• Title/Summary/Keyword: combined treatment

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Optimum Dose Combination of External Radiation and High Dose Rate ICR in FIGO IB Uterine Cervical Cancer (병기 IB 자궁경부암의 방사선치료에서 외부방사선치료와 고선량율 강내치료의 최적선량 배합)

  • Lee Sang Wook;Suh Chang Ok;Chung Eun Ji;Kim Woo Cheol;Chang Sei Kyung;Keum Ki Chang;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.201-209
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    • 1996
  • Purpose : To assess the efficacy of high dose rate - intracavitary radio-therapy (HDR-ICR) in the radiotherapy of FIGO stage IB squamous cell carcinoma of uterine cervix and to determine the optimum dose combination scheme of external radiotherapy and ICR to achieve acceptable local control without severe complication. Materials and Methods : One hundred and sixty two patients with FIGO stage Ib squamous cell carcinoma of uterine cervix who received definitive radiotherapy between May 1979 and December 1990 were retrospectively analyzed. All the patients received external radiotherapy combined with HDR-ICR. External dose of 40-46 Gy in 4.5-5 weeks was given to whole pelvis(median 45 Gy) and ICR dose of 30-39 Gy in 10-13 times was given to the point A. Midline shielding was done after 20-45 Gy of external radiotherapy(median 40 Gy) Summation of external dose Plus ICR dose to the point A range were 64.20-95.00 Gy. and mean was 83.94 Gy. We analyzed the local control rate, survival rate, and late complication rate. Rusults : Initial complete response rate was $99.4\%$ for all patients. Overall 5-year survival rate was $91.1\%$ and 5-year disease free survival rate was $90.9\%$. Local failure rate was $4.9\%$ and distant failure rate was $4.3\%$. Tumor size was the only significant prognostic factor. When tumor size greater than 3cm, 5-rear survival rate was $92.6\%$ and less than 3cm, that was $79.6\%$. Late complication rate was $23.5\%$ with $18.5\%$ of rectal complication and $4.9\%$ of bladder complication. Mean rectal dose summation of external midline dose plus ICR rectal point dose was lower in the patients without rectal complication(74.88 Gr) than those with rectal complication (78.87 Gy). Complication rate was increased with low rate of improvement of survival rate when summation of external midline dose plus point A or point R dose by ICR was greater than 70-75 Gy. Conclusion : The definitive radiation therapy using high dose rate ICR in FIGO stage IB uterine cervical cancer is effective treatment modality with good local control and survival rate without severe complication.

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Neoadjuvant Chemotherapy and Radiotherapy in Locally Advanced Hypopharyngeal Cancer (국소 진행된 하인두암의 선행 항암화학요법 후 방사선치료)

  • Kim Suzy;Wu Hong-Gyun;Heo Dae-Seog;Park Charn I1
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.244-250
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    • 2000
  • Purpose : To see the relationship between the response to chemotherapy and the final outcome of neoadiuvant chemotherapy and radiotherapy in patients with mocanry advanced hypopharyngeal cancer. Methods and Materials :A retrospective analysis was done for thirty-two patients with locally advanced hypopharyngeal cancer treated in the Seoul National University Hospital with neoadiuvant chemotherapy and radiotherapy from August 1979 to July 1997. The patients were treated with Co-60 teletherapy unit or 4MV or 6MV photon beam produced by linear accelerator. Daily fractionation was 1.75 to 2 Gy, delivered five times a week. Total dose ranged from 60.8 Gy to 73.8 Gy. Twenty-nine patients received continuous infusion of cisplatin and 5-FU. Other patients were treated with cisplatin combined with bleomycin or vinblastin. Twenty-four (75$\%$) patients received all three prescribed cycles of chemotherapy delivered three weeks apart. Six patients received two cycles, and two patients received only one cycle. Results :The overall 2-year and 5-year survival rates are 65.6$\%$ and 43.0$\%$, respectively. 5-year local control rate is 34$\%$. Organ preservation for more than five years is achieved in 12 patients (38$\%$). After neoadjuvant chemotherapy, 24 patients achieved more than partial remission (PR): the response rate was 75$\%$ (24/32). Five patients had complete remission (CR), 19 patients PR, and 8 patients no response (NR). Among the 19 patients who had PR to chemotherapy, 8 patients achieved CR after radiotherapy. Among the 8 non-responders to chemotherapy, 2 patients achieved CR, and 6 patients achieved PR after radiotherapy. There was no non-responder after radiotherapy. The overall survival rates were 60$\%$ for CR to chemotherapy group, 35.1$\%$ for PR to chemotherapy group, and 50$\%$ for NR to chemotherapy group, respectively (p=0.93). There were significant difference in five-year overall survival rates between the patients with CR and PR after neoadjuvant chemotherapy and radiotherapy (73.3$\%$ vs. 14.7$\%$, p<0.01). The prognostic factor affecting overall survival was the response to overall treatment (CR vs. PR, p<0.01). Conclusion :In this study, there were only five patients who achieved CR after neoadiuvant chemotherapy. Therefore the difference of overall survival rates between CR and PR to chemotherapy group was not statistically significant. Only the response to chemo-radiotherapy was the most important prognostic factor. There needs to be more effort to improve CR rate of neoadjuvant chemotherapy and consideration for future use of concurrent chemoradiotherapy.

