• Radiation Oncology Journal
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• v.15 no.4
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• pp.357-367
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• 1997

Purpose : To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radio-therapy, a retrospective analysis was undertaken. Materals and Methods : I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radio-therapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dese rate intracavitary radiation. Results : Overall 5 year survival rate and relapse free survival rate were $75.4\%,\;73.5\%$, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node matastasis. tumor size and vaginal resection margin involvement were significant prognostic factos. Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only $56\%$ and nine of twenty two patients recurred. Conculsion : Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and /or other methods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen.

• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.4
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• pp.16-38
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• 2018

Objectives: The objective of this in vivo study is to observe the anti-osteoporotic activities of Gojineumja aqueous extracts (GJEJ) on the ovariectomized (OVX) mice as compared to those of risedronate sodium (RES). Methods: Thirty five days after bilateral OVX, GJEJ was orally administered, for 35 days once a day and then the changes on the body weight and gain during experimental periods, femur weights, bone mineral density (BMD), bone strength (failure load), mineral contents - calcium (Ca) and inorganic phosphorus (IP), histological profiles and histomorphometrical analyses at sacrifice were conducted with serum biochemistry - osteocalcin contents and bone specific alkaline phosphatase (BALP) activities. And the results of GJEJ were compared with RES orally administered OVX mice. Results: As a result of OVX, noticeable increase of body weight and gains and serum osteocalcin levels, decrease of serum BALP activities, femur weights, femur Ca and IP contents, BMD and strength were observed as compared to those of sham control mice, respectively. Also, the decrease of all histomorphometrical indices indicating the bone mass and structure, and the increase of indices about resorption were also detected in the femur of OVX control. However, these estrogen-deficient osteoporotic signs were significantly and dose-dependently inhibited by 35 days of continuous oral treatment of GJEJ, at dose levels of 500, 250 and 125 mg/kg, respectively. Especially, GJEJ 500 mg/kg showed favorable inhibitory activities against estrogen-deficient osteoporosis symptoms induced by OVX as comparable to those of RES 2.5 mg/kg. Conclusions: The results in this study suggest that oral administrations of GJEJ have clear dose-dependent favorable anti-osteoporotic activities in OVX mice.

• Tuberculosis and Respiratory Diseases
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• v.57 no.4
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• pp.311-319
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• 2004

Background : It has been well known that bronchiectasis (BE) is a predisposing condition for pulmonary NTM infection, whereas there are some suggestions that BE, especially nodular BE, may be a result of NTM pulmonary infection. This retrospective study was done to investigate the prevalence of NTM pulmonary infection in the patients with BE. Methods : Eight hundred sixty-six patients, who underwent chest CT and sputum AFB examination and had BE detected by chest CT at Asan Medical Center in 2002, were included in this study. They were divided into Group I (bilateral BE, especially in RML, lingular or both lower lobes; 134), Group II (BE accompanied with fibrocavitary lesions commonly found in tuberculosis, usually both upper lobes; 233) and Group III (except Group I, II; 499) according to the radiological findings. Group I was subdivided into Group I+ (62) or Group I- (72) according to the presence or absence of centrilobular nodules, respectively. The sputum AFB examination, clinical and radiological findings were analyzed and compared between groups. Results : The number of patients who had at least one positive NTM culture was significantly higher in Group I+ compared with others (p<0.05); 24.2% in Group I+, 6.9% in Group I-, 9.9% in Group II, 6.0% in Group III and 4.1% in control. The number of patients who had true NTM infection defined by ATS guideline was higher in Group I+ (5, 8.1%) compared with others (p<0.05). In all groups, M. avium-intracellulare comlex was the most common isolates. Conclusion : Even though true NTM pulmonary disease was more prevalent in the patients with nodular BE, especially located in RML, left linguar, or both lower lobes, only a small population of the patients with nodular BE met the ATS diagnostic criteria for NTM pulmonary disease. The other patients in nodular BE group may have subclinical stage of NTM infection or completely different diseases from NTM infection. Long-term clinical studies are needed to clarify this issue.

