-water toiler and as a pressureless steam-water was found most suitable for farm mushroom growing.

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Studies on the selection in soybean breeding. -II. Additional data on heritability, genotypic correlation and selection index- (대두육종에 있어서의 선발에 관한 실험적연구 -속보 : 유전력ㆍ유전상관, 그리고 선발지수의 재검토-)

  • Kwon-Yawl Chang
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.3
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    • pp.89-98
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    • 1965
  • The experimental studies were intended to clarify the effects of selection, and also aimed at estimating the heritabilities, the genotypic correlations among some agronomic characters, and at calculating the selection index on some selective characters for the selection of desirable lines, under different climatic conditions. Finally practical implications of these studies, especially on the selection index, were discussed. Twenty-two varieties, determinate growing habit type, were selected at random from the 138 soybean varieties cultivated the year before, were grown in a randomized block design with three replicates at Chinju, Korea, under May and June sowing conditions. The method of estimating heritabilities for the eleven agronomic characters-flowering date, maturity date, stem length, branch numbers per plant, stem diameter, plant weight, pod numbers per plant, grain numbers per plant and 100 grain weight, shown in Table 3, was the variance components procedures in a replicated trial for the varieties. The analysis of covariance was used to obtain the genotypic correlations and phenotypic correlations among the eight characters, and the selection indexes for some agronomic characters were calculated by Robinson's method. The results are summarized as follows: Heritabilities : The experiment on the genotype-environment interaction revealed that in almost all of the characters investigated the interaction was too large to be neglected and materially affected the estimates of various genotypic parameters. The variation in heritability due to the change of environments was larger in the characters of low heritability than in those of high heritability. Heritability values of flowering date, fruiting period (days from flowering to maturity), stem length and 100 grain weight were the highest in both environments, those of yield(grain weight) and other characters were showed the lower values(Table 3). These heritability values showed a decreasing trend with the delayed sowing in the experiments. Further, all calculated heritability values were higher than anticipated. This was expected since these values, which were the broad sense heritability, contain the variance due to dominance and epistasisf in addition to the additive genetic variance. Genotypic correlations : Genotypic correlations were slightly higher than the corresponding phenotypic correlations in both environments, but the variation in values due to the change of environment appeared between grain weight and some other characters, especially an increase between grain weight and flowering date, and the total growing period(Table 6). Genotypic correlations between grain weight and other characters indicated that high seed yield was genetically correlated with late flowering, late maturity, and the other five characters namely branch numbers per plant, stem diameter, plant weight, pod numbers per plant and grain numbers per plant, but not with 100 grain weight of soybeans. Pod numbers and grain numbers per plant were more closely correlated with seed yields than with other characters. Selection index : For the comparison and the use of selection indexes in the selection, two kinds of selection indexes were calculated, the former was called selection index A and the later selection index B as shown in Table 7. Selection index A was calculated by the values of grain weight per plant as the character of yield(character Y), but the other, selection index B, was calculated by the values of pod numbers per plant, instead of grain weight per plant, as the character of yield'(character Y'). These results suggest that selection index technique is useful in soybean breeding. In reality, however, as the selection index varies with population and environment, it must be calculated in each population to which selection is applied and in each environment in which the population is located. In spite of the expected usefulness of selection index technique in soybean breeding, unsolved problems such as the expense, time and labor involved in calculating the selection index remain. For these reasons and from these experimental studies, it was recognized that in the breeding of self-fertilized soybean plants the selection for yield should be based on a more simple selection index such as selection index B of these experiments rather than on the complex selection index such as selection index A. Furthermore, it was realized that the selection index for the selection should be calculated on the basis of the data of some 3-4 agronomic characters-maturity date(X$_1$), branch numbers per plant(X$_2$), stem diameter(X$_3$) and pod numbers per plant etc. It must be noted that it should be successful in selection to select for maturity date(X$_1$) which has high heritability, and the selection index should be calculated easily on the basis of the data of branch numbers per plant(X$_2$), stem diameter(X$_3$) and pod numbers per plant, directly after the harvest before drying and threshing. These characters should be very useful agronomic characters in the selection of Korean soybeans, determinate growing habit type, as they could be measured or counted easily thus saving time and expense in the duration from harvest to drying and threshing, and are affected more in soybean yields than the other agronomic characters.