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Performance Improvement of Dielectric Barrier Plasma Reactor for Advanced Oxidation Process (고급산화공정용 유전체 장벽 플라즈마 반응기의 성능 개선)

  • Kim, Dong-Seog;Park, Young-Seek
    • Journal of Korean Society of Environmental Engineers
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    • v.34 no.7
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    • pp.459-466
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    • 2012
  • In order to improved treatment performance of dielectric barrier discharge (DBD) plasma, plasm + UV process and gas-liquid mixing method has been investigated. This study investigated the degradation of N, N-Dimethyl-4-nitrosoaniline (RNO, indicator of the generation of OH radical). The basic DBD plasma reactor of this study consisted of a plasma reactor (consist of quartz dielectric tube, titanium discharge (inner) and ground (outer) electrode), air and power supply system. Improvement of plasma reactor was done by the combined basic plasma reactor with the UV process, adapt of gas-liquid mixer. The effect of UV power of plasma + UV process (0~10 W), gas-liquid mixing existence and type of mixer, air flow rate (1~6 L/min), range of diffuser pore size (16~$160{\mu}m$), water circulation rate (2.8~9.4 L/min) and UV power of improved plasma + UV process (0~10 W) were evaluated. The experimental results showed that RNO degradation of optimum plasma + UV process was 7.36% higher than that of the basic plasma reactor. It was observed that the RNO decomposition of gas-liquid mixing method was higher than that of the plasma + UV process. Performance for RNO degradation with gas-liquid mixing method lie in: gas-liquid mixing type > pump type > basic reactor. RNO degradation of improved reactor which is adapted gas-liquid mixer of diffuser type showed increase of 17.42% removal efficiency. The optimum air flow rate, range of diffuser pore size and water circulation rate for the RNO degradation at improved reactor system were 4 L/min, 40~$100{\mu}m$ and 6.9 L/min, respectively. Synergistic effect of gas-liquid mixing plasma + UV process was found to be insignificant.

Comparison of shaping ability using various Nickel-Titanium rotary files and hybrid technique (다양한 전동 니켈 티타늄 파일과 혼합사용법에 의한 근관 성형 효율 비교)

  • Kim, Jung-Won;Park, Jeong-Kil;Hur, Bock;Kim, Hyeon-Cheol
    • Restorative Dentistry and Endodontics
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    • v.32 no.6
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    • pp.530-541
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    • 2007
  • Currently, various Nickel-Titanium rotary files are used in endodontic treatment, but there is no one perfect system that can be applied to any clinical situation. Therefore, the combined uses of various file systems which can emphasize the advantages of each system are introduced as hybrid instrumentation. The ProTaper system is efficient in body shaping and apical pre-enlargement but is reported to have more possibility of transportation and produce more aberrations and deformation in more or less severe curved canals. Recently, new ProTaper system(ProTaper Universal) with different configuration and cross-sectional design to overcome the week points of ProTaper have been marketed. The purpose of this study was to compare and evaluate the shaping abilities of ProTaper, ProTaper Universal system, and two hybrid methods using S-series of ProTaper Universal and Hero Shaper or ProFile. The time lapses for instrumentation were measured and the used files were inspected for distortion. The pre- and post-instrumented root canals were scanned and superimposed to evaluate the aberrations and reduction of root canal curvature and change of radius of canal curvature. The increased canal width and apical centering ratio were calculated at 1, 2, 3, 4 and 5 mm levels from apical foramen. Under the conditions of this study, the ProTaper Universal seems to have better shaping ability than ProTaper in terms of instrumented width and instrumentation time. It may be suggested that the ProTaper Universal system is efficient as much as hybrid instrumentation using ProTaper and other constant-tapered NiTi file systems in highly experienced operators.