• Journal of the Korean Society of Food Science and Nutrition
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• v.34 no.1
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• pp.27-35
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• 2005

This study was performed to determine the effect of three different concentrations of soy-isoflavones on excretions through urine and feces in either sham-operated or ovariectomized female rats. Seventy-two 16-week old Sprague-Dawley rats underwent sham operation or bilateral ovariectomy. They were provided diets containing different levels of soy isoflavones for 6 weeks: 50 ppm (low isoflavone intake; LI), 250 ppm (medium isoflavone intake; MI) and 500 ppm (high isoflavone intake; HI). The subsequent fecal and urinary excretions of daidzein and genistein were then measured. In the sham operated rats, body weight gains and food efficiency ratio of the MI and HI groups were significantly lower than control group, while food intake was not different. However, there was no significant difference in ovariectomized rats. The fecal excretion of daidzein was significantly higher in the HI group than the LI and MI groups, and that of genistein increased as dietary isoflavone intakes increased in both the sham operation and ovariectomy. The reverse tendency of fecal recovery was shown with dietary isoflavone dose only in genistein among ovariectomized rats. When dietary isoflavones were increased from 50 ppm to 500 ppm, the amounts of daidzein and genistein in the urine increased dose-dependently. The higher intakes of isoflavones leaded to lower recovery rates of daidzein and genistein in the urine in the sham-operated rats but not in the ovariectomized rats. The urinary recovery was significantly higher in the LI group than the MI and HI groups in the sham-operated rats. The excreted amounts and recovery of the two isoflavones in the urine were higher in the sham operated groups than in the ovariectomized groups, which implied an increased bioavailability of isoflavones by ovariectomy. Therefore, the results suggest that a more efficient use of soy isoflavones in ovariectomized conditions may occur, which indicates that a higher dose of soy isoflavones is necessary for the postmenopausal states.

• Radiation Oncology Journal
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• v.27 no.1
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• pp.29-34
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• 2009

Purpose: This study was designed to evaluate long-term results in terms of failure, survival and voice preservation after radiation therapy for early glottic cancer. Materials and Methods: From February 1988 to December 2003, 70 patients with early glottic cancer were treated with radiation therapy at Keimyung University Dongsan Medical Center. Patient age distribution was from 39 to 79 years, with a median age of 62 years. All patients had squamous cell carcinoma. According to the TNM stage, 58 patients had stage I disease, 12 patients had stage II disease; 67 patients were male. The laryngeal area was irradiated with the use of bilateral opposing fields with/without a wedge filter with 6 MV photons at a total dose of $54{\sim}70.2$ Gy in $1.8{\sim}2.2$ Gy fractions over $6{\sim}8$ weeks. We delivered a median radiation dose of 60 Gy for stage I patients and a median radiation dose of 66 Gy for stage II patients. Salvage surgery was performed in patients with local recurrence. The voice preservation rate was analyzed after all treatments including salvage surgery. Follow-up periods were from 13 to 180 months, with a median follow-up period of 77.5 months. The survival rate was analyzed by the use of the Kaplan Meier method and log rank test. A comparison of two groups was performed with the use of the chi-squared test. Results: The local control rate was 98.5% (69/70). The five-year-overall survival rate was 93.9%. The five-year disease free survival rate (5YDFS) was 84.1% and the 5YDFS after radiation and salvage surgery was 92.8%. According to stage, the 5YDFS was 93.1% and 91.7% for stage I and stage II respectively. Thirteen patients (18.5%) had local failure with 24 months of median time to local failure and nine patients received salvage surgery; however, four patients were lost to follow-up after a diagnosis of recurrence. Only two patients died due to a distant metastasis at 33 months and 71 months after radiation therapy, respectively. Nine patients died due to other diseases with a median time of 73 months. There were no severe acute or chronic complications after radiation therapy. Voice preservation was ultimately achieved in 88.5% (62/70) of patients. Conclusion: We considered that radiation therapy was effective and we achieved excellent survival and voice preservation in early laryngeal cancer. The use of radiation therapy should be the first choice for the treatment of early glottic cancer.