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A Comparative Study on the Chemical Methods for the Determination of Available Phosphorus in Korean Soils (한국토양(韓國土壤)의 유효인산량(有效燐酸量) 검정(檢定)을 위한 화학적(化學的) 방법(方法)에 대한 연구(硏究))

  • Lim, Sun-Uk;Chung, Jong-Bae;Sa, Tong-Min
    • Applied Biological Chemistry
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    • v.29 no.1
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    • pp.62-72
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    • 1986
  • At present, the definition and chemical analysis method of available soil phosphorus for plants have not been standardized because of the complexity of crop and soil characteristics in Korea and many analysis methods have been suggested with different extraction conditions. Suitable analytical method of available soil P should be established by the trial of various methods based on crop nutrition and soil conditions. To establish the most suitable analysis method of available soiIP, a pot experiment with young maize was conducted over 44 different upland soils collected over the land of Korea. The amount of uptaken P by the plant was determined by ten different chemical methods for the available soil P. The results obtained were as follows: 1. Total phosphorus content in the sample soils ranged ranged $533{\sim}4917\;ppm$, and showed significant positive correlation with the content of organic matter. 2. The P content was relatively low in the acid sulfate soil and very high in the volcanic ash soil although both types of soil contained high level of orgic matter. 3. The amount of extractable P determined by ten different methods were varied more or less, and the ratios of the extractable P to the total soil P were in the range of $1{\sim}48%$. 4. The relative values to the amount of extractable soil P by different methods were in the order of $H_2O(5\;min.)\;1.0\;<\;H_2O(60min.)\;2.27\;<\;NH_4HCO_3\;5.57\;<\;NaHCO_3\;7.42\;<\;Double\;lactate\;9.71\;<\;Bray\;No.1\;12.53\;<\;Lancaster\;17.63\;<\;Nelson\;25.96\;<\;AcOH\;27.6\;<\;CAL-method\;50.27$ 5. The amount of extractable P determined by all of applied methods was very low in acid sulfate soil, volcanic ash soil and coarse textured soil. 6. Soil pH and total soil P generally showed significant positive correlation with the chemically extracted P, and soil organic matter was negatively correlated with the determined by Nelson-and CAL-method. Olsen method which showed significant correlation with exchangeable calcium seemed to be recommendable for calcareous soils. 7. Total amount of uptaken P by Young maize through continuos twice cropping was 4.05% of total soil P in average, and the uptake in the second cropping was twice as much as that of the first cropping. 8. Three determination methods, i.e. Soltanpour-, Double lactate and Bray No. 1-method seemed to be more suitable than Lancaster method which is widely practiced at present in Korea. However, further study should be carried out with other crops and soils to most adequate chemical method for determination of available soil P.

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Radiation Dose-escalation Trial for Glioblastomas with 3D-conformal Radiotherapy (3차원 입체조형치료에 의한 아교모세포종의 방사선 선량증가 연구)

  • Cho, Jae-Ho;Lee, Chang-Geol;Kim, Kyoung-Ju;Bak, Jin-Ho;Lee, Se-Byeoung;Cho, Sam-Ju;Shim, Su-Jung;Yoon, Dok-Hyun;Chang, Jong-Hee;Kim, Tae-Gon;Kim, Dong-Suk;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.237-246
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    • 2004
  • Purpose: To investigate the effects of radiation dose-escalation on the treatment outcome, complications and the other prognostic variables for glioblastoma patients treated with 3D-conformal radiotherapy (3D-CRT). Materials and Methods: Between Jan 1997 and July 2002, a total of 75 patients with histologically proven diagnosis of glioblastoma were analyzed. The patients who had a Karnofsky Performance Score (KPS) of 60 or higher, and received at least 50 Gy of radiation to the tumor bed were eligible. All the patients were divided into two arms; Arm 1, the high-dose group was enrolled prospectively, and Arm 2, the low-dose group served as a retrospective control. Arm 1 patients received $63\~70$ Gy (Median 66 Gy, fraction size $1.8\~2$ Gy) with 3D-conformal radiotherapy, and Arm 2 received 59.4 Gy or less (Median 59.4 Gy, fraction size 1.8 Gy) with 2D-conventional radiotherapy. The Gross Tumor Volume (GTV) was defined by the surgical margin and the residual gross tumor on a contrast enhanced MRI. Surrounding edema was not included in the Clinical Target Volume (CTV) in Arm 1, so as to reduce the risk of late radiation associated complications; whereas as in Arm 2 it was included. The overall survival and progression free survival times were calculated from the date of surgery using the Kaplan-Meier method. The time to progression was measured with serial neurologic examinations and MRI or CT scans after RT completion. Acute and late toxicities were evaluated using the Radiation Therapy Oncology Group neurotoxicity scores. Results: During the relatively short follow up period of 14 months, the median overall survival and progression free survival times were $15{\pm}1.65$ and $11{\pm}0.95$ months, respectively. The was a significantly longer survival time for the Arm 1 patients compared to those in Arm 2 (p=0.028). For Arm 1 patients, the median survival and progression free survival times were $21{\pm}5.03$ and $12{\pm}1.59$ months, respectively, while for Arm 2 patients they were $14{\pm}0.94$ and $10{\pm}1.63$ months, respectively. Especially in terms of the 2-year survival rate, the high-dose group showed a much better survival time than the low-dose group; $44.7\%$ versus $19.2\%$. Upon univariate analyses, age, performance status, location of tumor, extent of surgery, tumor volume and radiation dose group were significant factors for survival. Multivariate analyses confirmed that the impact of radiation dose on survival was independent of age, performance status, extent of surgery and target volume. During the follow-up period, complications related directly with radiation, such as radionecrosis, has not been identified. Conclusion: Using 3D-conformal radiotherapy, which is able to reduce the radiation dose to normal tissues compared to 2D-conventional treatment, up to 70 Gy of radiation could be delivered to the GTV without significant toxicity. As an approach to intensify local treatment, the radiation dose escalation through 3D-CRT can be expected to increase the overall and progression free survival times for patients with glioblastomas.