Size and Retention of Tongue Bulb for Tongue Retaining Device (혀 유지구의 크기와 유지력 평가)

  • Park, Nam-Seon;Lee, Ki-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.283-292
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    • 2007
  • In several treatment modalities for snoring and obstructive sleep apnea (OSA), oral appliances mainly including mandibular advancement appliance (MAA) and tongue retaining device (TRD) are recognized as a non-invasive, reversible alternative with favorable results. Tongue bulb is a major component of TRD which prevents the tongue from approaching the posterior wall of the pharynx and can be combined with MAA. Determination of tongue bulb size for the patient is important for therapeutic effect, but frequently needs time-consuming work. For effective fabrication and standardization of tongue bulbs, this study aimed to categorize tongue bulb size for healthy young men and to examine its relation with maximum retention force and with physical parameters including tongue-related variables. 36 non-snoring, asymptomatic young men with normal occlusion were voluntarily participated in this study (mean age: $24.47{\pm}2.58$ years). Experimental procedures consisted of prefabrication of tongue bulb set (20 types with a width of 27-36mm and thickness of 8 and 10 mm), determination of tongue bulb size and the maximum retention force for each subject, and measurement of physical parameters including body mass index (BMI), neck circumference and width, thickness and length of tongue. This study showed that there was significant difference of retention force among the bulb size-related groups both in upright and supine position (p<0.05) and that retention force increased with bulb size. Correlation of tongue bulb size with physical parameters was not clearly verified and there was no significant difference in retention force between upright and supine positions. Based on our results, it can be suggested that retention force relates with tongue bulb size, ultimately with tongue volume. A further study needs to be performed in the patients with snoring and OSA.

Clinical Characteristics of Pulmonary Aspergillosis (폐 국균증의 임상적 특성)

  • Park, Ik-Soo;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.6
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    • pp.624-631
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    • 1994
  • Background: Genus of Aspergilli are ubiquitous saprophytic molds in nature, but its change from a saprophytic fungus to a pathogenic organism has occurred since the use of various antibiotics. The fungus affects the chronically ill and debilitated population. Recently frequency of the fungal infection is increasing in Korea with abuse of antibiotics and glucocorticoids. Method: We analyzed medical records of 52 patients with pulmonary aspergillosis seen at Hanyang University Hospital from 1980 to 1994. The results were as follows; Results: 1) Ages ranged between second to eighth decades with majority(50%) in the fourth to fifth decades. The male to female ratio was 1.1:1. 2) Hemoptysis and productive cough, the leading symptoms, occurred in 42.3% and 25% respectively. 3) On chest X-ray fingings, the characteristic "fungus ball" pattern were observed in 53.8% of the 52cases. 4) Sputum culture for aspergilli were positive in 21.6% of the cases. We performed fine needle aspiration in 22 patients and the diagnostic yield was 100%. 5) Thirty-six patients had history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis for an average of 27.3 months. But sputum analysis for acid-fast bacilli were positive in 5.6%(2cases of 36cases), and postoperative pathologic findings showed that 38.9%(12 cases of 28cases) were combined with tuberculosis. 6) Right upper and left upper lobes were predominantly involved(34.6% and 19.2% respectively) and lobectomies were performed in 21 cases. 7) Underlying diseases were present in 47 cases and 48.9% of them were pulmonary tuberculosis. Conclusion: These results showed that pulmonary aspergillosis usually develops in patients with open cavitary pulmonary tuberculosis. And we must consider the possibility of pulmonary aspergillosis in a patient with hemoptysis and cavitary lung lesion.

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Analysis of Antioxidant Content and Growth of Agastache rugosa as Affected by LED Light Qualities (LED 광질 조건에 따른 배초향 생장 및 항산화 물질 함량 분석)

  • Kim, Sungjin;Bok, Gwonjeong;Park, Jongseok
    • Journal of Bio-Environment Control
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    • v.27 no.3
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    • pp.260-268
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    • 2018
  • The aim of this study was to evaluate the effect of light quality using either monochromatic or combined LEDs on the growth and antioxidant accumulation of Agastache rugosa cultivated under hydroponics for 4 weeks. This experiment was performed in a controlled-environment room at $22{\pm}1^{\circ}C$ and $18{\pm}1^{\circ}C$ (day and night temperatures, respectively) and 50-70% relative humidity, with a provided photosynthetic photon flux density (PPFD) of $180{\pm}5{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$ and irradiated with either monochromatic (W10 and R10) or mixed LEDs (W2B1G1, R3B1, R2B1G1, and W2B1G1) with a differing ratio of each LED's PPFD and fluorescent lighting (FL: control) with a 16/8 h photoperiod. Fresh and dry weights were highest for plants grown under the W2B1G1 treatment. A. rugosa grown with R10 had the greatest plant height but the lowest SPAD among all treatments. The concentration of rosmarinic acid in plants grown under W2B1G1 was significantly higher than that of plants grown under other treatments. Tilianin content was significantly higher in R3B1 than in the other treatments. However, whole-plant rosmarinic acid and tilianin content was the highest under the W2B1G1 condition. To cultivate A. rugosa in a plant factory, mixed-LED light conditions with W2B1G1 is considered to be more advantageous for the growth and antioxidant accumulation of A. rugosa. It is though that the total whole-plant antioxidant content is more crucial for commercial use; the present study demonstrates the potential to achieve higher content of functional materials in plants through the selection of light quality.