• The korean journal of orthodontics
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• v.29 no.1 s.72
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• pp.83-94
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• 1999

The purpose of this study was to evaluate the changes of cancellous and cortical bone and the effect of estrogen in ovariectomized rats. Fifty female rats, 250gm in body weight, were divided into three groups : ovariectomized group(OVE), ovariectomized and estrogen-injected group(OVE-EST), and sham operated and estrogen-injected group(EST). Bilateral ovariectomy was performed at the onset of the experiment. In OVE-EST group and EST group, estrogen was injected $50{\mu}g/kg$ B.W. every other days from 3 weeks after surgery to sacrifice. Each five rats were sacrificed after 5, 6, 7 weeks. One side of mandibular body was radiographed with a soft x-ray apparatus(Hitex Co., Ltd., Japan). Thereafter the obtained microradiographs were used for the morphometric analysis using a Image analyzer. The morphometric analysis was perforrmed for parameters such as total bone area, cortex bone area and medullary bone area. The other side of the mandibular bone was decalcified and embedded in paraffin as using a general method. The specimens were sectioned and stained with Mallory's anilline blue and observed light microscopically. The results were as follows. 1 In all groups, the proportion of cortex to total bone area was not significantly different. 2. In ovariectomized(OVE) group, the proportion of marrow cavity to medullary bone area increased significantly from 5 to 7 weeks(p<0.05). In ovariectomized and estrogen-injected(OVE-EST) group, it decreased significantly at 7 weeks, and in estrogen-injected(EST) group, it decreased significantly from 6 weeks(p<0.05). 3. Microradiogram and histopathologic findings revealed that marrow cavity was enlarged and osteoclasts were observed around irregular bone surface in OVE group. In OVE-EST group, the size of marrow cavity at 7 weeks was similar to that of control group. In EST group, as dense trabecular bone increased from 5 to 7 weeks, marrow cavity decreased.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.2
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• pp.100-106
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• 2009

Purpose: The study was to assess I-123-N-(3-iodopropen-2-yl)-2[beta]-carbomethoxy-3[beta]-(4-cholorophenyl) tropane(IPT) SPECT in differential diagnosis among early stage of Parkinson's disease(PD) and essential tremor(ET) and normal control(NL) groups quantitatively. Materials and Methods: I-123 IPT brain SPECT of 50 NL, 20 early PD, 30 advanced PD, and 20 ET were performed at 20 minutes and 2 hours. Specific/nonspecific binding of striatum was calculated by using right and left striatal specific to occipital non-specific uptake ratio(striatum-OCC/OCC). Results: Mean value of specific/nonspecific binding ratio was significantly different between advanced PD group and NL group. However, significant overlap of striatal specific/nonspecific binding ratio was observed between PD group and ET group. Bilateral striatal specific/nonspecific binding ratios were decreased in advanced PD. Lateralized differences in the striatal uptake of I-123 IPT correlated with asymmetry in clinical findings in PD group. Conclusion: I-123 IPT SPECT may be a useful method for the diagnosis of PD and objective evaluation of progress of clinical stages. Care should be made in the differential diagnosis of early stage of PD and other motor disturbances mimicking PD such as ET in view of significant overlap in striatal I-123 specific/nonspecific binding ratio.

• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.241-250
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• 2001

