• Title/Summary/Keyword: distant function

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The Role of Primary Radiotherapy for Squamous Cell Carcinoma of the Suprag1ottic Larynx (성문상부 상피세포암에서의 근치적 방사선치료의 역할)

  • Kim, Won-Taek;Kim, Dong-Won;Kwon, Byung-Hyun;Nam, Ji-Ho;Hur, Won-Joo
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.233-243
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    • 2000
  • Purpose : First of all, this study was performed to assess the result of curative radiotherapy and to evaluate different possible prognostic factors for squamous cell carcinoma of the supraglottic larynx treated at the Pusan National University Hospital. The second goal of this study was by comparing our data with those of other study groups, to determine the better treatment policy of supraglottic cancer in future. Methods and Material : Thirty-two patients with squamous cell carcinoma of the supraglottic larynx were treated with radiotherapy at Pusan National University Hospital, from August 1985 to December 1996. Minimum follow-up period was 29 months, Twenty-seven patients (84.4$\%$) were followed up over 5 years. Radiotherapy was delivered with 6 MV photons to the primary laryngeal tumor and regional iymphatics with shrinking field technique. Ail patients received radiotherapy under conventional fractionated schedule (once a day). Median total tumor dose was 70.2 Gy (range, 55.8 to 75.6 Gy) on primary or gross tumor lesion. Thirteen patients had Induction chemotherapy with cisplatln and 5-fluorouracil (1-3 cycles). Patient distribution, according to the different stages, were as follows: stage I, 5/32 (15.6$\%$): stage II, 10/32 (31.3$\%$); stage III, 8/32 (25$\%$): stage IV, 9/32 (28.1$\%$). Results :The 5-year overall survival rate of the whole series (32 patients) was 51.7$\%$. The overall survival rate at 5-years was 80$\%$ in stage I, 66.7$\%$ in stage II, 42.9$\%$ in stage III, 25$\%$ in stage IV (p=0.0958). The S-year local control rates after radiotherapy were as fellows: stage I, 100$\%$; stage II, 60$\%$ stage III, 62.5$\%$; stage IV, 44.4$\%$ (p=0.233). Overall vocal preservation rates was 65.6$\%$, 100% In stage I, 70% in stage II, 62.5$\%$ In stage III, 44.4$\%$ in stage IV (p=0.210). There was no statistical significance in survival and local control rate between neoadjuvant chemotherapy followed by radiotherapy group and radiotherapy alone group. Severe laryngeal edema was found in 2 cases after radiotllerapy, emergent tracheostomy was done. Four patients were died from distant metastsis, . three in lung, one in brain. Double primary tumor was found in 2 cases, one in lung (metachronous), another in thyroid (synchronous). Ulcerative lesions were revealed as unfavorable prognostic factor ( p=0.0215), and radiation dose (more or less than 70.2 Gy) was an important factor on survival (p=0.002). Conclusion : The role of radiotherapy treatment of supraglottic carcinoma is to important factor on survival and to preserve the laryngeal function. Based on our data and other studies, early and moderately advanced supragiottic carcinomas could be successfully treated with either consewative surgery or radiotherapy alone. Both modalities showed similar results in survival and vocal preservation. For the advanced cases, radiotherapy alone is Inadequate for curative aim and surgery combined with radiotherapy should be done in operable patients. When patients refuse operation or want to preserve vocal function, or for the patients with inoperable medical conditions, combined chemoradiotherapy (concurrent) or altered fractionated radiotherapy with or without radiosensitizer should be taken into consideration in future.

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Haptic Perception presented in Picturesque Gardens - With a Focus on Picturesque Garden in Eighteenth-Century England - (픽처레스크 정원에 나타난 촉지적 지각 - 18세기 영국 픽처레스크 정원을 중심으로 -)

  • Kim, Jin-Seob;Kim, Jin-Seon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.2
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    • pp.37-51
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    • 2016
  • Modern optical mechanisms slanted toward Ocular-centrism have neglected diverse functions of vision, judged objects in abstract and binary perspectives, and organized spaces accordingly, there by neglecting the function of eyes groping objects. Recently, various experiences have been induced through communication with other senses by the complex perception beyond the binary perception system of vision. Haptic perception is dynamic vision that induces accompanying bodily experiences through interaction among the various senses; it recognizes the characteristics of material properties and various sensitive stimulations of human beings. This study elaborates on the major features of haptic perception by examining the theoretical background of this concept, which stimulates the active experience of the subject and determines how characteristics of haptic perception are displayed in picturesque gardens. In order to identify the major features of haptic perception, this study examines how Adolf Hildebrand's theory of vision is developed, expanded, and reinterpreted by Alois Riegl, Wilhelm Worringer, Walter Benjamin, Maurice Merleau Ponty, and Gilles Deleuze in the histories of philosophy and aesthetics. Based thereon, the core differences in haptic perception models and visual perception models are analyzed, and the features of haptic perception are identified. Then, classical gardens are set for visual perception and picturesque gardens are set for haptic perception so that the features from haptic perception identified previously are projected onto the picturesque gardens. The research results drawn from this study regarding features of haptic perception presented in picturesque gardens are as follows. The core differences of haptic perception in contrast to visual perception can be summarized as ambiguity and obscureness of boundaries, generation of dynamic perspectives, induction of motility by indefinite circulation, and strangeness and sublime beauty by the impossibility of perception. In picturesque gardens, the ambiguity and obscureness of boundaries are presented in the irregularity and asymmetric elements of planes and the rejection of a single view, and the generation of dynamic perspectives results from the adoption of narrative structure and overlapping of spaces through the creation of complete views, medium range views, and distant views, which the existing gardens lack. Thus, the scene composition technique is reproduced. The induction of motility by indefinite circulation is created by branching circulation, and strangeness and sublime beauty are presented through the use of various elements and the adoption of 'roughness', 'irregularity', and 'ruins' in the gardens.