STUDIES ON THE DIMORPHISM AND TRANSITION OF BISEXUALITY OF HETEROSTYLOUS POLYGONACEAE (여뀌과 이형경식물의 Dinorphism과 Bisexuality의 변화)

  • Harn, Chang-Yawl
    • Journal of Plant Biology
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    • v.3 no.2
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    • pp.6-18
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    • 1960
  • The present experiments were designed in order to clarify the differences between the long and short styled plants and the transgressive gradition in the degree of dimorphism among the three heterostylous species of the Polygonus, P. japonica, F. esculentum, and P. senticosa, based on investigations regarding the floral structure, ecological and physiological traits, the results of which are summarized as follows: (1) P. japonica, although it exhibits typical dimorphism, has undergone so high a differentiation between long and short styled that its long styled individuals behave as if they were female; and short styled individuals as if male. In long-styled individuals, filament, anther, and pollen grains show signs of degeneration, most of the pollen being abortive. On the other hand, in short styled individuals, the filament, anther, and pollen grains have attained remarkable development; the pollen grians are large and fertile. In short-plant the fertilized flowers readily drop off in every stage of their embryo development. This species has completely lost the self-fertile property, which is characteristic of the non-dimorphic Polygonum genus. Although this specsei typically exhibits the physiological characteristics of the non-dimorphic Polygonum genus. Although this specisei typically exhibits the physiological characteristics of dimorphism in controlled pollination, the short-styled individuals bear no seed in nature, thus misleading taxonomists to idenfity the short-styled plant as male. 2) The morphological feature of the flower organ of P. senticosa obviously indicates definite dimorphism. Physiologically, however, no differentiation towards dimorphism was observed, the species still retaining, both in long and short-individuals, the self-fertile property common to the Polygonum genus. Elaborate examinations revealed that regardless of the modes of pollination, both fertiization and seed setting flourish, no differentiation betwen legitimate and illegitimate unions being recognizable. This sort of physiological property has not been observed in the investigations of other heterostylous plants. It is assumed that this species is differentiated structurally into dimorphism, but not yet physiologically. In nature, however, this plant would have more opportunities to be cross-pollinated, i.e., legitimately combined, than self-pollinated because of the development of two forms of flowers. 3) In terms of heterostylism, the F. esculentum just occupies the intermediate position between P. japonica and P. senticosa structurally, ecologically, and physiologically. Doescription of some of the physiological behavior of the plant will suffice to demonstrate the above facts. While P. japonica has completely lost its self-fertile property, P. senticosa still retains it wolly. In F. esculentum 2-6% of self-fertility is the result in illegitimate combination. There occur occasionally hereditary self fertile individuals among some of the F. or 20 min. irradiation plot, when they reach any stage of the same bacterial population. In addition to this increase of total population in the plots with the more dose of UV light irradiation, it seems that the more dose of UV light irradiation is the more shortened the generation time of Azotobacter. Therefore, it is clear that variation of reproductive rate must be, mere or less, due to the genetic effects induced by UV light irradiation. On the other hand, the lag phase or logarithmic growth phase in nonirradiated culture is shortened prominently, and this must be due to the difference in bacterial number of the original inoculm. The generation time of Azotobacter is shortened by exogeneous treatment of nuclei acid derivatives, and the degree is greater in case of DNA derivatives than RNA dervatives. W.H. Price reported that the rate of ribose nucleic acid to protein in Staphylococcus muscae is proportional to the generation time: that is the faster the cell can form ribose nucleic acid, the more rapid its growth. This explains the shortening of generation time by exogeneous RNA derivatives in this work reasonably. On the other hand, it is well known that the desoxyribose nuclic acid content per cell is constant and independent of the generation time. A.D. Laren and W.N. Takahashi reported that the infectious RNA from TMV is 6 times as sensitive to inactivation by UV as it is in the form of intact virus, and that inactivation of infectious TMV involves onlu a local change on RNA chain. But, the effect of exogeneous DNA in this work suggests that irradiated living cell which cotain DNA bring about some change on DNA moleculs as well as RNA molecules. And if the mutagenic effects of UV take into consideration, it is very reasonable. Therefore, it is clear that the variation of the generation time by UV irradiation is, more or less, due to the genetic effects. Therefore, it seems that the shortness of the average lifewpan of Azotobacter by UV irradiation is resulted not only from the influence of the environmental conditions, but also from the variation of genetic factor of the individual.