Effect of Protein Fractionation and Buffer Solubility of Forage Sources on In Vitro Fermentation Characteristics, Degradability and Gas Production (조사료 자원의 단백질 분획 및 Buffer 추출이 In Vitro 발효 성상, 분해율 및 Gas 생성량에 미치는 효과)

  • Jin, Guang Lin;Shinekhuu, Judder;Qin, Wei-Ze;Kim, Jong-Kyu;Ju, Jong-Kwan;Suh, Seong-Won;Song, Man-Kang
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.32 no.1
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    • pp.59-74
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    • 2012
  • Buffer solubility and protein fractionation were evaluated from the hays (timothy, alfalfa and klein) and straws (tall fescue and rice), and $In$ $vitro$ trial was conducted to examine the effect of buffer extraction on fermentation characteristics, degradability and gas ($CO_2$ and $CH_4$) production. Buffer soluble protein (SP) content and A fraction in total protein were highest in alfalfa hay as 61% and 41.77%, respectively while lowest in rice straw (42.8% and 19.78%, respectively). No difference was observed in B1 fraction among forages but B2 fraction was slightly increased in klein hay (12.34%) and tall fescue straw (10.05%) compared with other forages (6.34~8.85%). B3 fraction of tall fescue was highest as 38.49% without difference among other forages while C fraction was highest in rice straw. pH in incubation solution was higher in all forages after extraction than before extraction at 3h (P<0.01) and 6h (P<0.05), and pH from hays of timothy and alfalfa was higher than the other forages at 6h (P<0.05) and 12h (P<0.001). Regardless of extraction, ammonia-N concentration from alfalfa hay was increased at all incubation times and extraction effect was appeared only at 3h incubation time (P<0.01). Total VFA concentration from alfalfa hay was highest up to 24h incubation while those from tall fescue straw and rice straw were lowest. Buffer extraction decreased (P<0.01~P<0.001) the total VFA concentration. Acetic acid proportion was increased (P<0.001) before extraction of forages but no difference was found between forages. Propionic acid($C_3$) proportion was also increased(P<0.001) before extraction in all forages than in straws at 3h, 24h and 48h incubations, and $C_3$ from hays were mostly higher (P<0.05) than from straws. Butyric acid proportion, however, was not affected by extraction at most incubation times. Parameter 'a' regarding to the dry matter (DM) degradation was increase (P<0.001) in all forages before extraction, and was decreased (P<0.05) in tall fescue straw and rice straw compared with hays. Parameter 'b' was also increased (P<0.001) before extraction but no difference was found between forages. Effective degradability of DM (EDDM) was higher (P<0.001) before extraction in most forages except for rice straw. Buffer extraction decreased (P<0.05) all parameters (a, b, and c) regrading to the crude protein (CP) degradation but no difference was found between forages. Effective degradation of CP (EDCP) was lower (P<0.05) in straws than in hays. Parameters 'a' and 'b' regarding to the NDF degradation (P<0.01) and effective degradability of NDF (EDNDF, P<0.001) were also higher in forages before extraction than after extraction but no difference was found between forages. Buffer extraction reduced (P<0.05~P<0.001) $CO_2$ production from all the forages uo to 24h incubation and its production was greater (P<0.05~P<0.01) from hays than straws. Methane ($CH_4$) production was also greater (P<0.01~P<0.001) in all forages at all incubation times, and its production was greater (P<0.05) from hays than from straws at most incubation times. Based on the results of the current study, it can be concluded that buffer solubility and CP fractionation might be closely related with $In$ $vitro$ VFA concentration, degradability and gas ($CO_2$ and $CH_4$) production. Thus, measurement of buffer solubility and protein fractionation of forages might be useful to improve TMR availability in the ruminants.