Closed Interlocking Intrmedullary Nailing of Metastatic Diaphyseal Fractures of the Humerus (상완골 간부 악성 병적골절의 비관혈적 고합성 골수강내 금속정 고정술)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.1-11
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    • 2003
  • Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

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Cancinoma of Uterine Cervix Treated wvith High Dose Rate Intracavitary Irradiation : 1 Patterns of Failure (자궁경부암의 고선량율 강내치료후 실패양상에 대한 고찰)

  • Kim Ok Bae;Choi Tee Jin;Kim Jin Hee;Lee Ho Jun;Kim Yung Ae;Suh Young Wook;Lee Tae Sung;Cha Soon Do
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.369-376
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    • 1993
  • 226 patients with carcinoma of the uterine cervix treated with curative radiation therapy at the Department of Therapeutic Radiology, Dongsan hospital, Keimyung university, School of medicine, from July,1988 to May,1991 were evaluated. The patients with all stages of the disease were included in this study. The maximum and mean follow up durations were 60 and 43 months. The radiation therapy consisted of external irradiation to the whole pelvis (2700~4500 cGy) and boost parametrial doses (for a total of 4500~6300 cGy)with midline shild $(4{\times}10\;cm),$ and combined with intracavitary irradiation (5700~7500 cGy to point A). The distribution of patients according to the stage was as follows: stage IB 37 $(16.4\%),$ stage IIA 91 $(40.3\%),$ stage IIB 58 $(25.7\%),$ stage III 32 $(13.8\%),$ stage IV 8 $(3.5\%).$ The overall failure rate was $23.9\%$ (54 patients). The failure rate increased as a function of stage from $13.5\%$ in stage IB to $15.4\%$ in stage IIA, $25.9\%$ in stage IIB, $46.9\%$ in stage III, and $62.5\%$ in stage UV. The pelvic failure alone were 32 patients and 11 patients were as a components of other failure, and remaining 11 patients had distant metastasis only. Among the 43 patients of locoregional failure,28 patients were not controlled initially and in other words nearly half of total failures were due to residual tumor. The mean medial paracervical (point A) doses were 6700 cGy in stage IIB,7200 cGy in stage IIA,7450 cGy in stage IIB,7600 cGy in stage III and 8100 cGy in stage IV. The medial paracervical doses showed some correlation with tumor control rate in early stage of disease (stage Ib, IIA), but there were higher central failure rate in advanced stage in spite of higher paracervical doses. In advanced stage, failure were not reduced by simple increment of paracervical doses. To improve a locoregional control rate in advanced stages, it is necessary to give additional treatment such as concomitant chemoradiation.

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Combined Transcatheter Arterial Chemoembolization and Local Radiotherapy for Unresectable Hepatocellular Carcinoma (절제불가능 원발성 간암에서 경간동맥 항암 색전술과 국소 방사선의 병용요법)

  • Seong Jinsil;Keum Ki Chang;Han Kwang Hyub;Lee Do Yun;Lee Jong Tae;Chon Chae Yoon;Moon Young Myoung;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.159-165
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    • 1998
  • Purpose : The best prognosis for hepatocellular carcinoma can be achieved with surgical resection. However, the number of resected cases is limited due to the advanced lesion or associated liver disease. A trial of combined transcatheter arterial chemoembolization(TACE) and local radiotherapy(RT) for unresectable hepatocellular carcinoma(HCC) was prospectively conducted and its efficacy and toxicity were investigated. Materials and Methods : From 1992 to 1994, 30 Patients with unresectable HCC due either to advanced lesion or to associated cirrhosis were entered in the study Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child's class C, tumors occupying more than two-thirds of the whole liver, and an ECOG scale of more than 3. Patient cHaracteristics were : mean tumor size $8.95\pm3.4cm$, serum AFP+ in all patients, portal vein thrombosis in all patients, liver cirrhosis in 22 patients, and UICC stage III and IVA in 10 and 20 patients, respectively. TACE was performed with the mixture of Lipiodol(5ml) and Adriamycin(50mg) and Gelfoam embolizatin. RT(mean dose $44.0\pm9.3Gy$) 10 days with conventional fractionation. Results : An objective response was observed in 19 patients($63.3\%$). Survival rates at 1 2, and 3 years were $67\%,\;33.3\%$ and $22.2\%$, respectively. Median survival was 17 months. There were 6 patients surviving more than 3 years. Distant metastasis occurred in 10 patients, with 8 in the lung only and 2 in both lung and bone, Toxicity included transient elevation of liver function test in all patients, fever in 20, thrombocytopenia in 4, and nausea and vomiting in 1. There was no treatment-related death. Conclusion : Combined TACE and RT appear to produce a favorable response and survival results with minimal toxicity.

