• Tuberculosis and Respiratory Diseases
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• v.49 no.3
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• pp.323-331
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• 2000

Purpose: Brain metastases are present in approximately 10-16% of small cell lung cancer patients at diagnosis. Brain metastasis is an important clinical problem associated with increasing the survival rate, with a cumulative incidence of up to 80% in patients surviving 2 years. Prophylactic cranial irradiation(PCI) reduces the incidence of brain matastasis and may prolong survival in patients with limited small-cell lung cancer who achieved complete remission. This study was performed to analyze the incidence of brain metastasis, survival and clinical aspects after PCI in patients with limited small-cell lung cancer who achieved complete remission. Methods : Between 1989 and 1999, forty-two patients with limited small-cell lung cancer who achived achieved complete remission after therapy were enrolled into this study retrospectively. All patients received etoposide and cisplatin(VPP) alternating with cytoxan, adriamycin, and vincristine(CAV) every 3 weeks for at least 6 cycles initially. All patients received thoracic radiotherapy: concurrent(38.1%) and sequential(61.9%). All patients received late PCI. Results : Most patients(88.1%) were men, and the median age was 58 years. The median follow-up duration was 18.1 months. During the follow-up period, 57.1% of the patients developed relapse. The most frequent site of relapse was chest(35.7%), followed by brain(14.3%), liver(11.9%), adrenal gland(44%), and bone(2.2%). With the Kaplan-Meier method, the average disease-free interval was 1,090 days(median 305 days). The average time to development of brain relapse after PCI and other sites relapse(except brain) were 2,548 days and 1,395 days(median 460 days), respectively. The average overall survival was 1,233 days(median 634 days, 21.1 months), and 2-year survival rates was 41.7%. The average overall survival in the relapse group was 642 days(median 489 days) and in the no relapse group was 2,622 days(p<0.001). The average overall survival in the brain relapse group was 928 days(median 822 days) and in the no brain relapse group was 1,308 days(median 634 days)(p=0.772). In most patients(85.7%), relapse(except brain) or systemic disease was the usual cause of death. Brain matastasis was the cause of death in 14.3% of the cases. Conclusions : We may conclude that PCI reduces and delays brain metastasis in patients with limited small cell lung cancer who achieved complete remission. We found decreased survival in relapse group but, no significant survival difference was noted according to brain matastasis. And relapse(except brain) or systemic disease was the usual cause of death. In order to increase survival, new treatment strategies for control methods for relapse and systemic disease are required.

• Restorative Dentistry and Endodontics
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• v.32 no.3
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• pp.248-259
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• 2007

The aim of this research was to study the effect of intermittent polymerization on marginal adaptation by comparing the marginal adaptation of intermittently polymerized composite to that of continuously polymerized composite. The materials used for this study were Pyramid (Bisco Inc., Schaumburg, U.S.A.) and Heliomolar (Ivoclar Vivadent, Liechtenstein) . The experiment was carried out in class II MOD cavities prepared in 48 extracted human maxillary premolars. The samples were divided into 4 groups by light curing method: group 1- continuous curing (60s light on with no light off), group 2-intermittent curing (cycles of 3s with 2s light on & 1s light off for 90s); group 3- intermittent curing (cycles of 2s with 1s light on & 1s light off for 120s); group 4- intermittent curing (cycles of 3s with 1s light on & 2s light off for 180s). Consequently the total amount of light energy radiated was same in all the groups. Each specimen went through thermo-mechanical loading (TML) which consisted of mechanical loading (720,000 cycles, 5.0 kg) with a speed of 120 rpm for 100hours and thermocycling (6000 thermocycles of alternating water of $50^{\circ}C$ and $55^{\circ}C$). The continuous margin (CM) (%) of the total margin and regional margins, occlusal enamel (OE), vertical enamel (VE), and cervical enamel (CE) was measured before and after TML under a $\times200$ digital light microscope. Three-way ANOVA and Duncan's Multiple Range Test was performed at 95% level of confidence to test the effect of 3 variables on CM (%) of the total margin: light curing conditions, composite materials and effect of TML. In each group, One-way ANOVA and Duncan's Multiple Range Test was additionally performed to compare CM (%) of regions (OE, VE CE). The results indicated that all the three variables were statistically significant (p < 0.05). Before TML, in groups using Pyramid, groups 3 and 4 showed higher CM (%) than groups 1 and 2, and in groups using Heliomolar. groups 3 and 4 showed higher CM (%) than group 1 (p < 0.05). After TML, in both Pyramid and Heliomo)ar groups, group 3 showed higher CM (%) than group 1 (p < 0.05) CM (%) of the regions are significantly different in each group (p < 0.05). Before TML, no statistical difference was found between groups within the VE and CE region. In the OE region, group 4 of Pyramid showed higher CM (%) than group 2, and groups 2 and 4 of Heliomolar showed higher CM (%) than group 1 (p < 0.05). After TML, no statistical difference was found among groups within the VE and CE region. In the OE region, group 3 of Pyramid showed higher CM (%) than groups 1 and 2, and groups 2,3 and 4 of Heliomolar showed higher CM (%) than group 1 (p < 0.05). It was concluded that intermittent polymerization may be effective in reducing marginal gap formation.