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The Diagnostic Value of Bronchoalveolar lavage fluid microscopic study and PCR in Pulmonary tuberculosis (폐결핵에 있어서 기관지폐포세척액 결핵균검사 및 PCR의 진단적 가치)

  • Park, Moon-Hwan;Choi, Choon-Han;Kim, Nam-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.128-137
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    • 1996
  • Background : We can diagnose pulmonary tuberculosis with sputum AFB smear and culture, but sputum AFB smear has low sensitivity and culture needs long period, and they are not available in the patients who can not expectorate effectively. Recently developed, PCR is a fast diagnostic tool in tuberculosis, but false positive and false negative are important problems. So, we studied the diagnostic value of bronchoalveolar lavage fluid AFB smear, culture, PCR through the bronchoscopy. Methods : The 67 pulmonary tuberculosis patients and 43 non-pulmonary tuberculosis patients were analyzed with their sputum specimen AFB smear and culture. Also, bronchoscopy and bronchoalveolar lavage were done, and bronchoalveolar lavage fluid AFB smear, culture and PCR were done. Results: 1) In the cases of pulmonary tuberculosis, the sensitivity of sputum AFB smear and culture were 32.8% and 57.4%, respectively. And the sensitivity of bronchoalveolar lavage fluid AFB smear and culture were 47.8% and 80.6%. respectively. 2) In the cases of pulmonary tuberculosis, the sensitivity and the positive predictive value(for predicting a positive culture) of PCR were 80.6% and 81.5%, respectively. 3) In the cases of sputum AFB smear-negative and culture-negative pulmonary tuberculosis, the sensitivity of bronchoalveolar lavage fluid AFB smear, culture, PCR, and the positive predictive value(for predicting a positive culture) of PCR were 23.1%, 100%, 88.5%, and 82.4%, respectively. 4) The specificity of bronchoalveolar lavage fluid PCR was 77.0%. 5) The median number of days between obtaining a specimen and starting therapy was 5 days for sputum AFB smear, 9 days for bronchoalveolar lavage fluid AFB smear, 26 days for bronchoalveolar lavage fluid PCR, 32 days for sputum culture, 56 days for bronchoalveolar lavage fluid culture. Conclusion : The sensitivity of bronchoalveolar lavage fluid AFB smear and culture are higher than sputum AFB smear and culture. So, the bronchoscopy must be considered for evaluating suspected cases of pulmonary tuberculosis in patients from whom smears of expectorated sputum do not reveal mycobacteria or from whom no sputum can be obtained. Especially, combined with PCR, it is expected that pulmonary tuberculosis can be diagnosed more rapidly and more accurately, so bronchoalveolar lavage fluid APB smear and PCR can be helpful in the early treatment of pulmonary tuberculosis.

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Failure Behavior and Separation Criterion for Strengthened Concrete Members with Steel Plates (강판과 콘크리트 접착계면의 파괴거동 및 박리특성)

  • 오병환;조재열;차수원
    • Journal of the Korea Concrete Institute
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    • v.14 no.1
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    • pp.126-135
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    • 2002
  • Plate bonding technique has been widely used in strengthening of existing concrete structures, although it has often a serious problem of premature falure such as interface separation and rip-off. However, this premature failure problem has not been well explored yet especially in view of local failure mechanism around the interface of plate ends. The purpose of the present study is, therefore, to identify the local failure of strengthened plates and to derive a separation criterion at the interface of plates. To this end, a comprehensive experimental program has been set up. The double lap pull-out tests considering pure shear force and half beam tests considering combined flexure-shear force were performed. The main experimental parameters include plate thickness, adhesive thickness, and plate end arrangement. The strains along the longitudinal direction of steel plates have been measured and the shear stress were calculated from those measures strains. The effects of plate thickness, bonded length, and plate end treatment have been also clarified from the present test results. Nonlinear finite element analysis has been performed and compared with test results. The Interface properties are also modeled to present the separation failure behavior of strengthened members. The cracking patterns as well as maximum failure loads agree well with test data. The relation between maximum shear and normal stresses at the interface has been derived to propose a separation failure criterion of strengthened members. The present study allows more realistic analysis and design of externally strengthened flexural member with steel plates.