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The Results of Combined Modality Treatment with Transurethral Resection, Cisplatin and Radiation Therapy for Invasive Bladder Cancer (침윤성 방광암에서 경요도적절제술 및 Cisplatin과 방사선의 병용치료의 효과)

  • Oh, Yoon-Kyeong
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.311-317
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    • 1991
  • Ten patients with deep muscle-invading bladder carcinoma (clinical stages T3a to T4b) who were not candidates for cystectomy were treated with combined modality treatment with transurethral resection, cisplatin chemotherapy and pelvic irradiation from 1989 through 1990, and were analyzed retrospectively. All patients were not candidates for cystectomy because the tumors were judged unresectable or they were not fit for a radical cystectomy. Of the patients 5 had clinical stage T3a, 3 stage T3b and 2 stage T4b disease. The minimum follow-up was 16 months. The complete response rate is 60$\%$ for all patients. The complete responses were achieved in 4 of 5(80$\%$) with stage cT3a, in 2 of 3(67$\%$)with stage cT3b and in none of 2(0$\%$) with stage cT4b. The partial responses were achieved in 2, so an overall response rate was 80$\%$. All six patients with grade I or II transitional cell carcinoma showed complete responses. Four patients with higher grade tumors showed partial responses in 2 and no response in 2, and all died of their bladder cancer. Six patients who showed complete responses after treatment are alive and only one of them showed a local recurrence 10 months after treatment. Distant metastases developed in 3 patients: lungs in 2(cT4b) of those who were never locally free of disease and spine in 1 patient (cT3b) among those with a partial response. Two patients died of metastases to lungs. During the follow-up diarrhea occurred in one which was improved after conservative treatment. On the basis of this analysis it is suggested that combined modality treatment seems to be a tolerable regimen and can be offered with a relatively high probability of success and conservation of bladder function in those with less advanced tumors by clinical stage and low grade.

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A Study on the Space Planning and Landscape of 'Unjoru(雲鳥樓)' as Illustrated in the Family Hereditary Drawing, "Jeolla Gurye Ohmidong Gado(全羅求禮五美洞家圖)" ('전라구례오미동가도(全羅求禮五美洞家圖)'를 통해 본 운조루(雲鳥樓)의 공간배치계획과 경관 고찰)

  • Shin, Sang-sup
    • Korean Journal of Heritage: History & Science
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    • v.46 no.4
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    • pp.48-63
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    • 2013
  • The results of the study on the space planning and landscape design of Unjoru(雲鳥樓) through the 'Jeolla Gurye Omidong Gado(全羅求禮五美洞家圖)' drawn using GyeHwa(界畵) technique are as follows. First, 'Omidong Gado' is believed to date back to the period when Unjoru(1776~1783) was established for the following reasons: (1) The founder, Yoo-IJu(柳爾?), sent the drawing for the house while he was serving as the governor of YongCheon county(龍川府史). (2) It shows the typical dwelling houses' space division and its location is in a good spot with mountain in the back and water in front(背山臨水) and there is every indication of scheme drawing. (3) Front gate was changed and remodeled to a lofty gate in 1804. Second, Nogodan & Hyeongjebong of Jiri Mountain sit at the back of Unjoru, and faces Obong mountain and Gyejok mountain. In addition, the Dongbang stream flowing to the east well illustrates the Pungsu theory of mountain in the back and water in the front. Third, the house is structured in the shape resembling the character 品, divided into 5 areas by hierarchical order in the cross line from all directions. The site, which includes the outdoor yard and the back garden, consists of 5 blocks, 6 yards and 2 gardens. Fourth, the outdoor yard with aesthetical value and anti-fire function, is an ecological garden influenced by Confucianism and Taoism with a pond (BangJiWonDo Type, 方池圓島形) at the center. Fifth, the Sarang yard(舍廊庭) is decorated with terrace garden and flower garden, and the landscaping components such as oddly shaped stone, crane, plum, pine tree, tamarisk tree and flowering plants were used to depict the ideal fairy land and centrally placed tree for metaphysical symbolism. The upper floor of Sarangchae commands distant and medium range view, as well as upwards and downwards. The natural landscape intrudes inside, and at the same time, connects with the outside. Sixth, pine forest over the northern wall and the intentionally developed low hill are one of the traditional landscaping techniques that promotes pleasant residential environment as well as the aesthetics of balanced fullness.