Purpose: Vasospasm is a complication of aneurysmal subarachnoid hemorrhage (aSAH). We assessed the role of acetazolamide-enhanced brain perfusion SPECT (ACZ-SPECT) with Tc-99m ECD for predicting the prognosis of patients with aSAH. Materials and methods: Two SPECT studios (baseline with 740 MBq and ACZ-SPECT with 1480 MBq) with image subtraction were performed in 21 patients with aSAH. All patients had brain CT and angiogram. Vasoreactivity on ACZ-SPECT, perfusion defect on baseline SPECT, and vasospasm on angiogram were correlated with Hunt-Hess grading, extent of SAH (unilateral or bilateral) on CT, and clinical outcome. Vasoreactivity was considered decreased when cerebral/cerebellar uptake ratio difference from baseline SPECT to ACZ-SPECT was greater than 2SD of normal control values. Results: Decreased vasoreactivity was observed in 38% (8/21), perfusion defect in 81% (17/21), and vasospasm in 38% (8/21). The preserved vasoreactivity group showed better outcome scale (92%, 12/13) and the decreased vasoreactivity group showed poorer outcome scale (62.5%, 5/8) (p=0.014). Extensive SAH was more frequently seen in the decreased vasoreactlvlty group (87.5%, 7/8) than in the preserved vasoreactivity group (30.7%, 4/13)(p=0.017). The perfusion defect and vasospasm did not show good correlation with outcome scale, extent of SAH, and Hunt-Hess grading (p=ns). Vasoreactivity represented the patient's outcome better than the vasospasm in all of the vasoreactivity/vasospasm-mismatched cases (6 cases). Conclusions: Our data show that decreased vasoreactivity on ACZ-SPECT does not always represent vasospastic condition. But patients with decreased vasoreactivity reveal poorer outcome than patients with angiographic vasospasm do. Therefore ACZ-SPECT is a valuable, noninvasive test for predicting the prognosis of patients with aSAH.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.303-308
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• 2002

Purpose : To determine the optimal radiation dose in a localized non-Hodgkin's lymphoma of the head and neck in the treatment setting for combined chemoradiotherapy. Materials an Methods :Fifty-three patients with stage I and II diffuse large ceil non-Hodgkin's lymphoma of the head and neck, who were treated with combined chemoradiotherapy between 1985 and 1998 were retrospectively reviewed. The median age was 49 years, and the male-to-female ratio was approximately 1.6. Twenty-seven patients had stage 1 disease and 26 had stage II. Twenty-three patients had bulky tumors $(\geq5\;cm)$ and 30 had non-bulky tumors (<5 cm). The primary tumors arose mainly from an extranodal organ $(70\%)$, most cases involving Waldeyer's ring $(90\%)$. All patients except one were initially treated with $3\~6$ cycles of chemotherapy, which was followed by radiotherapy. Radiation was delivered either to the primary tumor area alone $(9\%)$ or to the primary tumor area plus the bilateral neck nodes $(91\%)$ with a minimum dose of 30 Gy $(range\;30\~60\;Gy)$. The failure patterns according to the radiation field were analyzed, and the relationship between the dose and the in-field recurrence was evaluated. Results : The 10-year overall survival and the 10-year disease free survival rates were similar at $75\%\;and\;76\%$, respectively. A complete response (CR) after chemotherapy was achieved in 44 patients $(83\%)$. Subsequent radiotherapy showed a CR in all patients. Twelve patients $(23\%)$ had a relapse of the lymphoma after the initial treatment. Two of these patients had a recurrence inside the radiation field. No clear dose response relationship was observed and no significant prognostic factors for the in-field recurrences were identified because of the small number of in-field recurrences. However, for patients with tumors <5 cm in diameter, there were no in-field recurrences after a radiation dose 30 Gy. The 2 in-field recurrences encountered occurred in patients with a tumor $\geq5\;cm$. Conclusion .A dose of 30 Gy is sufficient for local control in patients with a non-bulky (<5 cm), localized, diffuse large cell non-Hodgkin's lymphoma when combined with chemotherapy. An additional boost dose in the primary site is recommended for patients with bulky tumors $(\geq5\;cm)$.

• The Korean Journal of Nuclear Medicine
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• v.32 no.2
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• pp.151-160
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• 1998

Purpose: Piccolo et al. advocated the usefulness of $^{99m}Tc$-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied $^{99m}Tc$-MDP uptake pattern and lesion/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of $^{99m}Tc$-MDP scan. Materials and Methods: Total 34 patients were studied with physical examination, mammo-gram and $^{99m}Tc$-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq $^{99m}Tc$-MDP. Breast uptake pattern of $^{99m}Tc$-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammogram. Results: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of $^{99m}Tc$-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 217, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. Conclusion: $^{99m}Tc$-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.